Article: Wait, Can You Swim With That? Medical Devices at the Pool

Aquatic staff encounter medical conditions and medical devices more often than they may realize. A swimmer may have a small sensor attached to their arm, an insulin pump under their clothing, a feeding tube hidden beneath a swimsuit, a medical alert bracelet on their wrist, an inhaler in their bag, or emergency medication that needs to remain close to the pool. Another swimmer may tell an instructor that they have epilepsy or explain that the phone sitting beside the pool is monitoring a medical device.

Most aquatic professionals are not medical professionals, and they do not need to become medical experts to serve people with medical conditions safely and respectfully. What they do need is enough awareness to recognize that something may be medically necessary, understand how it could interact with aquatic operations, and know when a question belongs with the swimmer, caregiver, supervisor, healthcare provider, manufacturer instructions, or emergency medical services rather than with the lifeguard.

Aquatic Staff Need Medical Awareness, Not Medical Authority

When staff encounter an unfamiliar medical condition or device, it is natural to have questions. Can that get wet? Can they swim with that? Should they remove it? What happens if something goes wrong? Those questions can be reasonable, but they can also lead employees into making medical decisions that are outside their role.

A lifeguard should not decide whether someone's prescribed medical device is waterproof based on something they remember hearing. A swim instructor should not tell someone to disconnect an insulin pump. A front desk employee should not decide that a feeding tube makes a child medically unable to participate in lessons. An employee should not prohibit someone with epilepsy from swimming simply because they disclosed a seizure disorder.

The role of aquatic staff is to understand the legitimate safety requirements of the activity, determine whether a medical need interacts with those requirements, and know when additional planning is necessary. Sometimes the appropriate response is simply asking the swimmer what they need. Sometimes a supervisor should become involved. Sometimes an established medical or emergency action plan should be followed. In many situations, staff do not need to do anything differently at all.

Continuous Glucose Monitors May Look Like Ordinary Electronics

Continuous glucose monitors, usually called CGMs, are devices used by many people with diabetes to track glucose levels throughout the day. A small sensor is worn on or under the skin, often on the arm or abdomen, and glucose information may be transmitted to a phone, smartwatch, receiver, insulin pump, or another compatible device.

To an aquatic employee unfamiliar with CGMs, the sensor may simply look like a small piece of electronic equipment attached to someone's body. A phone sitting near the pool may look like someone ignoring the facility's electronics policy when it is actually displaying glucose readings and alerts.

Staff should not ask someone to remove a CGM simply because electronics are normally restricted in an aquatic area. They also should not provide advice about whether a particular CGM can be submerged. Different devices have different manufacturer specifications for water exposure, depth, duration, temperature, and use. The person wearing the device is generally far more familiar with those requirements than the employee seeing it for the first time.

Insulin Pumps May Need Different Management Around Water

An insulin pump is a device that delivers insulin to help someone manage diabetes. Some pumps connect to the body through tubing, while others attach directly to the skin. A person using an insulin pump may also use a CGM, and some systems communicate with each other to help manage insulin delivery.

Different insulin pumps have different requirements around water. Some equipment may be designed for certain types of water exposure, while other equipment may need to be disconnected or protected. Those decisions should be made by the person using the pump according to the instructions for their specific device and their healthcare plan.

Aquatic employees should not tell someone when to disconnect an insulin pump, how long they can safely remain disconnected, or how they should adjust their insulin. What staff should understand is that the device is medically necessary and that managing it may require the swimmer to do things that look different from what other patrons do.

Diabetes May Require Food, Drinks, Phones, or Supplies on Deck

A facility may normally prohibit food on the pool deck, require bags to remain in lockers, or restrict phone use. Someone managing diabetes may need an exception to one or more of those rules.

A swimmer may need rapid access to glucose if their blood sugar becomes low. They may need a phone or receiver nearby to monitor glucose readings. A child participating in swim lessons or practice may need diabetes supplies accessible to a caregiver or staff member. Someone may also need insulin, testing equipment, or other supplies available during a longer aquatic program.

The existence of a general rule does not mean there can never be a medically necessary exception. Facilities should establish an accommodation process so frontline employees are not forced to decide whether someone's medical need is important enough to override a normal deck rule.

