ABSTRACT: In areas where lifeguard services operate, less than 6% of all rescued persons need medical
attention and require CPR. In contrast, among areas where no lifeguard services are provided almost 30%
require CPR. This difference indicates in importance of the lifeguard. Lifeguard work requires effective problem
identification, diagnostic strategies and management decisions to be made in high-risk environments, where time
is of the essence. The purpose of this investigation was to assess all variables involved in lifeguard work related
to a water rescue, and how the information obtained could inform lifeguard training and therefore performance.
Methods: By using the drowning timeline, the authors explored all variables involved in a single rescue event
by inviting 12 lifeguards to complete a survey of their professional role using a three-round Delphi survey
technique. The total potential number of decisions for each phase and sub-phases, the number of variables, the
probability of a single event repeating, the duration of each sub-phase and amount of variables demanded per
minute were measured. Each sub-phase was presented as predominantly rational (if less than 1 variable per/min)
or intuitive (if more than 1/min).
Results: The variables identified in sub-phases were: “preparation to work” (8
variables and 0.0001 variables/min) and “prevent” (22 variables; 0.03 variables/min); these sub-phases were
predominately considered to lead to rational decisions. The variables identified during “rescue” (27 variables
and 2.7 variables/min) and “first-aid” (7 variables and 1.7 variables) were predominantly considered intuitive
processes.
Conclusion: This study demonstrates the complexity of a decision-making process during the quick,
physically and mentally stressful moments of rescuing someone. The authors propose better decision-making
processes can be achieved by reducing the time interval between identification of a problem and making a
decision. Understanding this complex mechanism may allow more efficient training resulting, in faster and more
reliable decision-makers, with the overall benefit of more lives saved