STATE OF NEVADA

BRIAN SANDOVAL
Governor

MARTA E. JENSEN
Acting Administrator

RICHARD WHITLEY, MS
Director

TRACEY D. GREEN, MD
Chief Medical Officer

DEPARTMENT OF HEALTH AND HUMAN SERVICES

DIVISION OF PUBLIC AND BEHAVIORAL HEALTH

4150 Technology Way, Suite 300
Carson City, Nevada 89706
Telephone: (775) 684-4200 Fax: (775) 684-4211

July 16, 2015

John L. Hunsucker, PhD., PE
President, NASCO
The National Aquatics Safety Company
1002 Avenue L
Dickinson, TX 77539
Dear Dr. Hunsucker:
The Nevada Department of Health and Human Resources recently completed a review of the recognition status of
NASCOs lifeguard training certification courses. Following a careful evaluation of the appropriateness of NASCOs inwater-intervention (IWI) protocol, which specifies the use of up to five abdominal thrusts on an unconscious, nonbreathing near drowning victim while still in the water, the Department has determined that the use of this protocol is
not supported by the relevant scientific literature, and therefore, recognition of NASCOs current lifeguard training
course that includes the IWI protocol is being immediately withdrawn. Although the Department appreciates NASCOs
arguments for maintaining the IWI protocol, given the absence of endorsements - and in some instances strong
recommendations against the use of this controversial protocol by nationally-recognized, independent rescue and
scientific research organizations - the Nevada Department of Health and Human Resources cannot justify continued
recognition of NASCOs lifeguard training course certifications if they continue to include the IWI protocol. Specifically,
the Department uses the American Red Cross and United States Lifeguarding Association as models for lifeguarding
course certification in Nevada; however, neither organization currently uses or endorses the IWI protocol. Should such
supporting evidence/endorsements be provided in future, the Department may reconsider this action. Recognition of
NASCOs lifeguard certification course can be reinstated following deletion of this protocol from NASCOs Lifeguard
Textbook and training course or the provision of a Nevada-specific Lifeguard Textbook and training course that do not
include the IWI protocol.
Should you have any questions, advice or request additional information please contact Dr. Ihsan Azzam at
iazzam@health.nv.gov or (775) 684-5946.
Sincerely,

Tracey D. Green, MD
Chief Medical Officer
Public Health: Working for a Safer and Healthier Nevada