Make Your Manikins Look More Like Real People: 12 DIY Additions for More Realistic Lifeguard Training

Lifeguard training is full of simulation. We use manikins instead of people for CPR, training AEDs instead of live equipment, fake wounds instead of real injuries, and staged scenarios instead of waiting for emergencies to happen before practicing our response. The point has never been to make a simulation perfect. It is to make it realistic enough that responders can practice the decisions, skills, and problems they may encounter when the situation is real. That same philosophy can help us create more inclusive training.

A standard CPR manikin usually presents responders with a fairly uncomplicated patient. There is no insulin pump attached to the abdomen, no hearing aid to notice, no ostomy appliance under the clothing, no religious garment to navigate, no communication board beside the patient, and usually very little variation in body type or anatomy. Those differences do not necessarily change the fundamental first aid or emergency care we provide, but they can change what responders see, what they have to work around, how they communicate, and how confident they feel doing it. You also do not need an expensive simulation lab to introduce that variability.

With an old manikin, inexpensive supplies, donated or repurposed items, silicone inserts, tubing, adhesive dressings, clothing, printed materials, and a little creativity, aquatic teams can build realistic training aids that expose lifeguards to more of the people they may actually encounter.

The goal is not to teach lifeguards to diagnose medical conditions or manipulate medical devices they are not trained to manage. The goal is much simpler: notice it, don't panic about it, don't unnecessarily remove it, provide care within your training, communicate when possible, and adapt around it.

Here are 12 DIY additions you can build into lifeguard practice.

1. Create a Manikin With Breasts

This is one of the easiest places to start because a traditional flat-chested CPR manikin leaves out a basic anatomical reality responders may encounter. If purchasing a female manikin or commercial breast attachment is not realistic for your budget, designate an older manikin for scenario training. Put an inexpensive bra on the manikin and fill the cups with reusable silicone breast forms, removable bra inserts, soft foam, or homemade fabric pouches filled with polyester fiberfill.

For something more reusable, sew pockets into the inside of a bra or fitted tank top and place silicone inserts inside. This keeps the forms relatively stable while allowing them to be removed for cleaning or replaced with different sizes. Dress the manikin in a shirt before the scenario so staff do not know exactly what they will encounter until they begin care.

Use this setup to practice exposing the chest when necessary, working around breast tissue, following current CPR/AED training and manufacturer instructions for AED pad placement, navigating bras and clothing, and maintaining dignity without delaying necessary lifesaving care.

Keep any DIY anatomy external to the manikin's CPR mechanisms so it does not interfere with compression depth, recoil, ventilation, feedback sensors, or other training functions.

2. Make a DIY Insulin Pump

You don't need an actual insulin pump to expose staff to what a wearable medical device might look like. An old pager, small plastic electronics case, empty earbud case, or similarly sized object can become a simulation pump. Add a short piece of thin flexible tubing and secure the end near the manikin's abdomen with a medical-style adhesive dressing.

For a tubeless version, use a small rounded plastic piece secured to the abdomen or arm.

Put it underneath the manikin's clothing rather than announcing that it is there. Now run an unrelated first aid scenario. The learning moment occurs when someone notices it.

Ask afterward:

• What did you think it was?

• Did its presence change your assessment?

• Did you need to touch or remove it?

• What information would you want from a responsive person or caregiver?

The lesson should not be “here is how to operate an insulin pump.” Lifeguards generally shouldn't be experimenting with someone's medical equipment. The lesson is that medical devices exist, responders may encounter unfamiliar ones, and unfamiliar does not automatically mean something needs to be removed.

3. Build a DIY Ostomy Appliance

An ostomy is another medical difference staff may have never encountered until they see one on an actual person. For simulation purposes, create a removable ostomy pouch using a small clean zippered pouch, soft plastic pouch, or purpose-made practice pouch if you have access to one. Attach it to a removable fabric abdominal wrap or old shirt rather than permanently attaching anything to your CPR manikin.

If you want more realism, put a small amount of gel or another sealed soft material inside the training pouch so it has some weight and dimension. Keep everything completely sealed and clearly labeled as simulation equipment. Place it under clothing and allow responders to discover it naturally during an assessment.

Then discuss what actually matters.

• Does it interfere with the care being provided?

• Is there any reason staff need to manipulate it?

• How can responders avoid damaging or unnecessarily removing medical equipment?

• If the person is responsive, could you simply ask them about it?

This is also a good opportunity to normalize medical devices without turning them into the centerpiece of the emergency.

