INSTRUCTOR ANSWER GUIDE



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INSTRUCTOR ANSWER GUIDE

BRONZE MEDALLION WORKBOOK INSTRUCTOR ANSWER GUIDE Published by the Lifesaving Society, 400 Consumers Road, Toronto, Ontario, Canada M2J 1P8 Phone: 416-490-8844 Fax: 416-490-8766 E-mail: experts@lifeguarding.com Web: www.lifesavingsociety.com April 2014. Copyright 2014 by The Royal Life Saving Society Canada. Reproduction, by any means, of materials contained in this book is prohibited unless authorized by the publisher. The Lifesaving Society is Canada s lifeguarding expert. The Society works to prevent drowning and water-related injury through its training programs, Water Smart public education initiatives, drowning prevention research, aquatic safety management services, and lifesaving sport. Annually, over 1,000,000 Canadians participate in the Society s swimming, lifesaving, lifeguard and leadership training programs. The Society sets the standard for aquatic safety in Canada and certifies Canada s National Lifeguards. The Society is an independent, charitable organization educating Canadian lifesavers since the first Lifesaving Society Bronze Medallion Award was earned in 1896. The Society represents Canada internationally as an active member of the Commonwealth Royal Life Saving Society and as Canada s Full Member in the International Life Saving Federation. The Society is the Canadian governing body for lifesaving sport a sport recognized by the International Olympic Committee and the Commonwealth Games Federation. Registered Charity No. 10809 7270 RR0001 Water Smart and Lifesaving Society are registered trademarks of The Royal Life Saving Society Canada. Trademarks other than those owned by the Lifesaving Society used in this document belong to their registered owners.

NOTE TO INSTRUCTORS The Lifesaving Society s Bronze Medallion Workbook is filled with questions and activities which help candidates master Bronze Medallion content. This answer guide is designed to make it easy for Instructors teaching Bronze Medallion to quickly locate sample answers for the questions and activities featured in the workbook. The Canadian Lifesaving Manual (CLM) must be used in conjunction with the workbook as the go-to resource for candidates and Instructors. Workbook exercises are accompanied by references to chapters in the Canadian Lifesaving Manual. This answer guide contains specific page references to further assist the instructor. Some workbook questions may have several possible answers which may not be listed in this answer guide. Instructors should review alternative answers candidates find in the Canadian Lifesaving Manual. The Bronze Medallion Workbook is meant to help introduce and reinforce content. It is meant to assist candidate learning. It is not to be used as a tool to fail candidates. The Workbook exercises build and reinforce knowledge progressively, with tips to help recall Bronze Medallion content. Learners have their best experience when they participate fully in the acquisition of the four elements of water rescue: judgment, knowledge, skill and fitness. Instructors are encouraged to use active practice-bydoing to build confidence and increase the likelihood of skill use after training.

1.2 Drowning and Lifesaving Society How many Canadian lives are lost in water-related incidents each year? About 500 on average. Reference: CLM, page 1-2 When was the Lifesaving Society founded in Canada? The first Bronze Medallion classes were held in Canada in 1896. In 1908, the first Branch (Ontario) of the Society was officially founded. Either answer is correct, as is over 100 years ago. Reference: more information available at www.lifesavingsociety.com in About Us section. What is the mission of the Lifesaving Society? To prevent drowning and water-related injury. Reference: CLM, page 1-5 How many Canadians participate in the Society s programs annually? Over 1, 000,000. Older editions of the CLM may have a smaller number. Reference: CLM, page 1-5 2.1 Walk, Spot, Demonstrate Diagram of your aquatic environment: The student s diagram should represent the environment in which the course is taught. Discuss unsafe activities common to your facility with candidates. Describe how you would reduce the risk of unsafe behaviours or hazards in your aquatic environment: Possible answers may include: Check for currents before entering water in rivers, lakes. Read and abide by rules and instructions. Check any depth markings. Always walk on pool decks. Wear a lifejacket or PFD. Swim in supervised areas. Supervise children at all times. Reference: CLM, page 2-2/2-3/2-5

