19 July, 2010

"Drowning Doesn't Look Like Drowning"

Everyone - whether you have a kid or not - needs to read this:
The new captain jumped from the cockpit, fully dressed, and sprinted through the water. A former lifeguard, he kept his eyes on his victim as he headed straight for the owners who were swimming between their anchored sportfisher and the beach. “I think he thinks you’re drowning,” the husband said to his wife. They had been splashing each other and she had screamed but now they were just standing, neck-deep on the sand bar. “We’re fine, what is he doing?” she asked, a little annoyed. “We’re fine!” the husband yelled, waving him off, but his captain kept swimming hard. ”Move!” he barked as he sprinted between the stunned owners. Directly behind them, not ten feet away, their nine-year-old daughter was drowning. 
I come from Phoenix, where the news keeps a daily count of the children who've drowned, and I still didn't know this stuff.  Read this article.  It will save lives.

There's some literature after the jump for ye, if you want to learn more about drowning behavior and the Instinctive Drowning Response.

The following is from Pia Enterprises, and can be found in their document Reflections on Lifeguard Surveillance Programs:

Drowning Behavior

As mentioned earlier an active drowning person struggles on the surface of the water in a highly predictable, patterned, and to the trained eye, recognizable way. The Instinctive Drowning Response represents a person's attempts to avoid the actual or perceived suffocation in the water. The key concept in understanding a drowning person's behavior is to keep in mind that suffocation in water triggers a constellation of autonomic nervous system responses that result in external, unlearned, instinctive drowning movements.

Research has shown that this response is present wherever active drownings occur ( pools, lakes, beaches, rivers, and waterparks). The reader must keep in mind that the drowning process starts at the point when person are no longer able to keep their mouths above the surface of the water. The aspiration of water which leads to a wet or dry drowning occurs at a later point in the drowning process. It is therefore misleading to tell lifeguards that distress covers all behavior up to the aspiration of water and drowning includes all subsequent behavior.

Characteristics of the Instinctive Drowning Response (IDR)

The following information describes the movements of the Instinctive Drowning Response, explains why certain behaviors are or are not occurring, and offers insights into what physiological processes are prompting drowning persons' movements. The IDR is a group of signs and symptoms which collectively indicate an active drowning is occurring and differentiate it from the characteristics of distress.

The first characteristic of Instinctive Drowning Response is that persons, except in very rare circumstances, are physiologically unable to call out for help. The respiratory system was designed for breathing; speech is the secondary or overlaid function. This means the primary function breathing must be satisfied first, before the secondary function speech can occur. The second reason drowning persons cannot call out for help is their mouths alternately sink below and reappear above the surface of the water. The mouths of drowning persons are not above the surface of the water long enough for them to exhale, inhale, and call out for help.

When the drowning persons' mouths are above the surface, they exhale and inhale quickly as their mouths start to sink below the surface of the water. While their mouths are below the surface of the water drowning persons keeps them tightly closed to avoid swallowing water. The second characteristic of the Instinctive Drowning Response is that drowning persons cannot wave for help. Immediately after drowning persons begins gasping for air, they are instinctively forced to extend their arms laterally and begin to press down on the surface of the water with their arms and hands.

This response, over which drowning persons have no voluntary control, renders them unable to wave for help. The arm movements of drowning person's are intended to keep their heads above water so they can continue to breathe. By pressing down on the surface of the water, they lift their mouths out of the water to breathe. The third characteristic of the Instinctive Drowning Response is that drowning persons cannot voluntarily control their arm movements. Physiologically, drowning persons who are struggling on the surface of the water cannot stop drowning and performvoluntary movements such as waving for help, moving toward a rescuer, or reaching out for a piece of rescue equipment.

These actions require a swimming or floating skill, which by using the definition of the term drowning, drowning persons do not have. When a drowning person grabs a rescuer, it is because the rescuer did not give the drowning person enough support to stop the Instinctive Drowning Response. Rather, the rescuer only provided enough support to use either the rescuer or the rescue device as a base of support to grab the lifeguard. In such cases, lifeguards did not give drowning persons enough support to convince them they were no longer suffocating.

The fourth characteristic of the Instinctive Drowning Response is that drowning persons' bodies are perpendicular in the water, and they are not able to move in a horizontal or diagonal direction. Also, there is no evidence of a supporting kick. The fifth characteristic of the Instinctive Drowning Response is that drowning persons struggle on the surface of the water from 20 to 60 seconds. This data was obtained and validated over a 21 year period at Orchard Beach, Bronx , New York where approximately 40,000 rescues, an average of 2,000 per summer occurred.

Observations at Orchard Beach also revealed that drowning persons were often surrounded by patrons who did not realize that a drowning was occurring next to them. It is therefore imperative that new lifeguards be trained to rely on the signs of drowning to begin their rescue procedure and not wait for patrons or more experienced to tell them that a person is drowning. Because manipulation of variables in my observational drowning studies at Orchard Beach were neither ethically nor morally possible, the only way to obtain this data was direct observation of drowning persons during rescues.

This methodology conformed to the qualitative research methods noted by Patton and others. This behavior of drowning persons, originally studied at Orchard Beach in the 1950's and l960's, and then written about in the 1970's has been shown to exist in other areas. The confirmation for this conclusion consists of letters and telephone calls from lifeguards, parents, camp counselors, and park employees who noted that drowning person recognition concepts contained in On Drowning, Drowning: Facts & Myths, and The Reasons People Drown enabled them to identify a drowning person that was surrounded by bathers who did not recognize the Instinctive Drowning Response.

Tip o' the shot glass to Highly Allochthonous.

1 comment:

Chris said...

I can add a personal (and equally chilling) experience to this which anyone taking kids to the beach should absolutely burn into their brains.

When my daughter Morgan was about 5 years old, we were all at a Lake Superior beach in swimsuits. Now although we always kept close eye on our kids, we weren't worried too much about drowning. This is because the water depth was shallow and didn't get up to her head for at least a hundred feet from the water's edge.

Anyway, there she was, NOT EVEN IN the water but standing near the edge, and my attention momentarily strayed. But when I looked back, she was running into the water and at 5 or 6 feet away from shore, lost her balance. Her head QUICKLY slipped beneath the surface - even though she was in water which barely came up to her waist. Incredibly, I was the only one who noticed.

I got up and SPRINTED over to to her. And its a good thing I did. The undertow was pulling her out from shore with a speed and strength you just had to see to believe. I mean - she was REALLY MOVING! If I hadn't gotten to her in time, she would have been pulled out into the lake in seconds. And yes, drowned.

So, parents really need to consider this: even though the water is shallow, if there are waves (and there always are) there is an undertow. And even though the undertow may not be strong enough to pull a fully erect child under, it is likely strong enough to KEEP them under and pull them out towards deeper water if they should lose their balance. And just as importantly, once a child is under - it may be impossible for even an alert parent to locate and reach them in time.

And oh yeah, it IS possible for parents to be a little over-cautious and wind up denying their kids the simple pleasure of going to the beach. But if they are going to be near the water, make sure they are wearing a reasonably effective floatation device (even in shallow water) and keep a sharp eye. Sorry for the length of this comment guys, but this post really hit home...