4. Add a Hearing Aid or Cochlear Implant Simulator

An inexpensive behind-the-ear Bluetooth earpiece, old nonfunctioning hearing device, or simple 3D-style prop can simulate a hearing aid. A small external disk and cable can visually approximate the external portion of a cochlear implant for scenario purposes. The more important part of the scenario is communication. Have the “guest” not respond to verbal instructions until the responder recognizes that another communication method may be necessary. Then give staff options. Include a small whiteboard, pen and paper, basic communication board, or other visual communication tool in the first aid supplies. Now the scenario tests whether staff can recognize a communication barrier and adapt rather than simply continuing to speak louder.

5. Create an AAC Communication Setup

This can be extremely inexpensive. Print and laminate a basic communication board containing words, symbols, or pictures relevant to first aid: yes, no, pain, head, neck, chest, stomach, breathe, medication, caregiver, ambulance, hospital, stop, help, hot, cold, and other concepts relevant to your operation.

For a higher-tech simulation, place the board on an old tablet or phone that is no longer being used operationally. During the scenario, tell the person playing the patron that they cannot answer verbally and must communicate through the board or device.

That changes the responder's job immediately. They have to allow time for a response, pay attention to how the person communicates, and resist the temptation to direct every question toward someone standing nearby.

6. Add Modest or Religious Clothing

You don't need a specialized manikin to expose responders to different types of clothing. Build a scenario clothing bin.

Include:

• long-sleeved athletic shirts

• loose pants

• swim leggings

• swim skirts

• head coverings

• rash guards

• oversized shirts

• multiple clothing layers

• other garments responders may encounter

The goal should never be teaching staff that religious or modest clothing is itself an obstacle. Instead, give them experience providing care when a person is wearing more than a traditional swimsuit. Ask staff to determine what actually needs to be moved or removed to provide necessary care and what can remain in place. This is a good place to discuss dignity as well. Emergency care may require exposure, but that does not mean unnecessary exposure.

7. Create Different Skin Presentations for First Aid Practice

Many first aid resources have historically shown signs and symptoms primarily on lighter skin. Training can intentionally expose staff to more variation. Rather than trying to permanently paint your manikins, create laminated assessment cards using appropriately licensed medical education images showing how relevant conditions or injuries may present across different skin tones. During a scenario, hand the responder the appropriate card when they assess that area of the manikin. For example, instead of telling the lifeguard, “The victim looks pale,” provide a visual clue and ask what they notice.

This turns skin assessment into something staff actually have to observe rather than a memorized phrase an instructor supplies automatically. For this particular training aid, use medically accurate educational resources rather than DIY makeup intended to imitate a particular skin tone since this can be seen as insensitive or offensive.

8. Build a Sensory Support Kit Into Your Scenarios

Create a small sensory kit that lives with your first aid or scenario equipment. It could contain a few cleanable fidgets, sunglasses, ear protection, a small whiteboard, visual choice cards, and other simple communication or sensory tools your organization has determined are appropriate. Then actually use them.

During a scenario, have the person receiving care become increasingly overwhelmed by noise, touch, multiple people talking, or the surrounding crowd. See whether staff recognize that reducing unnecessary stimulation may help. The solution should not automatically be handing someone a fidget.

Staff should practice asking what would help when possible and changing the environment itself.

• Can unnecessary responders move away?

• Can one person communicate instead of four?

• Can the person be moved somewhere quieter if their medical condition and emergency procedures allow it?

That is much more realistic than simply telling staff that sensory differences exist.

9. Make Medical Alert Jewelry

Medical alert jewelry is incredibly easy to incorporate into training and just as easy for responders to miss.

Use:

• inexpensive bracelets

• silicone wristbands

• dog-tag-style necklaces

• laminated tags

Label them with simulated information such as “DIABETES,” “SEIZURE DISORDER,” “ALLERGY,” or another condition relevant to the scenario. Don't tell staff it is there. See whether anyone notices during the assessment.

This gives you a great post-practice question: What information did you gather from the person and their surroundings, and what did you miss?

The tag should provide information, not turn the scenario into a diagnosis guessing game. Staff still need to assess and respond according to their level of training.

10. Add Mobility Equipment to the Scene

Not every realistic modification needs to be physically attached to the manikin. Place a wheelchair, walker, cane, crutches, or another mobility aid next to the person in the scenario. If you don't have access to the actual equipment, create a scenario card identifying what the person uses. Then think beyond the immediate rescue.

• What happens to the mobility equipment if the person is transported?

• Does it need to remain nearby?

• Is the route being used by responders accessible?