3.1 The Rescue Process List the key points in the following elements of the rescue process as they apply to self-rescue: Recognize: Recognize you are in trouble and must rescue yourself. Recognize the water conditions and changing conditions of the environment. Assess: Assess what self-rescue skills you have, closest point of safety, equipment at hand, etc. Act: Do the things you decided to do in your assessment. Watch for changes that make reassessment necessary. Direct bystanders as needed. Call EMS. 3.2 Self-Rescue Skills Reference: CLM, page 3-2 Self-rescue from cold water: Priority is to get out of the water fast: Get out of water, using a quick burst of energy to do so. Remove wet clothing immediately. Dry off and keep warm. If unable to get out of the water assume HELP (Heat Escape Lessening Posture) or huddle position, leave clothing on if wearing a PFD. Only remove clothing if you are weighed down. Reference: CLM page 3-8 Self-rescue from moving water: Answers may vary; refer to the Canadian Lifesaving Manual for details. Main points to remember: Stay calm. Don t fight current. Reference: CLM page 3-10 Self-rescue from a capsized boat: Call or signal for help. Stay with the boat. Try to right canoes and small craft. If help will not come, consider trying reach shore safely, conserving as much energy as possible. Reference: CLM page 3-4

True or false: 1. T (if you have a PFD/lifejacket) F (if you are wearing clothes) 2. T 3. F 4. T 5. F Self-rescue skills chart Skill Huddle position Pants, shirts HELP position Roll away, don t stand up Boots and shoes Boat PFD/lifejacket Description Small groups of two or four people can use this position to stay warm in cold water. While PFDs or lifejackets are much more effective, they are not always available during a self-rescue. Some of these items can be useful as self-rescue or towing assists. This is the position you would use if you are by yourself in cold water. You would do this to move away from a break in the ice until you find solid ice. The first item you remove during a self-rescue in the water (if you are not wearing a PFD). If this capsizes, you should stay with it. You should always wear one of these on a boat of if you are a non-swimmer around water. 4.1 The Rescue Process Recognize: Someone is in trouble and needs help. Recognize victim condition, water and weather conditions, hazards, number of victims, etc. Assess: What self-rescue skills does the victim have? Physical and emotional condition of the victim? Nearest point of safety? Available rescue equipment, etc. Act: Direct bystanders. Contact EMS contact. Perform the rescue using the rescuer s checklist. Reference: CLM, page 4-2.

4.2 The Ladder Approach Description of Ladder Approach: Take up answers starting at the bottom of the ladder, step 1, as shown in the Workbook to emphasize rescuers should start with the safest rescue. Step 8: Carry rescue swim to the victim and carry him or her to safety. Step 7: Tow rescue Swim to victim, provide a buoyant assist and tow victim to safety without making direct contact. Step 6: Swim rescue Swim to victim, provide a buoyant assist and talk to him or her without making contact. Step 5: Row rescue row to the victim in a watercraft and extend an assist while staying in the craft. Step 4: Wade rescue wade into shallow water and extend an assist to the victim or enter deep water while holding the edge of a sold object (tree root, ladder, etc.) and extend an assist to the victim. Step 3: Reach rescue from a dry, safe location, reach with an assist to the victim and pull him or her to safety. The assist may be buoyant or non-buoyant; it may also be a buoyant assist on a rope. Step 2: Throw rescue from a safe location, throw a buoyant assist to the victim and talk/encourage him or her to safety. Step 1: Talk rescue from a safe location talk to the victim and encourage him or her to safety. 4.2 The Ladder Approach True or false: 1. F 2. T 3. F 4. T 5. T 6. T Reference: CLM page 4-5

