The Home Pool
Chapter Five-B~Floats--Instructor





CHAPTER SIX

DROWNING PREVENTION





According to American Red Cross statistics, in the United States each year there are about three drownings for every one hundred thousand persons.That doesn't sound like many but if you divide the total U.S. population by one hundred thousand it comes to about three thousand a year.

The American Red Cross has done much in lowering the number of drownings since 1914 when Commodore Wilbert E. Longfellow first initiated Water Safety courses. At that time the rate had been 10.4 per one hundred thousand. Such a high rate was scandalous considering a far lower populace and fewer people per capita availing themselves of water activities in those days.

Most drownings are preventable if the victim does not become panicked and / or knows how to swim. Drownings caused from blows on the head, heart attacks, seizures or other previous problems that render victims unconscious, although included in these figures, are less frequent.

The ability to swim may save your life, but often people don't realize that even the most experienced swimmer can drown if panicked and chooses a wrong action. Too often we hear the comment, "...and he was such a good swimmer, too," after someone drowns.

Of course, there are foolish acts people do when calm, like the man in a newspaper story who went sailing on a windy day. This was fine except for two mistakes--he didn't wear a life jacket and he had a heavy cast on one leg. As anyone who sails knows, sailboats often tip over. When his boat overturned the man fell out and his cement cast soaked up water, pulling him under. No amount of swimming expertise could have kept him afloat.

Another newspaper account told of a man who didn't know how to swim so underwent hypnosis to learn. Convinced by his "guru" that he could do it, he attempted to swim across a river. Neither man took into account that endurance and body condition determine ability just as much as swimming skill. The man drowned not far from where he had started. The average person is not likely to take such foolish chances. However, all of us are subject to doing something wrong if we become panicked.

THE IMPORTANCE OF RELAXATION

The key to preventing panic is relaxation. When confronted with a problem, breathe deeply and let your body become limp. TRUE STORY: When I was a teenager, a girl I knew and two of her friends drowned in the ocean. They were pretty and popular and their deaths were a terrible shock. Newspaper headlines read: Three Drown at Beach, and then described how four girls on a church outing while frolicking in the surf were swept away by an undertow. Only one of the girls was rescued. Several years later, while chatting with a saleswoman I commented that I liked to swim. The woman asked if I recalled reading about the three girls who had drowned at a local beach a few years back. I said that I did, and that I knew one of them. The woman then mentioned that she was the girl who had been rescued that day. Then she told me something that surprised me--she never knew how to swim! Intrigued, I asked how she survived. She said that the four of them had suddenly and rapidly been pulled out to sea by a strong undertow which can reach speeds up to forty miles an hour. The other three knew how to swim and attempted to reach shore by swimming against the the flow. By the time rescue teams reached them they were so exhausted they couldn't be revived. She explained that she was terrified at first, but since she couldn't swim she knew she was going to drown and there was nothing she could do about it so she simply gave up and prayed. Without putting up a struggle, she let the current sweep her out to sea. When the undertow played itself out she realized that she was floating and slowly moving toward shore. A rescuer spotted her and pulled her to safety. I have always told my pupils, "A relaxed body is a floating body," especially with lungs that are inflated with air.

A TYPICAL DROWNING




A nice area to fish? Or a place of slippery rocks? A pleasant outing whether picnicking or fishing can lead to an unpleasant experience.


The following example is a composite of excerpts from typical drownings and not necessarily from any one event.

Murgatroid is a man in his early twenties. He likes to swim but doesn't have time to devote to the sport. Except for a few summer outings at local rivers and lakes and once or twice a year at a swim facility, he's seldom near large bodies of water.

One hot summer day Murg. and his friends decided to have a barbecue on the banks of the Kanupookie, a small but swiftly moving river. Close to shore the water barely moves and is only about three feet deep so Murg and two other men jump in and toss around a Frisbee. They've eaten some burgers, had a few beers and are ready for some exercise. When Murg smiles at some young ladies who are soaking up rays near the riverbank he misses the Frisbee which lands a few feet behind him in deeper water. No problem for Murg--he can walk to the toy. The depth is now only four feet and he decides to swim because the rocks underfoot are slippery. As he reaches for the Frisbee, it's carried away by the fast current. After futile attempts to retrieve it, Murg decides to head back to the gang. Without realizing it he swam a little too far and now finds himself in the rushing current. Try as he may he's unable to reach shore. Murg is surprised the current is so strong. He's concerned but too embarrassed to call for help. He tries again with more effort to cut through the fast water but can't make any headway. Now, on the verge of panic, he unabashedly yells for help. The sound of rushing water makes it difficult to hear Murg, so his friends think he's just having fun and calling out, "Yee-Haw!"