Low Blood Sugar Can Become a Water-Safety Concern

Physical activity can affect blood glucose, which means someone with diabetes may need to monitor and manage their glucose around swimming and other aquatic activities. Low blood sugar can cause symptoms such as shakiness, weakness, confusion, dizziness, unusual behavior, or difficulty concentrating.

Aquatic staff should not look at someone behaving differently and immediately decide that they are experiencing low blood sugar. There are many possible causes of those symptoms. Staff should respond according to their first-aid training, any established medical plan, and the information provided by the swimmer or caregiver.

The operational responsibility is making sure medically necessary supplies can actually be reached when they are needed. Allowing glucose in the building but requiring it to remain locked inside a locker across the facility may not create meaningful access during an urgent situation.

Feeding Tubes May Be Completely Invisible

Some people receive nutrition, hydration, or medication through a feeding tube. A gastrostomy tube, often called a G-tube, enters directly into the stomach through the abdomen. Some G-tubes are low-profile devices that sit close to the skin and may be completely covered by a swimsuit or rash guard.

A swimmer with a feeding tube may participate in aquatic activities when swimming is appropriate for their individual medical situation. Whether a particular person can submerge a feeding-tube site can depend on factors such as healing, the type of device, and instructions from their healthcare team.

Aquatic employees should not see a feeding tube and automatically decide that someone cannot enter the pool. They also should not inspect the site or independently determine whether it has healed enough for swimming. If an individual or caregiver says they are medically cleared to participate and there is no specific facility safety issue requiring additional information, staff should generally focus on providing access to the program.

Feeding Tubes Can Create Other Accommodation Needs

The feeding tube itself may not affect swimming, but the person's medical needs could affect other parts of their visit. Someone may need feeding supplies nearby, access to medication, additional time in the changing room, a scheduled break, or assistance from a caregiver.

This is another reason aquatic staff should ask what someone needs rather than demanding their entire medical history. Knowing that a child has a G-tube may be much less useful than knowing that they need a 15-minute break at a particular time and that their caregiver needs access to a bag of supplies.

Staff need actionable information that affects the aquatic program. They generally do not need every detail about why someone has the medical device.

Tracheostomies Require Special Consideration Around Water

A tracheostomy is an opening surgically created in the neck into the trachea, or windpipe, to support breathing. A tracheostomy tube may be placed through that opening. Unlike many other medical devices someone might wear at the pool, a tracheostomy creates a particularly significant concern around water because the opening is connected directly to the airway.

Water entering a tracheostomy can potentially travel toward the lungs. That makes aquatic participation with a tracheostomy something that requires individualized medical planning rather than casual advice from pool staff. Some people may participate in specialized aquatic therapy or activities using specific equipment, clinical protocols, or supervision, but that does not mean a lifeguard should independently determine that a particular situation is safe.

If someone with a tracheostomy wants to participate in an aquatic program and staff are uncertain about the established plan, this is an appropriate situation to involve facility leadership and obtain the information necessary to understand how participation will occur safely.

A Tracheostomy May Be Part of Someone's Airway

Staff also need to understand that a tracheostomy is not simply another tube or wound on someone's body. For some people, it is part of how they breathe. That becomes particularly important during an emergency.

If your facility regularly serves someone with a tracheostomy, emergency planning should happen before an emergency occurs. Appropriate staff should understand the participant's emergency plan and follow their current lifeguard, first-aid, CPR, and emergency medical protocols.

The goal is not for every seasonal lifeguard to become an expert in tracheostomy care. It is to make sure employees understand that the device has airway implications and know how to access the appropriate emergency response.

Seizure Disorders Require Individualized Planning

People with epilepsy and other seizure disorders can participate in swimming and aquatic recreation, but a seizure occurring in water creates a serious drowning risk. The level of support someone needs can vary significantly depending on the person's seizure history, type of seizures, level of awareness during a seizure, swimming ability, and recommendations from their healthcare team.

A diagnosis of epilepsy should not automatically create a blanket prohibition against swimming. One person may need close supervision while another may have a very different safety plan. Someone may have a seizure action plan that provides specific information about what their seizures look like, what staff should do, when emergency medication is used, and when EMS should be activated.

