Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Microphone (Logitech USB (00:04):
Hello and welcome to the podcast.
I'm Ryan, a certifiedoccupational therapy assistant,
and today I'd like to talk toyou a little bit about safety
first.
Safety, obviously is veryimportant in all of the
therapies that we provide beingthat we tend to work in
environments that are lesscontrolled than a typical
(00:25):
clinical setting.
So either working outdoors inthe forest or at the barn with
the horses or in the pool.
These places all have inherentrisks to them, and so it's
certainly something that we needto consider every time we go
into a session.
So I'm going to break this downtoday through a P E O lens
because that kind of helps me toorganize my own thoughts on the
(00:50):
topic and how I like to thinkabout it.
P first we're gonna talk aboutthe people, right?
Person, environment andoccupation.
In this case, we're going tolook at both the population of
the clients that we're seeing aswell as the therapists and the
staff themselves.
So first is the, Population anda big part of why the client's
(01:13):
screening is so important andwhat should be factored into a
client's screening should besome safety considerations such
as who is the population thatwe're looking at helping?
Is it mostly children or adults?
Is it People with physicaldysfunction or people are coming
to us with other disorders.
(01:34):
So identifying the clients,their conditions and how many
you'd be looking at servingconcurrently are all going to
factor into what you need whenit comes to the decision making
process.
As far as how many staff you'regonna need on hand and what
(01:54):
types of tools and equipment youmight need at the pool that
you're going to be in.
Next, I would say we would lookat the staff.
Again, the number of staff thatyou would need to maintain a
safe environment, depending onhow many clients that you're
going to be seeing.
The training of that staff.
If you're at a community pool,we're gonna talk about we're
(02:16):
gonna talk about this from thelens of an uncontrolled
environment.
So something like a communitypool, something that's not in,
in your own facilitynecessarily.
Because it's a lot harder tocontrol if you're in a community
pool as far as setting up theenvironment.
Are there lifeguards on staff?
If not, do you have access tostaff with lifeguard training?
(02:36):
Does everybody have CPRcertifications?
Knowing where things such as theAED and other lifesaving
equipment that could be neededwould also be important.
We'll talk about that a bit morewhen we get into looking at the
environment.
Another important factor that I,I would put under the P would be
the emergency action plan.
So this is a,"what would you doif." So, knowing first of all
(03:00):
how to respond immediately inthe event that someone needs to
be rescued or pulled out of thewater.
What you would have to do as faras your primary assessment and
and then reaching out for helpas needed.
And what level of help thiscould be even having, access to
your cell phone close by andJust in case, it's not something
that we like to think about, butit's something we have to think
(03:22):
about.
Having access to things such asa first aid kit and a CPR kit.
And another thing that I like tohave on my person is a whistle.
And there's a few reasons forthis.
One of it is safety.
If I needed to get somebody'shelp, and the environment made
it difficult to yell across thepool deck.
Having a whistle drawseverybody's attention.
(03:43):
Whistles also can be helpful fortransitions.
And another thing that I have onmy body pretty much at all times
is a wetsuit.
Now the wetsuit is a safetymeasure for me because if I'm in
the pool for three or fourhours, depending on the water
temperature, that can reallytake a toll on your body take a
lot of energy and your core bodytemperature can drop down.
(04:04):
But the other interesting thingabout the wetsuit is it
increases your own buoyancy.
So in the event that you had tohelp somebody else in the pool,
you already have a little bit ofextra flotation to assist you
with that.
And also with that addedbuoyancy, it helps you to
conserve your own energy ifyou're getting into deeper water
(04:26):
where you might have to treadwater or swim a little bit.
So then moving on to theenvironment, we're looking at a
site visit.
So before you even really gointo the, to the confirm that
you're gonna have sessions at alocation.
You wanna do a site visit, youwanna make sure that it's
appropriate for the populationthat you're going to be working
(04:48):
with, and that they have theequipment there that can support
the needs of that population.
Considering the population, youwanna look at the needs.
So the level of function.
Is there gonna be a need for aHoyer lift or a chair lift or
something to get somebody in andout of the pool?
Sensory needs.