By now, Murg is gasping as the current carries him faster downstream. He no longer has the strength to battle the icy cold river.

Meanwhile, back at the barbecue, his best friend, Bandy, realizes Murg is in trouble and gets everyone nearby to run along the shoreline to reach him but an overgrowth of bushes makes the bank inaccessible.

Murg goes under but manages to fight his way above the much deeper water. He chokes and is panicked. He can't think. He goes under again and keeps clawing at the water in an effort to reach the surface and get some air. While underwater, Murg chokes again. He can no longer breathe and loses consciousness. By the time his friends manage to find him a few hundred yards downstream, Murg has drowned.

If Murg had known a few simple rules about swimming in rivers it's doubtful he'd have drowned. Let's review the event to show how he could have saved himself after each wrong step, even up to his last attempt.

First, Murg and his buddies had a big picnic lunch and drank several cans of beer. Both large meals and alcohol cause drowsiness. The digestion of food saps energy and alcohol impairs the ability to make good decisions. The men should have waited longer before going into the cold river. Murg would have probably been aware of how far out he had swum had he waited for the alcohol to wear off. He may also have had enough strength to move out of the current had he not eaten a big meal.

It's difficult to determine the strength and speed of a river current simply by looking at it. If an object moves swiftly when thrown atop a current, it should be assumed the water is moving fast and strong. The Frisbee moved too fast for a safe retrieval. The best swimmers are unable to swim five miles an hour and it was obvious the current was moving the Frisbee at a faster rate than that. Murg should not have attempted to retrieve it at all.


SWIMMING AGAINST, OR WITH THE CURRENT?



Where the river bends, debris builds up which can offer troubled swimmers refuge.

When Murg found himself in the fast current should he have tried to overtake it? Many river currents are stronger than the strongest swim stroke and swimming against them only tires a swimmer. It's best to swim WITH the current. Small rivers usually wind, leaving piles of debris at each bend. If Murg had swum with the current he might have been thrown onto a mound of debris where he could await rescue. Larger rivers flow straight for longer distances. Swimming with the current in such a river would help keep Murg from becoming exhausted and he would also be easier to spot. In a wide river, if Murg had moved with the current and veered slightly away from it at an angle, he would have gradually moved into slower water or reached a bend where water depth is shallow and full of debris. In either case he would have saved his energy. He could have floated on his back as well and saved even more energy.

Murg's friends should have driven their car to another clearing downstream and had Murg been swimming with the current, they could have thrown him an empty picnic jug, a tree branch, garbage can or anything floatable for him to grab. If he was too weak to grab anything they could have formed a "human chain" by lining up and holding onto each other's wrists hand by hand and wade out into the river with the end person grabbing Murg as the current brought him downstream.

Murg's body would have remained floatable had he taken a few deep breaths. Instead, he yelled several times, using up precious air. When water went down his windpipe (trachea) he coughed, expelling even more air. Human lungs are an excellent floatation device. Had Murg relaxed and breathed deeply he would have been able keep his head above water or even float on his back. There was no need for Murg to frantically claw at the water to rise above it. His body would have surfaced on its own. Had he not panicked he wouldn't have required as much oxygen and there would be no need to gasp for air the moment he surfaced. Gasping caused water to enter his trachea instead of his esophagus, so he choked, expelling more air. It was the loss of air in Murg's lungs that caused him to sink each time. When his brain wasn't getting enough oxygen, Murg passed out. Soon, he stopped breathing and a few minutes later his heart stopped.

Up until the last time Murg choked he could have saved himself, and up to the time that he stopped breathing he could have been saved with mouth to mouth resuscitation (MTMR). Even after his heart stopped, Murg might have lived had he been given cardiopulmonary resuscitation (CPR). Everyone should know how to administer MTMR and CPR, particularly those who enjoy swimming and other sports.