If a participant provides a seizure action plan, determine which staff actually need that information and make sure they can access it when necessary. The first time a lifeguard learns that a regular participant has an emergency plan should not be while that person is experiencing a seizure.

A Seizure in the Water Is an Emergency

A seizure occurring in the water requires immediate action. Lifeguards should follow their current certification training and facility emergency action plan to support and remove the swimmer, assess breathing and other conditions, provide appropriate care, and activate emergency medical services when indicated.

This is another reason medical information should be connected to operational planning rather than simply collected on a registration form. A parent checking a box that says "epilepsy" does not automatically mean the swim instructor, lifeguard, or supervisor knows what to do with that information.

If your organization collects medical information because it matters for participant safety, there should be a process for getting the relevant information to the employees who actually need it while still protecting the participant's privacy.

Medical Alert Devices Can Provide Important Information

Medical alert bracelets, necklaces, watch bands, shoe tags, identification cards, and other medical identification may provide information about diabetes, epilepsy, severe allergies, medications, implanted devices, or other conditions.

Aquatic employees do not need to routinely inspect medical alert jewelry or ask patrons to explain it simply because they notice it. During an emergency, however, medical identification may provide useful information when someone cannot communicate for themselves.

Staff should understand that medical alert items can have a functional purpose and should not automatically be removed because jewelry is normally discouraged. If an attraction has a legitimate rule prohibiting certain jewelry because of an entanglement or equipment hazard, the facility should have a process for addressing medically necessary identification rather than forcing a frontline employee to improvise.

Inhalers Need to Be Reachable

People with asthma and other respiratory conditions may carry rescue inhalers. For someone who needs one urgently, its location matters. If your facility requires every personal belonging to remain in a locker, think about what that means for someone who may need an inhaler during exercise. A medication that is technically somewhere in the building may not be meaningfully accessible if retrieving it takes several minutes.

Youth programs create additional considerations because rules about children carrying and using medication can depend on state law, organizational policy, and program structure. Leadership should determine those procedures rather than leaving individual instructors to decide where an inhaler belongs.

Epinephrine Auto-Injectors May Need Immediate Access

Someone with a severe allergy may carry an epinephrine auto-injector. Like inhalers and glucose, emergency medication needs to be available quickly enough to be useful. Aquatic facilities should understand how patron-carried emergency medication interacts with bag restrictions, locker policies, camps, swim lessons, and other programs. Staff should also know their organization's procedures for recognizing a severe allergic reaction, activating EMS, and assisting with or administering medication within the scope of their training and applicable policies. The solution should not be hiding emergency medication somewhere simply because bags normally aren't allowed on deck.

Rescue Seizure Medication Creates Additional Staff Questions

Some people with seizure disorders have prescribed rescue medication that may be used for certain seizures. Depending on the medication, it may require specific training, authorization, storage, and administration procedures. A swim instructor should not receive an unfamiliar medication from a caregiver five minutes before class and simply be expected to figure it out.

Organizations serving children or adults who may require emergency medication should have established procedures addressing who can receive medication, who can administer it, where it is stored, what documentation is required, and how staff access the person's emergency plan. These procedures may vary significantly based on jurisdiction and program type, which is another reason they belong at the organizational level rather than being improvised by frontline staff.

Phones and Smartwatches Can Be Medical Equipment Too

A phone at the pool does not necessarily mean someone is scrolling social media. A smartwatch is not necessarily just tracking steps. Phones, watches, receivers, and other electronics may receive glucose readings, medical alerts, caregiver notifications, or information from other medical devices. Someone may need that technology reasonably close to them even when your facility normally restricts electronics.

This does not mean every person who says their phone is medically necessary automatically gets unlimited permission to use it however they want. It means the facility should understand the actual need and determine how to accommodate it while still addressing legitimate concerns such as photography, privacy, water damage, or distraction.

A phone can remain available for medical monitoring without becoming permission to photograph people in the locker room. Accommodating one need does not eliminate every other facility rule.

Bags on Deck May Contain More Than Personal Belongings

A bag beside the pool may contain insulin, glucose, feeding supplies, suction equipment, emergency medication, spare medical-device components, or other necessary equipment.