4.3 The Rescuer s Checklist Answers in bold. Steps Hazards Description Before doing anything else, deal with items in the environment that could be dangerous for you or the victim. Assists Entries Approaches Reverse, ready & reassess When you are 2 or 3 metres from the victim, reverse, and take a ready position. Push the assist to the victim, and talk to him or her while reassessing the situation. Talk, tow or carry Removals Follow-up Remove victims from the water as soon as possible, and use the removal method with the least risk for you and the victim. Once the victim is out of the immediate physical danger, evaluate his or her condition, and start follow-up procedures. If possible, get help moving the victim to a comfortable environment. Call EMS if necessary. Reference: CLM page 4-10

4.4 Possible Assists What is an appropriate throwing aid? Possible throwing aid Appropriate Inappropriate Explain your choice, include possible advantages and/or disadvantages Rescue tube They are buoyant and made of soft foam Reaching pole Used for reaching, when victim is within reach Ring buoy Found on many beaches/docks, they are buoyant Flutter board Rope PFD/Lifejacket Buoyant, widely available in pools, but not easy to grab onto or throw accurately Can be thrown a long way, but may not be buoyant depending on make of rope They are easy to throw and are buoyant Stick/Branch Not easy to throw and provides no buoyancy Reference: CLM page 4-12 4.5 Choosing an Assist Match the factors with the appropriate description: Factors Availability Manageability Your fitness & strength Your immediate surroundings Strength Buoyancy Assists Floating objects support victims higher in the water and allow you to rest as needed The assist must be readily available Be sure you can carry and use the assist effectively. If you don t, you could put yourself in danger The assist you choose should fit the surroundings. For example while a reaching pole is long, it is harder to maneuver if there are people nearby The assist must be easy to handle on land and in the water, and it should add little or no resistance on your approach The assist must be strong for the task at hand Reference: CLM page 4-12

5.1 Avoidance Explain the importance of avoidance during a high-risk rescue: You need to minimize the risk of being grabbed during a rescue. What position should a rescuer assume to avoid being grasped by a victim? Reverse and Ready. What other steps could you take as rescuer to minimize the risk of having to make physical contact with your victim? Watch the victim and be attentive to the victim s body movements and intentions. Use the Ladder Approach to choose the safest rescue. Swim away or submerge if they try to grab you. 5.2 Defences Arm block Duck away from front Foot block Duck away from rear 5.3 Releases Reference: CLM Page 5-2 Reference: CLM Page 5-3 Front: Submerge victim / Push up on elbow and back on head / Push victim away Rear: Pull victim over your head / Release from rear, pushing up on arm Foot block: Submerge victim / Push victim away Arm block: Push up on elbow and back on head / Submerge victim 5.4 Spinal Injury Management Canadian Rollover Vice Grip Rollover Modified Body Rollover Reference: CLM Page 5-4 Rescuers must use judgment in deciding how and when to stabilize a victim using a rollover and when to use a spineboard. Factors to consider when making these decisions include the number of rescuers available, the victim s condition and the water and weather conditions. Reference: CLM page 5-13 to 5-17

5.4 Spinal Injury Management Canadian rollover Vice grip Modified body Advantages Used in shallow water, victim is smaller than rescuer, few trained rescuers. Useful when there are few trained rescuers. Disadvantages May not be suitable for victims with bulky, muscular shoulders since arms may not be able to squeeze the victim s head. ABCs cannot be assessed or monitored during the rollover and immobilization by lone rescuer. 5.5 Search Review diagrams provided by candidates with reference to the search patterns for shallow and deep water illustrated in the Canadian Lifesaving Manual. 5.6 Searches in Swimming Pools Clear the pool of all swimmers before starting search. Investigate all unidentifiable shadows or objects on the bottom. Pay attention to corners of pool and drains. Start search of shower rooms, etc. 6.1 Shock 1. T 2. F 3. T 4. T 5. F 6. T 7. T 8. F 9. T 10. F Reference: CLM page 5-5 Reference: CLM page 5-6