So this is one that, that we'veseen that was interesting,
(05:09):
because we work with a lot ofkids with autism spectrum
disorder.And I know from workingin the forest that sometimes
we'll be walking down a trailwhere the visual field is really
restricted and then we'll cometo an open area and the response
from the client when the visualfield opens up was something
(05:30):
that the first time I saw it, Iwasn't quite sure what was going
on, but then when I thought backto the previous five minutes
about what we'd just been doing,it was, ah-ha and being aware of
that and being mindful that mostcommunity pools are very big,
wide open spaces.
And so they may be going from asmall restricted hallway and
(05:50):
then coming into this big wideopen space that can sometimes
have unanticipated effects ontheir sensory system that we
should be prepared for orexpect.
I've seen kiddos climb thecement bleachers and go all the
way up to the top and walk alongthe wall.
I think maybe walking along thewall a little bit helps to limit
(06:13):
their visual field, but then theelevation may also provide an
increased sense of security.
So just having an understandingthat just being in that open
environment can challengecertain clients' sense of
security.
And so maybe thinking of someways to help mitigate that or at
least decrease the time totransition into the session and
(06:35):
having an understanding thatit's important to limit the
amount of time from when theyenter the pool deck to
transitioning into the session.
So we want to consider, again,the physical and the sensory
needs.
Another thing we wanna look atis the entry and exit points.
Not only for the external comingout of coming onto the pool
(06:57):
deck, but also actually into thewater itself.
Again, ladders.
The pool that, that we useactually has a drop in stairwell
that is made out of pvc andthat's been really helpful.
Sometimes to help even help kidswho can, who could use an a
(07:18):
normal ladder, get in and outsometimes just to help those
kids transition into the pool.
Sometimes we'll do an activityjust on the steps and every
iteration of that activity,we'll do another step into the
water and we can use that to, tohelp coax them into the water.
But also knowing those entry andexit points, again, in case you
(07:40):
have to make a rescue or in caseyou have to help somebody out of
the pool.
What's gonna be the the safestand quickest way to do.
Another consideration is thewater temperature.
So I was talking about thewetsuit again.
We tell all of our clients andthe parents to consider
purchasing a wetsuit.
They're relatively cheap onAmazon and there's other places
(08:00):
that you can get'em.
But this can make it the sessiongo a bit smoother.
And our water temperature'stypically around 82 degrees.
It's usually low eighties.
If you're looking at physicaldysfunction, I know typical
aquatic therapy, when you'rereally working with physical
dysfunction, you want the watermuch, much warmer than that, but
(08:22):
where we're at, what we haveaccess to, and the population
that we're serving, that's notas much of a consideration.
To compensate for that we bearthat in mind to wear wetsuit
when possible.
And also maybe limit the lengthof the session depending on the
individual kid.
Hazards.
You, you certainly wannaidentify potential hazards, and
(08:45):
when I say hazards, areas of thefloor that are typically wet
because it is a pool, it's a wetenvironment and it can be very
slippery.
We go over all of the rules withall of our clients.
We have four rules and we evenput'em on a visual board for our
kids who have a hard timefollowing verbal directions to
(09:06):
help them understand the rulesto keep them safe.
And the four four rules that wehave are:no running entry and
from the ladder only, if thewhistle blows, then you have to
get out and no, no jumping andno diving we say specifically,
but for some of our kids we justsay no jumping to simplify it.
(09:28):
And so you also wanna look atoff limit areas.
So these are areas that if youhave any kiddos who are, or
clients who are elopers who youreally have to watch.
You want to identify what theycould get into, that could
potentially get them in trouble.
And you wanna figure out waysto, to either block or mitigate
(09:49):
the risk to that.
For example, there is a spiralstaircase that goes up into an
observation deck for swim meetsat the pool that we're at.
And we had one kiddo who decidedhe was gonna go exploring up
there and I had to I had to veryquickly I saw where he was
(10:09):
going, so I had to run over andphysically block and I don't
like to restrict kids as much aspossible, but again, knowing
that it's an environment thatwhere there are inherent risks
and he was going to do somethingthat was going to be risky it
was important to.
We've since kind of made surethat there's equipment stacked
in front of there that will atleast slow'em down a little bit
(10:31):
so that we could prevent themfrom accessing that.