• Where can EMS enter?

• Does the facility's emergency plan assume everyone can independently walk out of the building?

This kind of scenario can uncover facility problems rather than lifeguard problems, which is exactly why it is worth running.

11. Make a Low-Tech Language Kit

You do not need every lifeguard to speak five languages to make communication training more realistic. Create laminated cards containing a small number of emergency phrases in languages commonly encountered in your community, along with simple visual symbols. Include information about how employees access whatever interpreter or translation resources your organization has approved.

Then introduce a language difference into a normal first aid scenario. The important part comes after the scenario.

• Did staff know the resource existed?

• Could they find it quickly?

• Was it actually useful?

• Did they attempt other appropriate forms of communication?

• Did anyone assume the person understood nothing simply because they did not understand English?

  
  

You may discover that the translation resource listed in your emergency plan isn't particularly useful when someone actually tries to access it from the pool deck. That's useful information.

12. Create a Caregiver Role Card

This one costs almost nothing. Make scenario cards for the person playing the caregiver.

One card might say: “You know how the participant communicates. Offer information only when staff ask.” Another might say: “You are extremely anxious and keep interrupting responders.” Another could say: “The participant can communicate independently, but you keep answering questions for them.” A fourth might instruct the caregiver to explain a medical device staff do not recognize. Now responders have to determine how to use caregiver knowledge without automatically talking around the person receiving care.

That is a very real skill.

Build a DIY Inclusive Scenario Box

Once you've made several of these items, keep them together.

Your box could contain:

• DIY breast forms and training bras

• a simulated insulin pump

• an ostomy pouch

• medical alert jewelry

• a hearing-device prop

• laminated AAC boards

• whiteboards and markers

• sensory tools

• modest clothing options

• language resources

• caregiver role cards

• visual assessment cards

Then instructors can grab one or two variables and add them to an otherwise ordinary scenario. You don't need to make every scenario an elaborate exercise involving six different identities, three medical devices, a language barrier, and an angry caregiver. That stops being realistic and starts becoming a game of “what bizarre thing will the instructor throw at us today?” One variable can be enough. Run the same unconscious-person scenario staff have practiced before, except this time the person has breasts. Run it again next month with an insulin pump visible on the abdomen. During another practice, the person uses a hearing aid and communication becomes part of the challenge. Later, add an anxious caregiver. Small changes create repeated exposure without making someone's identity or disability the “problem” staff are expected to solve.

Don't Teach Lifeguards to Become Medical-Device Experts

There is an important boundary to all of this. The purpose of putting an ostomy appliance, insulin pump, hearing device, mobility equipment, or other medical device into a scenario is not to teach lifeguards how to operate, remove, repair, or manage equipment outside their training and protocols. Quite the opposite. We want staff to become comfortable encountering something they don't recognize without assuming they need to do something to it. Teach them to assess the person, provide care within their training, avoid unnecessarily disturbing medical equipment, communicate with a responsive person when possible, use caregivers appropriately, and get additional medical assistance when indicated. Sometimes the correct response to an unfamiliar medical device is simply recognizing that it exists and continuing to take care of the person.

Don't Make Difference the Emergency

There is another trap worth avoiding when developing inclusive scenarios. If every scenario involving a disabled person is complicated because of their disability, every transgender patron scenario involves conflict, every person speaking another language creates a communication disaster, and every medical device becomes a major emergency problem, our training can accidentally reinforce exactly the assumptions we are trying to reduce.

• Sometimes the lifeguard should encounter a woman with an insulin pump who simply slipped and hurt her ankle. The pump isn't the emergency.

• Sometimes the person receiving CPR has breasts. The breasts aren't the emergency.

• Sometimes the child with an AAC device has a bloody nose. The AAC device isn't the emergency.

  
  

That normalcy is part of realistic training too.

The Goal Is Familiarity Before Urgency

You cannot recreate every person a lifeguard might encounter with a manikin and a box of props, nor should you try. The goal is exposure to variation. We want a responder to see an ostomy appliance during an actual emergency and think, “I've seen something like that before,” rather than becoming distracted by it. We want them to know that someone who does not answer verbally may still be communicating. We want breasts, mobility devices, religious clothing, hearing aids, medical equipment, different bodies, and different communication methods to feel like ordinary variations among the people receiving care.

Aquatics already understands the value of simulation. We deliberately practice situations before the stakes are real because familiarity helps people perform when they are under pressure. Inclusive emergency training is not a separate concept. It is simply making sure the people in our practice scenarios look a little more like the people who actually come to our pools.