If your policy prohibits bags because they create trip hazards or clutter emergency pathways, that safety concern is legitimate. The solution may be identifying a safe location where medically necessary supplies remain accessible without obstructing the deck.

This is a better approach than forcing someone to choose between following the facility's bag rule and having access to their medical equipment.

Staff Should Never Remove or Adjust Medical Equipment Without a Reason

Aquatic employees should generally not disconnect, reposition, adjust, remove, or manipulate someone's medical device unless doing so is part of an emergency response within their training or the individual has specifically requested appropriate assistance.

A CGM, insulin pump, feeding tube, tracheostomy equipment, medical alert device, or other equipment belongs to the person using it. Staff should not touch unfamiliar equipment out of curiosity or because they believe it might interfere with swimming.

If equipment creates a legitimate safety concern with a specific attraction or activity, explain the concern and involve the swimmer in determining what options exist. Do not start manipulating medical equipment yourself.

Medical Equipment May Look Like a Rule Violation

Many of these situations have the same underlying problem. Something medically necessary can look exactly like something your facility normally prohibits. The phone looks like prohibited electronics. The bag looks like deck clutter. The juice box looks like prohibited food. The caregiver looks like an unauthorized spectator. The smartwatch looks like jewelry. The medical equipment looks like an unfamiliar object that staff assume should come off before swimming. That is why good accessibility policy cannot consist entirely of absolute rules. Facilities need a process for recognizing when the purpose behind a rule can still be protected while accommodating a legitimate medical need.

Don't Decide Whether Someone Looks Medically Fit to Swim

A person tells an instructor that they have epilepsy and suddenly everyone becomes nervous about allowing them into the water. Someone has a feeding tube and staff assume they must be medically fragile. Another person uses an insulin pump and an employee starts questioning whether exercise is safe for them. Those are medical judgments.

Aquatic staff should evaluate whether someone can meet the legitimate safety requirements of the activity and whether an accommodation or safety plan is needed. They should not independently decide that a diagnosis makes someone medically unfit to participate.

If your program legitimately requires medical clearance under particular circumstances, create a clear and consistently applied process for obtaining it. Do not suddenly demand a doctor's note simply because an employee is unfamiliar with someone's condition.

The Person Using the Device Is an Important Resource

Someone who lives with a medical device usually manages it every day. They may know exactly how it responds to water, how it is secured, what must stay dry, what supplies they carry, and what they need during physical activity. Parents and caregivers of children with complex medical needs often have similarly detailed knowledge.

That does not mean a patron can override legitimate facility safety requirements. It does mean staff should listen before making assumptions. Useful questions focus on operations. Is there anything staff need to know for safety? Do you need to keep anything nearby? What should we do if you need assistance? Is there an emergency plan we should have?

Those questions are very different from asking someone to explain their entire medical history.

Protect Medical Privacy

Aquatic facilities may need certain medical information to safely provide a program, particularly in camps, lessons, teams, and other supervised activities. That does not mean every employee needs access to every detail. Think about what information staff actually need, where it is documented, who can access it, and how it is discussed. A diagnosis should not become casual conversation in the lifeguard office. Front desk employees should also avoid asking sensitive questions within earshot of an entire lobby when a private conversation is possible. A patron requesting an accommodation should not have to publicly announce their medical history just to enter the pool.

Frontline Employees Need Somewhere to Escalate Questions

A teenage admissions employee should not be deciding whether someone with a tracheostomy can safely swim. A lifeguard should not be interpreting the waterproof rating of an insulin pump. A swim instructor should not independently decide how rescue seizure medication should be administered. Frontline employees need to recognize when something is outside their role and know exactly who to contact. A strong accommodation process does not require every employee to know every answer. It requires employees to know how to get the right answer without immediately denying access. Leadership then needs to be prepared to actually work through the question rather than simply saying no because something is unfamiliar.

Don't Turn Every Medical Condition Into a Disclosure Requirement

There is another side to medical planning that facilities should consider. You do not need to know every medical condition every patron has. Someone with diabetes may manage it completely independently. A feeding tube may be hidden beneath a swimsuit. A swimmer may wear a CGM that staff never notice. Someone with a seizure disorder may only need to disclose particular information in a structured program where additional safety planning is necessary. Collect the information your organization genuinely needs. Avoid collecting sensitive information simply because it might be useful someday.

