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Bridging the Safety Gap
by Mary Essert
Reprinted with permission from Aquatics International

As our general population ages, the need for physical therapy increases. For persons suffering from joint disease and other conditions that prevent comfortable weight bearing, aquatic therapy has proven to be quite effective.

Aquatic facilities of all types - including municipalities, universities, YMCAs, health clubs, etc. - are opening their doors to aquatic therapy and rehab programs. Facility operators and pool directors thus find themselves serving a new and fast-growing population.

With many therapists and patients unfamiliar with the pool environment, a new set of risk-management issues has come to the forefront. As an instructor trainer and practicing therapy technician, I believe that the link between serving these new clients and ensuring their safety at our facilities has not been made, and this poses significant safety risks.

Although a number of agencies offer certification in adapter aquatics, these courses don't cover all the potential scenarios in which the safety of patients - and the therapists themselves - can be compromised. Additionally, the growth of complementary therapies such as Watsu, and related thermal bodywork such as the Jahara Technique, have introduced yet another set of practitioners and clients to the water, all of whom require education in water safety.

As aquatic professionals, we must wake up and start to work with these new aquatic practitioners. By taking a proactive approach to water safety, we can ensure a safe livelihood for therapists and a safe experience for clients.

Playing Host
Many of you have discovered that revenues can be increased by renting out pool time to aquatic therapists. Before allowing any therapists to use your facility, consider setting some guidelines that include these elements:

  • Initial meeting: Sit down with therapists interested in using your pool to determine their water safety awareness level. Make sure they know what can go wrong, the various manners in which someone can get injured, how serious injuries can be and how everyone can work together to prevent injuries.

  • Contraindications: Therapists and pool staff must understand basic contraindications such as a fever over 100 F, uncontrolled epilepsy, uncontrolled incontinence, significant open wounds, tracheotomy surgery, and severe urinary or respiratory tract infection.

  • Basic Safety: Any instructor, aide or therapist using your pool should know how to swim and should be competent in basic water safety, rescue skills, CPR and First Aid. Therapists should learn to properly acclimate their patients and clients. If necessary, teach therapists proper and safe pool entry and exit procedures, recovery techniques (how to stand upright in the water when you need to), sculling for balance and coordination, and proper use of equipment.

  • Accessibility: If you plan on hosting injured or disabled clients, check your facility for safe, accessible and lighted entry and exit. Once inside your building, your locker rooms and restrooms should be fully accessible, and your pool should be equipped with lifts, ramps or steps with double railings, or a combination of these amenities. Perform periodic checks to ensure that your equipment remains in good working condition, and consult with the therapists regularly to make sure you meet the needs of their patients.

  • Chemistry: Although therapists don't need to know all the ins and outs of pool chemistry, they should know enough to be able to inform you when sanitizer levels might be low, when the water isn't as clear as it should be or when the indoor air seems unhealthy. You could even show therapists how you maintain water balance to give them a better idea of water chemistry.

  • In-Service training: Invite therapists to attend your in-service training sessions. Make sure they get a copy of your emergency action plan and know what's expected of them should an emergency occur. Stage an emergency drill while they're working to test what they've learned.

  • Current paperwork: Always keep current copies of state, county and local pool and emergency regulations on file. Periodically check to ensure therapists maintain current certifications, and keep copies on file. Initiate or update usable and comprehensible waiver and report forms. Insist that all patients have medical approval before participation, and keep copies of these approvals on file.

  • The basics: Remember the simple stuff- no gum chewing, glass bottles on deck or alcohol consumption before or during sessions. What's obvious to you is not obvious to everybody.

  • Lead person: Consider appointing a coordinator (perhaps your head lifeguard or assistant pool director) to be in charge of all communication between therapists and pool staff.
In summary, educate all staff - therapy and pool - to eliminate hazardous situations. If you experience just one negative incident at your pool, the effects can be catastrophic - loss of job, loss of insurance, psychological trauma and possible inability to obtain employment elsewhere.

Beyond your facility
Therapy pools have become common place at hospitals and independent therapy and rehab facilities, creating a boost to the aquatics industry. As more and more people discover the beauty and benefits of water through therapy, other facilities should experience a trickle-down effect.

You can help the growth of the aquatics industry be offering your assistance to owners and operators of therapy pools, spas and hot springs. Through networking with hospital wellness centers and rehab facilities - visit these facilities, invite their staff to your pool and to your meetings - these new practitioners can learn from your expertise.

A good proactive approach would be to let therapists in your area know about the new American Red Cross Basic Rescue course, a generic, low-key, water safety course ideal for those new to the wet environment. Other avenues could be offering advice on how to maintain water balance and healthy indoor air at therapy facilities, and offering therapists access to your professional library and contacts.

An accident at any facility in your community can cast aquatics as unsafe. Reach out to these newcomers and offer your help. You'll be glad you did.

- Mary Essert
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