• Date
• Day/Time
• Scenario
• Lifeguards on duty
• Elements of the rescue
(Include whether the lifeguard(s) and emergency team members were successful or unsuccessful in a particular element. Include comments as appropriate)
§ Lifeguard rescue ready
§ Victim recognized
§ Lifeguard activated emergency action plan
§ Lifeguard performed a safe and successful entry and in-water rescue as necessary
§ Emergency back-up surveillance coverage provided
§ Lifeguard used appropriate in-water rescue equipment
§ Lifeguard safely removes victim from the water
§ Lifeguard provided adequate victim assessment
§ Lifeguard provided appropriate care
§ Lifeguard used appropriate personal protective equipment
§ Emergency team responded appropriately
§ Emergency equipment (AED, O2, etc.) was available and usable within XX minutes
• Overall Remarks