List the steps Warmth ABC s Rest and assurance Treatment Recovery position Description of treatment Maintain body temperature Airway, Breathing, Circulation Reassure the victim and make sure they rest Treat the cause of the stress Lying on their side Reference: CLM page 8-2 6.2 Heart Attack or Angina Describe angina in your own words: Angina is a medical disorder caused by poor blood circulation to the heart. The heart muscle is having what might be considered muscle pain or muscle spasm. Angina usually responds to medication usually carried by victims. Fill in the missing signs and symptoms for angina: Answers in italics Signs and symptoms Pain, pressure or tightness in the chest or shoulder Flushed face, sweating Anxiety, fear Shock Trouble breathing, shortness of breath

6.2 Heart Attack or Angina Fill in the missing treatment steps for angina: Answers in italics Treatment: Assess responsiveness, maintain an open airway and assess the victim s breathing. Start CPR if needed. Contact EMS. Assist the victim into a comfortable position. This is often a semi-sitting position. Treat for shock. Help the victim take his or her angina medication. Loosen tight clothing around the neck and chest. Given oxygen if you are trained to do so, and if it is medically necessary and available. Describe a heart attack in your own words: A medical condition where the circulation of blood to the heart is severely affected. The severity of the heart attack and the damage to the heart muscle depend on the duration of the interruption in blood flow to the heart and the extent of the muscle affected. True or False: 1. F 2. F 3. F 4. T 5. T 6. T 7. F Reference: CLM page 8-6

6.3 External Bleeding: Tissue damage External bleeding 1. Skin tears Result in more blood loss because of the number of blood vessels 2. Facial cuts and head wounds Are more serious, and EMS must be called promptly 3. Deep cuts Will bleed, require treatment, and usually recover quickly 4. Cuts and wounds from larger May require stitches for tissue to heal veins and arteries Signs and symptoms external bleeding: circle answers to include Blood, pain, distress, anxiety, shock Severe bleeding treatment: Position: have victim lay down to prevent further injury Pressure: apply firm, direct pressure over the wound. Secure direct pressure with a tied bandage. Do not lift the bandage. List three reasons why you would contact EMS for a victim suffering from external bleeding: There is a lot of blood loss You cannot control the bleeding Moderate to severe shock becomes a factor Reference: CLM page 8-8 to 8-9 6.4 Stroke and Transient Ischemic Attack (TIA) Describe a stroke in your own words: Occurs when part of the brain has an insufficient supply of blood. Causes of this interruption in supply include blockage or bleeding. Describe a TIA in your own words: Results in temporary stroke symptoms lasting less than twenty minutes. The signs and symptoms are similar to those for stroke and treatment is the same. Reference: CLM page 8-7 to 8-8

6.4 Stroke and Transient Ischemic Attack (TIA) Fill in the missing signs and symptoms of a victim suffering from a stroke or TIA: Answers in italics Signs and symptoms Gradual or sudden onset Head pain Lack of strength or coordination in the muscles Facial problem on the side of the body opposite the area of the brain affected (facial muscle weakness, swallowing problems, drooling) Trouble understanding or speaking Unequal pupils Anxiety, agitation Decreased level of consciousness (confused, disorientated, unconscious) Loss of control of bowel or bladder Shock Fill in the missing treatment for a victim suffering from a stroke or TIA Signs and symptoms Assess responsiveness, maintain an open airway and assess the victim s breathing. Start CPR if needed. Contact EMS. Assist the victim into a comfortable position (often semi-sitting) or a recovery position if there are airway management problems. Loosen tight clothing around the neck and chest. Treat for shock. Give oxygen if you are trained to do so, and if it is medically necessary and available. Reference: CLM page 8-7 to 8-8

7.1 Benefits of Physical Fitness List the benefits Better performance of physical skills Lower risk of muscle injury Faster and better healing from injuries that do occur Improved blood circulation Improved cardiovascular (heart and lung) fitness 7.2 Components of Physical Fitness List the five components of physical fitness Body composition Flexibility Muscular strength Muscular endurance Aerobic fitness Reference: CLM page 10-2