Accident Training and Response

December 16, 2015

Why my facility EAP should differ from yours
Maggie Cattell
Recreation and Aquatics Supervisor
City of Pinellas Park

It is an eventuality for every facility. An accident; someone doesn’t eat before getting on the treadmill; a child enters the water without a lifejacket; or a person played tennis in 110 degree weather for 4 hours without drinking water while wearing a sweatshirt, with a broken ankle, a day after heart surgery (pick your scenario – we’ve all been through it). For those of us that are experienced in facility and staff management, we often don’t bat-an-eye when we hear about these moments. We shake our head, grin a bit, and add another accident response to our professional tool belt. What we tend to overlook is the response of the staff and it’s reflection on the training that they have been through.

Most Campus Recreation facilities put a large amount of time, effort, and money into staff training at the beginning of every semester. Most of these trainings have the same underlying lessons of prevention and response. However, 3 months after training, ask the staff what they learned from the training and their stream of thought will go something like this “Compressions… breaths…. Ice-bag….. Pizza…. Squirrel”. A review of CPR studies revealed that 66% of students would not be able to pass the skills portion of a CPR class just 3 months after they sat through a class, led by an instructor (AED Challenge 2014). All that time, effort, and money lasts you until midterms if you are lucky. As professionals, we can become numb to the lovely nuances of our facility that cause our participants to forget to eat or leave their inhalers at home. For our staff however, anxiety about having to remember skills but also potentially endangering someone’s life can cause some staff members to flop when they should fly. So, what do we do?
Training regarding accident response is something we all should focus heavily on, especially now that we know how quickly and easily the information we communicate disappears. But when I say training accident response, I’m saying going beyond what is written in our instructor’s manual and give information that may not be an answer on the American Red Cross CPR exam. Although staff passing their certifications is important, discussing the actual EAP or Emergency Action Plan is just as important.

The EAP is briefly mentioned in many certification classes, however it deserves more focus because each EAP differs. For example, as I have transitioned from Campus Recreation to working with municipalities, I’ve have noticed that City organizations entertain a whole different slew of issues when it comes to emergency response. Just as municipalities worry more about heart attacks, Campus Recreation has to be more aware of over-exercising. We entertain different communities, offer unique programs, and always have that one group exercise participant who feels faint but won’t stop participating (you all know who I am talking about). The participants that come to our facility, the programs we offer, and our facilities themselves all determine the types of accidents that occur and the way our EAP should run. And even though new staff is a never-ending story, we need to solidify our training techniques so we are efficient and uniform, whether the staff is brand new or a veteran worker.

To motivate you, consider this: when an accident occurs, your staff evaluates the situation and determines its severity based on their training. The tone of the EAP and the impending response is all determined and managed based on that staff member’s judgment. Yes, you read that right: the difference between providing proper care and possibly being sued for negligence all lies on the shoulders of Bobby, the freshman from Minnesota. If this doesn’t make you a bit nervous as a supervisor, instructor, and risk manager then you need to check yourself for a heartbeat.

To ease your panic attack, here are some training tips to remember when you meet with your staff:
• Nix marathon training sessions – before our season or semester begins, we always try to cram safety training, job training, and any other types of trainings we have in to a short period of time right before the staff starts their first day. If this is the only budgetary option you have, make sure you break up trainings with team building and fun, active activities. Deterring away from typical classroom settings for long periods of time can help staff retention of emergency procedures

• Use the past to help prevention – although we all mostly teach nationally recognized certifications (American Red Cross, American Heart Association, Ellis, etc.), you should feel compelled to add facility specific information to staff trainings. Talking about prior accidents, which accidents most likely to occur, and other “tricks of the trade” make your trainings more relevant and effective and can even the playing field of your new staff and veteran staff.

• Preach the call – going over with your staff when and when not to call 911 is a great tool for them to have. The decision-making process when under stress can be tough and often times we are putting 19 year old kids in charge of a life and a lawsuit. Give them clear cut descriptions of when or when not to call and then preach the “When in doubt – CALL” rule of thumb.

• Identify – make sure to go over what care is OK and not OK to give for your staff. Some facilities allow splinting, others don’t. Some allow oral glucose to be used, others deter from anything that can be “administered”. Don’t forget to then put away the corresponding First Aid materials that shouldn’t be used so staff aren’t tempted. Consider:

o Splinting
o Oral glucose
o Aspirin
o Portable eye wash
o Neosporin
o Aloe

• Don’t let them get hung up on acronyms – in our effort to simplify things, we sometimes forget to show our staff the “bigger picture” which may be what they truly need to understand the flow of the EAP. Telling them to do the “3 Cs”, check “ABCs, go through “SAMPLE”, and when in doubt “WWJD” can overload and distract them (yes I am joking about WWJD). Instead of trying to simplify, go ahead and actually show them the EAP in it’s entirety and who all is involved.

• Get involved – Don’t allow just one professional staff member to handle all the training. All supervisors should be involved, aware of what/how lifesaving skills are being taught, and fluent in the EAP. If you aren’t certified to teach these courses, you should at least be present and active EVERY YEAR in the training your staff goes through.

When looking to improve the effectiveness of your facilities EAP, consider the following:
• Make EAP decisions as “black and white” as possible – although EAPs never go exactly as planned, taking ambiguity out of situations can help ease staff anxiety. Make situations and decisions as clear cut as possible and make sure they go over the protocol you decide on in trainings. Consider:
o who has which responsibilities in the EAP?
o which AED do they run and get ?
o are they allowed to help with medication?
o which door should they tell the ambulance to come to?
o is a participant allowed to continue their program if they refuse care?

• A 911 script – whether you have member services call or a fellow lifeguard, giving them a general list of questions a dispatcher may ask, the address for the facility, and the facilities call back number can help save time when it’s most important and prevent frantic scrambling. Post this script in areas where staff can easily access it.

• Practice makes perfect – if you aren’t running drills to practice the EAP (not just CPR/First Aid skills) then you are doing your staff a disservice. Running full EAP drills helps give staff an idea of how they all must work together for the EAP to happen. It also may show you weak areas that need to be retaught.

• Post EAP charts – I have seen flow charts, lists, diagrams, and pictures all used to describe the facility EAP. Good places to post include all First Aid sites, above all your AEDs, and next to your front desk.

• Reevaluate your EAP on a regular basis – a good rule of thumb is at the end of each school year, look back at accidents and incidents your facility had, review report forms, and look at your EAP and EAP training. Adjust and modify what is needed.

• Don’t forget – remember that although we focused on Accident Response in this situation, an Emergency Action Plan should not be limited to just accidents. Have an EAP for active shooter situations, weather emergencies, fire evacuations, and other special circumstances so your staff responds just as efficiently.