Let me set the scene. You became a lifeguard in South Beach, Miami, for the summer. You thought it would be like Baywatch, but the uniforms are ugly, the guys are not cute, and you must wear a full, brimmed hat the entire day.
You are sitting on the tower looking out at the water, eyes blurring over because you haven’t taken a break in the last twenty minutes. Then suddenly a hand reaches out of the water. You jump and lean forward with the binoculars just to be sure it isn’t a false alarm. That’s definitely someone drowning. You hop down from the tower and quickly strip off your hat and long-sleeved top. To your left are fins and a rescue tube; you grab both. To picture this better I’ve added reference images below.
Your first step is to start running towards the water. The rescue tube is tucked under your arm, so you must maneuver it round to the front—while still running—and grab the strap and pull. If it’s tied properly, it should unravel easily and fall to the ground. Pull the strap over your head so it’s sitting across your chest diagonally and continue running. By now you have reached the water. It’s time to wade. Wading involves running like you’re jumping over hurdles, lifting your legs high and out to the side as you jump over the smaller waves. Now it’s time to put on your fins. This is tricky and can be time-consuming if not done properly. Try to sit down in the water and put one on at a time. At this point, the water should be about waist height and deep enough to start dolphin diving. This requires you to dive into the water, grab the sand with both hands to pull yourself into a crouching position, and then push off towards the surface. After this you can start swimming, making sure to lift your head regularly to check for oncoming waves or where the patient is.
You’ve reached the patient in record time, good work. You can see that they are conscious and responsive, so as you approach the patient, make sure to reassure them to create a calm atmosphere. For example, I would say, “Hey, my name is Nea and I’m a lifeguard. I’m here to help you out. Everything is going to be okay.” Now you stop approximately three feet from the patient. This is important as drowning people will cling onto anything, and if you go too close, they will cling onto you and then you’ll both drown. Push the rescue tube forward and tell them to hold onto it. Slowly swim around to the back of the patient and clip them in when they are calm enough. Be prepared to kick or push them off you if they try to grab you. Talk to them the entire time to keep them calm and distracted. “What is your name? Where are you from? How old are you?” If your patient is unconscious, signal ASSISTANCE REQUIRED immediately. This signal involves waving one arm to and fro above your head like you are waving vigorously at someone. Approach the patient from behind and reach under their armpit, across their chest, and clip them into the rescue tube. While making sure their head stays above the water, pull them back so they are floating on their back with the tube underneath them and clip on top. Keep them supported until an IRB (Inflatable Rescue Boat) arrives to pick you both up.
If your patient is conscious and able, encourage them to help you swim back into shore by kicking while they’re lying on their back. Swim backstroke away from your patient to make sure the rope between you and the tube doesn’t tangle. The rope should go taut, and you will feel the full weight of the person behind you. To make it easier, swim freestyle ahead of your patient, towing them behind you, until you reach the wave-breaking zone, then continue to swim backstroke. Keep an eye on the waves and the patient. If a big wave is coming, swim back to the patient and secure them. If you can lift them over the wave, do that, otherwise tell them to hold their breath as you both go under the wave. Once you have reached the shallows, help the patient out of the water by linking arms and walking out. They face forwards and you face backward to watch the water. Do not face away from the waves. Nature is unpredictable, and all it takes is one unusually large wave to come rushing in, and your rescue is ruined.
If the patient has a low level of consciousness or if they are unconscious, they will have to be transported back to shore by the IRB. However, the boat can’t go right on the shore, so you will have to remove your patient from the boat and perform a one-person drag. This drag happens in waist-deep water or shallower and only if you have no one else to help carry the patient onto dry land. Put your arms underneath their armpits and pull your arms up to hold their chin upwards to support their neck. Drag the person from the water to the beach as fast as possible. Once you are above the waterline, you can carefully place the person in a stable side position. This was once named the recovery position, but ironically too many people didn’t recover, so they had to rename it. The stable position involves the patient on their side with one arm raised underneath their head and the other arm lying across their body supporting themselves. The bottom leg is stretched outwards and the top one is crossed across the body like the arm. Their chin needs to be raised to make sure the airways are open, and you need to monitor their ABCs: airways, breathing, and circulation.
If the person is unconscious, you will need to perform CPR. I would hope most people would have some idea of how to perform CPR, but if not, I’ll have to write another essay about that.