Knowing you're off limit areasand knowing areas that maybe
your clients could get intotrouble it if if they wander
over to it.
And finally we're gonna look atoccupation.
So our occupation for this isgoing to be the treatment
session itself.
(10:52):
So I just covered this, but withthe population in mind,
anticipating hazards, some otherhazards that, that we've seen or
that are common if you havekids.
So for me I have a few clientswho have adhd.
And with scheduling, sometimesthere's toys left out from a
(11:14):
previous session that I don'tintend to use in the next
session.
And the clients with ADHD willright away identify those toys
and beeline straight to themand, which is okay, we can use
that, but at the same time,it's, it's not what I intend to
happen in the session.
(11:34):
And further, if those toys areleft out in an area where
they're at risk to either fallinto the pool or or they see
those toys and get excited anddecide they're going to run for
them before, before we even getinto the session and have our
little safety brief that couldbe a hazard.
So I always try to clean upthings and restore the area
before in between sessions.
(11:55):
Limiting time of the transitioninto the session.
This is another one that if.
Again if the kids are waiting inthe area for an extended period
of time, then there's moreopportunity to get into trouble
or get into those off limitareas.
So really getting themtransitioned in and.
(12:15):
Getting into the session asquickly as possible, can help to
mitigate any of the risks.
Having flotation devicesavailable.
This can be swim bubbles for thevery little.
Clients who have are stillhaving difficulty that are not
strong swimmers just yet.
Pool noodles, kickboards and ourflow through mat.
We love our flow through mat.
(12:35):
It's like our, we refer to it asour swing in the pool.
We can do all sorts of sensoryinput with it.
A lot of good vestibular.
We can even do someproprioceptive input with it.
It's it's a much more versatiletool than I think we realized it
first when we when we brought itin.
But it's also, it's, it is agood way to assist in buoyancy
(12:56):
as well.
We also use kickboards and poolnoodles.
Now, those are not, red Crosscertified flotation devices, but
they can help for buoyancy.
And if I, my clients, I reallynever keep them out of arm's
reach again for safety reasons.
But it's just another addedlayer of assistance if they
(13:19):
needed it.
With that in mind, you also wantto ensure that you have enough
help to be safe.
Again.
I talked about how many clientsyou intend to treat
concurrently.
So if you have multipletherapists in the pool we do
that at times where we will havetwo of us treating separately in
the same space.
Having either students with youor an aid somebody that can help
(13:43):
to stabilize a child if they'reon a flow through mat and you're
doing an activity on top of theflow through mat, having an
extra set of hands is.
Always a good thing and italways increases your level of
safety while you're in thewater.
And again, if something were toever happen or were to go wrong
knowing what, knowing exactlywhat directions you would
(14:05):
provide to help rescue thatperson who's in need of it and
and get them the help that theyneed if they needed it.
The last point that I will sayis never force a session into a
pool.
Swimming is supposed to be fun.
It's supposed to be an enjoyableexperience.
And we treat our therapysessions the same way that it's
(14:25):
not so much about being in thepool.
We are occupational therapypractitioners.
We're we're not swiminstructors.
The point isn't the pool, thepoint is the therapy.
And the pool is a just anothertool that we use.
There's a lot of sensoryelements to it that can be
helpful.
(14:45):
There's a lot of activities thatwe can do in there and a lot of
kids are are very excited aboutgetting into the water.
And so that can increase clientparticipation in the session.
If it is something that they'reexcited about doing and they're
motivated to do, however, ifthey don't want to get into the
(15:08):
water for whatever reason thatday, always have a plan B of
something that you can work on.
And if it is a motivation issue,then like I said, during the
environment piece You can lookfor ways to incrementally help
them transition into the pool.
I always try to start offsessions as an invitation to go
(15:30):
into the pool and never as a,"time to go into the pool- and
you're gonna go in whether youlike it or not." It's I don't
want kids to walk away from theexperience with with a lost
desire to to go swim.
I love being in the water.
It's always been something thatI've enjoyed and it's been very
important to me.
And I like sharing that withothers.
(15:53):
But never force a kid to to havea therapeutic activity in the
water.
So that's gonna wrap it up fortoday.
I hope you learned something.
I hope it was helpful, and dropus a comment and we'd love to
hear from you.