A typical group found near outdoor water areas who could perform a "human chain" rescue.

PHYSIOLOGICAL FUNCTIONS THAT TAKE PLACE IN DROWNING VICTIMS

What actually takes place inside the body of a drowning victim?

Let's return to Murgatroid. First, he entered extremely cold water. Rivers and lakes are often fed by mountain run-offs from glaciers or snow and can be icy cold. Being in water with very low temperatures for a half hour may deplete up to twice the body's normal supply of oxygen. Hypothermia can occur without realizing it. The mid-stage of hypothermia in water is the inability to use arm and leg muscles. In an effort to keep internal organs warm the body sacrifices use of the extremities. Murg's difficulty in swimming against the current was partly due to cold water. Bucking the current only exacerbated his lowered oxygen level.

When our hero panicked a message was sent from his brain to his adrenal glands to secrete epinephrine, a hormone which increases blood pressure by constricting the vessels. This in turn increases the heart rate, breathing rate and muscular reflexes (flight or fight responses.) Had Murg's heart been weak he could have had heart failure at this point.

Because his muscles and blood vessels were constricted, a small valve in his throat called the epiglottis, failed to function properly. The epiglottis is a valve which prevents air from going into the stomach, and food from getting into the lungs by closing off the trachea when swallowing and the esophagus while breathing. This is why we cannot swallow and breathe at the same time. There are many reasons for the epiglottis to malfunction other than panic, such as a sudden gasp for air, food trapped under the valve, too much alcohol, etc.. Only one drop of water going down the trachea is enough to cause violent coughing. Murg lost air each time he choked and coughed.

When the lungs are not inflated enough to breathe they lose their ability to keep the body afloat. The heaviest boned and muscled people will float at least within a foot or two of the water's surface if their lungs are fully inflated and It would be easy for them to kick up to the surface to breathe. Without fully inflated lungs and exhausted, along with insufficient oxygen to his brain, Murg lost consciousness. The brain uses up more oxygen than any other organ so when there's a sudden drop in the amount of inhaled air it begins shutting down. You may think now, that because Murg is relaxed, though unconscious, his body will float and he will breathe, but the chain of events have become too advanced for revival except from an outside rescue.

Murg's body now goes into a state of shock. Moments before, he was flushed with high heart rate and blood pressure, but in a relaxed state, these vital signs quickly return to normal, then below normal from lack of oxygen and his color becomes ashen. Were Murg to be given oxygen immediately he'd probably survive, but because there is so little oxygen in Murg's blood, his veins and arteries dilate (enlarge). To protect his vital organs Murg's body reacts by keeping blood around them. Blood moves slowly in his dilated vessels and Murg's blood pressure decreases. As a result, blood pools in his abdomen and lungs. Murg's fingernails, toenails and lips turn blue. Without air, his diaphragm can no longer compress his lungs, so his lungs collapse and breathing ceases. Final cause of death by drowning is lack of oxygen, or suffocation.

Years ago it was thought the cause of death from drowning was due to the lungs filling up with water. This was assumed because water pours from the victim's mouth when his chest is compressed, or when rolled over a barrel (as performed in the old days to revive someone.) Usually, there may be none, or very little water found in the lungs of an immediately drowned person. Water pouring from the victim's mouth is from his stomach, not the lungs because victims may often swallow a great amount of water.




How many camp items can you find in this picture that could be tossed to a swimmer in trouble?

The following items will float:
Picnic bench, table, rope, water jug, freezer chest, tree branches. If the swimmer is close to shore you could extend a towel, rope or branch--even the small tent to him.

When throwing, be sure to throw the item slightly upstream of the swimmer so it will float down TO the victim.

WARNING!!!! ONLY TRAINED LIFEGUARDS SHOULD ATTEMPT SWIMMING RESCUES!

Even trained lifeguards make a swimming rescue the LAST option, going by this old rule: THROW, TOW, ROW, GO. If they cannot THROW an item for a victim to grab, they wade out and extend an object for the victim to grasp and TOW the person to safety. If that's not possible they ROW a boat to the person who either holds onto the boat or is pulled into it. If there is no boat, THEN they GO for a swimming rescue.

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There will be more on various types of rescues in a later chapter.

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