Medical conditions and disability do not eliminate someone's right to privacy.

Train Staff to Recognize Needs Rather Than Diagnose Conditions

Medical conditions are often invisible until something happens. Someone may appear completely fine until they experience a blood sugar problem. A swimmer may have epilepsy without any visible medical device. A participant may carry emergency medication that nobody notices until they need it.

Staff training should therefore focus less on teaching employees to identify diagnoses and more on recognizing distress, following first-aid and emergency protocols, understanding common medical equipment, knowing how to access individualized plans, and recognizing when a normal facility rule may require an accommodation. The goal is not diagnosis. The goal is an appropriate response.

Put Medical Devices Into Staff Training

Give staff realistic scenarios involving things they may actually encounter. A swimmer has a CGM on their arm and another employee says electronics are prohibited in the pool. A child arrives for swim lessons with a feeding tube under their rash guard. A parent tells the instructor their child has epilepsy and provides a seizure action plan. A swimmer needs glucose beside the pool despite the no-food policy. A patron has an insulin pump and asks where they can safely keep additional supplies.

Then give them a harder scenario. A participant with a tracheostomy wants to enter the water and your lifeguard has never encountered a tracheostomy before. Ask staff whether the lifeguard should make that medical determination independently and who should become involved instead.

These scenarios teach the skill staff actually need. They learn when to proceed normally, when an accommodation may be appropriate, when to ask a useful question, when an emergency plan matters, and when the situation needs to move beyond the frontline employee.

Audit Your Medical and Accommodation Policies

Review your facility's policies involving food, drinks, phones, smartwatches, electronics, bags, jewelry, personal belongings, caregivers, medications, medical equipment, and access to the pool deck. Look particularly closely at rules containing words such as never, prohibited, or under any circumstances. Then ask what happens when someone has a legitimate medical reason for needing an exception.

Review medication policies for youth programs separately. Determine who receives medical information, where emergency action plans are stored, who is trained to respond, how substitute employees access necessary information, and what happens when medication needs to remain close to the participant.

Finally, review how these situations are escalated. Your accessibility system should not depend on whether the particular manager working that day happens to know what a CGM, G-tube, insulin pump, or tracheostomy is.

Medical Awareness Should Create Access, Not Fear

Learning about medical conditions and devices should not make aquatic staff more afraid to serve people who use them. It should do the opposite. A CGM does not automatically make swimming dangerous. A feeding tube does not automatically exclude someone from lessons. An insulin pump does not make a lifeguard responsible for managing someone's diabetes. A seizure disorder does not automatically mean someone cannot swim. A tracheostomy does create significant water-specific considerations, but those considerations should lead to individualized planning rather than an uninformed decision from a frontline employee.

Aquatic professionals need enough medical awareness to recognize what might matter, enough humility to recognize what they do not know, and a strong enough operational system to find the right answer. That is very different from asking lifeguards to practice medicine.

Resources for Aquatic Professionals

The Centers for Disease Control and Prevention provides information about diabetes management, continuous glucose monitors, physical activity, and protecting diabetes equipment. Individual device manufacturers should be used for specific instructions regarding water resistance, submersion, temperature limits, and use of a particular CGM or insulin pump because those specifications vary between products.

The Epilepsy Foundation provides resources specifically addressing seizures and water safety, including individualized swimming precautions and what to do when a seizure occurs in water. Facilities serving participants with known seizure disorders can also use individualized seizure action plans to help appropriate staff understand what a person's seizures may look like and what response has been established for them.

Major children's hospitals and medical centers provide patient education about feeding tubes and tracheostomies, but individual participation decisions should come from the person's own medical team when medical clearance or specialized planning is necessary. General online guidance should not be used by aquatic employees to override individualized healthcare recommendations.

Facilities should also follow their current lifeguard, first-aid, CPR, medication-administration, and emergency-response standards along with applicable state law and organizational requirements. Medical-device education should supplement those systems rather than replace them.

The U.S. Department of Justice's ADA resources on reasonable modifications and effective communication can also help facility leadership think about how general rules interact with disability-related needs. Policies can still protect legitimate safety objectives while allowing individualized consideration when someone needs an exception because of a disability or medical device.