Thanks.
Hello and welcome to the podcast.
I'm Ryan, a certifiedoccupational therapy assistant,
and today I'd like to talk toyou a little bit about safety
first.
Safety, obviously is veryimportant in all of the
therapies that we provide beingthat we tend to work in
environments that are lesscontrolled than a typical
(00:25):
clinical setting.
So either working outdoors inthe forest or at the barn with
the horses or in the pool.
These places all have inherentrisks to them, and so it's
certainly something that we needto consider every time we go
into a session.
So I'm going to break this downtoday through a P E O lens
because that kind of helps me toorganize my own thoughts on the
(00:50):
topic and how I like to thinkabout it.
P first we're gonna talk aboutthe people, right?
Person, environment andoccupation.
In this case, we're going tolook at both the population of
the clients that we're seeing aswell as the therapists and the
staff themselves.
So first is the, Population anda big part of why the client's
(01:13):
screening is so important andwhat should be factored into a
client's screening should besome safety considerations such
as who is the population thatwe're looking at helping?
Is it mostly children or adults?
Is it People with physicaldysfunction or people are coming
to us with other disorders.
(01:34):
So identifying the clients,their conditions and how many
you'd be looking at servingconcurrently are all going to
factor into what you need whenit comes to the decision making
process.
As far as how many staff you'regonna need on hand and what
(01:54):
types of tools and equipment youmight need at the pool that
you're going to be in.
Next, I would say we would lookat the staff.
Again, the number of staff thatyou would need to maintain a
safe environment, depending onhow many clients that you're
going to be seeing.
The training of that staff.
If you're at a community pool,we're gonna talk about we're
(02:16):
gonna talk about this from thelens of an uncontrolled
environment.
So something like a communitypool, something that's not in,
in your own facilitynecessarily.
Because it's a lot harder tocontrol if you're in a community
pool as far as setting up theenvironment.
Are there lifeguards on staff?
If not, do you have access tostaff with lifeguard training?
(02:36):
Does everybody have CPRcertifications?
Knowing where things such as theAED and other lifesaving
equipment that could be neededwould also be important.
We'll talk about that a bit morewhen we get into looking at the
environment.
Another important factor that I,I would put under the P would be
the emergency action plan.
So this is a,"what would you doif." So, knowing first of all
(03:00):
how to respond immediately inthe event that someone needs to
be rescued or pulled out of thewater.
What you would have to do as faras your primary assessment and
and then reaching out for helpas needed.
And what level of help thiscould be even having, access to
your cell phone close by andJust in case, it's not something
that we like to think about, butit's something we have to think
(03:22):
about.
Having access to things such asa first aid kit and a CPR kit.
And another thing that I like tohave on my person is a whistle.
And there's a few reasons forthis.
One of it is safety.
If I needed to get somebody'shelp, and the environment made
it difficult to yell across thepool deck.
Having a whistle drawseverybody's attention.
(03:43):
Whistles also can be helpful fortransitions.
And another thing that I have onmy body pretty much at all times
is a wetsuit.
Now the wetsuit is a safetymeasure for me because if I'm in
the pool for three or fourhours, depending on the water
temperature, that can reallytake a toll on your body take a
lot of energy and your core bodytemperature can drop down.
(04:04):
But the other interesting thingabout the wetsuit is it
increases your own buoyancy.
So in the event that you had tohelp somebody else in the pool,
you already have a little bit ofextra flotation to assist you
with that.
And also with that addedbuoyancy, it helps you to
conserve your own energy ifyou're getting into deeper water
(04:26):
where you might have to treadwater or swim a little bit.
So then moving on to theenvironment, we're looking at a
site visit.
So before you even really gointo the, to the confirm that
you're gonna have sessions at alocation.
You wanna do a site visit, youwanna make sure that it's
appropriate for the populationthat you're going to be working
(04:48):
with, and that they have theequipment there that can support
the needs of that population.
Considering the population, youwanna look at the needs.
So the level of function.
Is there gonna be a need for aHoyer lift or a chair lift or
something to get somebody in andout of the pool?
Sensory needs.
