Whenever a change occurs it’s a good time to check if anything else might be affected. It could be a procedural change, technological change or a design change.
In January last year (2016) the balance of evidence reached tipping point and the Australian & New Zealand Committee of Resuscitation (ANZCOR) officially recommending not using semi rigid collars (e.g. Stifneck collars) for managing suspected spinal injuries.
In light of this change, we could take the easy road and just deleting collars from pool lifeguard training and leave the rest of our response untouched. But maybe it’s a good time to really pull apart the box and see what happens.
One good way to do this is to talk to our senior lifeguards. They’re the ones who’ve done it the most, and know which bits are good and which bits are just a big pain in the proverbial.
If there’s one skill I see lifeguards do poorly it’s the vice grip rollover.
One reason is that preventative measures have now sent instances of spinal injuries to the ‘rare’ column and another reason is some of us just don’t practice it often enough.
The vice grip rollover also has some distinct disadvantages. You lose sight of your casualty when you roll under water and so you can’t monitor how well you controlled the cervical section of the spinal cord. Having gone underwater and having both hands busy you also have no way of wiping that annoying fringe out of your face or the water in your eyes. Now I know water in your eyes is a first world problem for a lifeguard but if there was a better way surely we should consider it.
Truth is, there is a better way and it’s been starring us in the face for years.
Since my first pool lifeguard training back in the 1990’s we’ve tended to favour the vice grip roll over the extended arm rollover, and for the life of me I can’t think why. It might have been because of semi rigid collars. If you used the extended arm rollover it created an extra step or two to control the neck and fit the collar. But, we’ve had a change… collars are gone.
While I still teach both methods to lifeguards I encourage them to see that one simpler, as effective and easier to master.
I can already hear someone yelling at me ‘what about deep water spinal?’ And you’d be right. For the moment let’s focus on rare events and leave extremely rare events for another time.
Try it for yourself at your next spinal training session. It’ll mean making a few adjustments to the usual routine and it’ll feel a bit unusual for a while. But in the end you’re likely to have better control over the neck and have the person out of the pool in less time.
And while you’re at it don’t stop there. Once you have them out of the water work out a way to get them off the board. Boards are uncomfortable and sometimes being strapped to them for long periods can do more harm than good. The paramedics might want to transport them on their own board. You’ll look pretty unprofessional if you’re saying to an ambo ‘we don’t know how to get them off the board’. I know the Western Australia is already all over this. Well done.