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Medicine for the Outdoors
Medicine for the Outdoors

Dr. Paul Auerbach is the world's leading outdoor health expert. His blog offers tips on outdoor safety and advice on how to handle wilderness emergencies.

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The United States Lifeguard Standards Coalition


The United States Lifeguard Standards Coalition (USLSC) is a collaborative effort of the American Red Cross, the United States Lifesaving Association, and the YMCA of the USA. These are leading nonprofit groups that are members of the International Life Saving Federation, and all contribute to setting standards for lifeguards.

The USLSC is embarking on a process to research, identify, and promote evidence-based standards for lifeguarding and water rescue. As for medicine in general, evidence-based methods and standards are essential to support rational and defensible activities by rescuers and health care providers.

Because many lifeguarding techniques, skills, and protocols are based on historical accounts and empirical observations and opinions, often without scientific support, this process is an excellent idea. Lack of scientific evidence does not necessarily make any particular recommendation incorrect, but eventually, it is important to have data to support activities and interventions that directly impact health and safety. Furthermore, we have learned that tried and true methods and medical dogma are often changed considerably once comprehensive data are thoroughly reviewed.

The process is going to be a review of the lifeguarding literature. Because there will undoubtedly be much discussion and perhaps arguments, the process will encourage collaboration, but also include conflict management procedures. Many organizations and disciplines will be represented, including nonprofit professional and technical organizations, scientific researchers, and government agencies.

Many of us are eager to learn the outcome of the reviews and discussions. The desired results are evidence-based standards for the most effective lifeguarding and water rescue skills. Another product of these deliberations will be identification of areas in which evidence is lacking, in order to promote necessary research. The final guidelines and evidence review will be made public and distributed without charge.

Having participated in many panels in which there have been lively debate about the best way to handle certain wilderness medicine situations, such as resuscitation from severe hypothermia, frostbite, high altitude illness, snake bites, and the like, I anticipate that there should be quite a bit of back-and-forth during the upcoming sessions. The medical literature is replete with opinions about rescue, resuscitation, and the management of submersed victims, so it will certainly be the same for these groups. When their work is done, I will have more to report.

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photo by Mike Sherrard
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About the Author

Dr. Paul S. Auerbach is the world’s leading authority on wilderness medicine.

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