So this is one that, that we'veseen that was interesting,
(05:09):
because we work with a lot ofkids with autism spectrum
disorder.And I know from workingin the forest that sometimes
we'll be walking down a trailwhere the visual field is really
restricted and then we'll cometo an open area and the response
from the client when the visualfield opens up was something
(05:30):
that the first time I saw it, Iwasn't quite sure what was going
on, but then when I thought backto the previous five minutes
about what we'd just been doing,it was, ah-ha and being aware of
that and being mindful that mostcommunity pools are very big,
wide open spaces.
And so they may be going from asmall restricted hallway and
(05:50):
then coming into this big wideopen space that can sometimes
have unanticipated effects ontheir sensory system that we
should be prepared for orexpect.
I've seen kiddos climb thecement bleachers and go all the
way up to the top and walk alongthe wall.
I think maybe walking along thewall a little bit helps to limit
(06:13):
their visual field, but then theelevation may also provide an
increased sense of security.
So just having an understandingthat just being in that open
environment can challengecertain clients' sense of
security.
And so maybe thinking of someways to help mitigate that or at
least decrease the time totransition into the session and
(06:35):
having an understanding thatit's important to limit the
amount of time from when theyenter the pool deck to
transitioning into the session.
So we want to consider, again,the physical and the sensory
needs.
Another thing we wanna look atis the entry and exit points.
Not only for the external comingout of coming onto the pool
(06:57):
deck, but also actually into thewater itself.
Again, ladders.
The pool that, that we useactually has a drop in stairwell
that is made out of pvc andthat's been really helpful.
Sometimes to help even help kidswho can, who could use an a
(07:18):
normal ladder, get in and outsometimes just to help those
kids transition into the pool.
Sometimes we'll do an activityjust on the steps and every
iteration of that activity,we'll do another step into the
water and we can use that to, tohelp coax them into the water.
But also knowing those entry andexit points, again, in case you
(07:40):
have to make a rescue or in caseyou have to help somebody out of
the pool.
What's gonna be the the safestand quickest way to do.
Another consideration is thewater temperature.
So I was talking about thewetsuit again.
We tell all of our clients andthe parents to consider
purchasing a wetsuit.
They're relatively cheap onAmazon and there's other places
(08:00):
that you can get'em.
But this can make it the sessiongo a bit smoother.
And our water temperature'stypically around 82 degrees.
It's usually low eighties.
If you're looking at physicaldysfunction, I know typical
aquatic therapy, when you'rereally working with physical
dysfunction, you want the watermuch, much warmer than that, but
(08:22):
where we're at, what we haveaccess to, and the population
that we're serving, that's notas much of a consideration.
To compensate for that we bearthat in mind to wear wetsuit
when possible.
And also maybe limit the lengthof the session depending on the
individual kid.
Hazards.
You, you certainly wannaidentify potential hazards, and
(08:45):
when I say hazards, areas of thefloor that are typically wet
because it is a pool, it's a wetenvironment and it can be very
slippery.
We go over all of the rules withall of our clients.
We have four rules and we evenput'em on a visual board for our
kids who have a hard timefollowing verbal directions to
(09:06):
help them understand the rulesto keep them safe.
And the four four rules that wehave are:no running entry and
from the ladder only, if thewhistle blows, then you have to
get out and no, no jumping andno diving we say specifically,
but for some of our kids we justsay no jumping to simplify it.
(09:28):
And so you also wanna look atoff limit areas.
So these are areas that if youhave any kiddos who are, or
clients who are elopers who youreally have to watch.
You want to identify what theycould get into, that could
potentially get them in trouble.
And you wanna figure out waysto, to either block or mitigate
(09:49):
the risk to that.
For example, there is a spiralstaircase that goes up into an
observation deck for swim meetsat the pool that we're at.
And we had one kiddo who decidedhe was gonna go exploring up
there and I had to I had to veryquickly I saw where he was
(10:09):
going, so I had to run over andphysically block and I don't
like to restrict kids as much aspossible, but again, knowing
that it's an environment thatwhere there are inherent risks
and he was going to do somethingthat was going to be risky it
was important to.
We've since kind of made surethat there's equipment stacked
in front of there that will atleast slow'em down a little bit
(10:31):
so that we could prevent themfrom accessing that.
Knowing you're off limit areasand knowing areas that maybe
your clients could get intotrouble it if if they wander
over to it.
And finally we're gonna look atoccupation.
So our occupation for this isgoing to be the treatment
session itself.
(10:52):
So I just covered this, but withthe population in mind,
anticipating hazards, some otherhazards that, that we've seen or
that are common if you havekids.
So for me I have a few clientswho have adhd.
And with scheduling, sometimesthere's toys left out from a
(11:14):
previous session that I don'tintend to use in the next
session.
And the clients with ADHD willright away identify those toys
and beeline straight to themand, which is okay, we can use
that, but at the same time,it's, it's not what I intend to
happen in the session.
(11:34):
And further, if those toys areleft out in an area where
they're at risk to either fallinto the pool or or they see
those toys and get excited anddecide they're going to run for
them before, before we even getinto the session and have our
little safety brief that couldbe a hazard.
So I always try to clean upthings and restore the area
before in between sessions.
(11:55):
Limiting time of the transitioninto the session.
This is another one that if.
Again if the kids are waiting inthe area for an extended period
of time, then there's moreopportunity to get into trouble
or get into those off limitareas.
So really getting themtransitioned in and.
(12:15):
Getting into the session asquickly as possible, can help to
mitigate any of the risks.
Having flotation devicesavailable.
This can be swim bubbles for thevery little.
Clients who have are stillhaving difficulty that are not
strong swimmers just yet.
Pool noodles, kickboards and ourflow through mat.
We love our flow through mat.
(12:35):
It's like our, we refer to it asour swing in the pool.
We can do all sorts of sensoryinput with it.
A lot of good vestibular.
We can even do someproprioceptive input with it.
It's it's a much more versatiletool than I think we realized it
first when we when we brought itin.
But it's also, it's, it is agood way to assist in buoyancy
(12:56):
as well.
We also use kickboards and poolnoodles.
Now, those are not, red Crosscertified flotation devices, but
they can help for buoyancy.
And if I, my clients, I reallynever keep them out of arm's
reach again for safety reasons.
But it's just another addedlayer of assistance if they
(13:19):
needed it.
With that in mind, you also wantto ensure that you have enough
help to be safe.
Again.
I talked about how many clientsyou intend to treat
concurrently.
So if you have multipletherapists in the pool we do
that at times where we will havetwo of us treating separately in
the same space.
Having either students with youor an aid somebody that can help
(13:43):
to stabilize a child if they'reon a flow through mat and you're
doing an activity on top of theflow through mat, having an
extra set of hands is.
Always a good thing and italways increases your level of
safety while you're in thewater.
And again, if something were toever happen or were to go wrong
knowing what, knowing exactlywhat directions you would
(14:05):
provide to help rescue thatperson who's in need of it and
and get them the help that theyneed if they needed it.
The last point that I will sayis never force a session into a
pool.
Swimming is supposed to be fun.
It's supposed to be an enjoyableexperience.
And we treat our therapysessions the same way that it's
(14:25):
not so much about being in thepool.
We are occupational therapypractitioners.
We're we're not swiminstructors.
The point isn't the pool, thepoint is the therapy.
And the pool is a just anothertool that we use.
There's a lot of sensoryelements to it that can be
helpful.
(14:45):
There's a lot of activities thatwe can do in there and a lot of
kids are are very excited aboutgetting into the water.
And so that can increase clientparticipation in the session.
If it is something that they'reexcited about doing and they're
motivated to do, however, ifthey don't want to get into the
(15:08):
water for whatever reason thatday, always have a plan B of
something that you can work on.
And if it is a motivation issue,then like I said, during the
environment piece You can lookfor ways to incrementally help
them transition into the pool.
I always try to start offsessions as an invitation to go
(15:30):
into the pool and never as a,"time to go into the pool- and
you're gonna go in whether youlike it or not." It's I don't
want kids to walk away from theexperience with with a lost
desire to to go swim.
I love being in the water.
It's always been something thatI've enjoyed and it's been very
important to me.
And I like sharing that withothers.
(15:53):
But never force a kid to to havea therapeutic activity in the
water.
So that's gonna wrap it up fortoday.
I hope you learned something.
I hope it was helpful, and dropus a comment and we'd love to
hear from you.
Thanks.
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