Drowning

FREQUENTLY ASKED QUESTIONS ON DROWNING & SURFING

1. What is the most common cause of drowning in surfers?

We do not know the exact answer as there are very limited studies conducted around drowning incidents among Surfers. SMI is currently participating in a large research project around Surfing Fatalities in Australia, more data to be released in coming year. Medical events as epilepsy, heart attacks and rhythm disorders, intoxication, lightening strike, head injuries with loss of consciousness are possible causes of drowning incidents among surfers. Anecdotal, events where leg ropes get stuck in reef/rocks have been described, leading to fatal and non fatal drowning.

2. What are risk factors of drowning for surfers?

The most important is a good understanding of your own limitations, taking in account your level of fitness, surfing capacity and ocean skills. Make a risk assessment of the circumstances (look after your equipment, the weather, rips, sea floor, water temperature, surfing with a buddy, surfing on a lifeguarded beach). Medical conditions as epilepsy, heart rhythm disorders, brittle asthma and diabetes may predispose individuals to drowning. Avoid any alcohol or drugs, given this provides a significant risk to become a drowning victim.

3. How should you approach the unconscious victim (Beach Setting)?

Approach safely and get professional help as soon as you think somone is unconcious. (call 112 or your national ambulance number). After approaching the unconcious person or pulling him/her into a safe location try to ask a question “how are you doing?”, if he/she does not answer, gently shake both shoulders. If he/she does not respond, asses if the victim is breathing by looking to the chest for movement and listening for air movement. If breathing: put the victim in the recovery position and support his breathing.(only do this if it is safe for you), wait for help and be sure that they can easily find you.

If NOT breathing: call 112/ambulance and tell them you have a victim that is not breathing.

Start CPR. If you are trained start with 5 ventilations and hereafter continue with 30 compressions, 5-6cm deep, at a rate of 100-120 compressions/min, hereafter continue with 2 ventilations and continue the alternating compressions: ventilations at 30:2 ratio until professional help arrives.

The current COVID-19 Pandemic provides a challenge around providing rescue breaths – ideally you want to have a family member/same person bubble to provide ventilation to reduce risk of transmission. If you are not a family member we advise you to follow the guidelines of your country on ventilations.

Further reading on the risks of ventilations and proposed strategy in drowning victims in the era of COVID-19 can be found here: https://www.ilsf.org/2020/06/05/idra-ils-imrf-joint-position-statement-resuscitation-of-the-drowned-person-in-the-era-of-covid-19-disease/

Download the Surf First Aid App – to practice Drowning Resuscitation of the Surfer

How should you approach the unconscious victim (in water setting)?

Surfers get frequently exposed to drowning victims in surf, this can put you in challenging scenarios. Unique situations occur when surfing reef / points / offshore breaks – there is no quick paddle to the beach. GET HELP, signal to beach and get help from surfers in lineup! FIRST of ALL your own safety should be central, get help first from other surfers with the large flotation SUP/Longboard if around. The main objective is to get the drowning victim out of the impact zone into the channel providing flotation, if trained so providing rescue breaths to reverse the drowning process. REVERSE the lack of Oxygen of the victim. Retrieve the victim in a safe manner to the beach and start resuscitation as find above.

Shortboard Rescue – Unconscious victim

4. How should you approach a conscious adult ?

If encounter on beach, approach safely, be aware of shore break / incoming tide. Call for help. (lifeguard and/or 112).

Support their breathing by putting them in a comfortable position (tripod if fully awake), or recovery position if exhausted. Having the chest upright makes it usually easier to breathe for a person that is in distress.

If in the water, always GET Help from line up and signal to beach, Surfer’s condition may deteriorate if underlying medical event or due injuries sustained during the drowning incident. Start with ensuring he/she is safe, provide flotation, guide out of impact zone and retrieve to beach for assessment.

5. When do you have to worry after swallowing or aspirating (sea)water?

If you have more complaints then you would after just having a zip of water in your throat (simple cough that passes within a minute) you might develop shortness of breath because of drowning. If the Surfer keeps coughing, or is extremely short of breath, coughs up foam or blood, or loses consciousness: the victim will need urgent medical care, when hesitating call 112.

6. When do you need to get checked by a doctor after a drowning incident?

When you have experienced a drowning incident and have complaints that do not direcly resolve within minutes you should seriously consider a doctors consult. When you have aspirated water in your lungs, deterioration can occur untill 4-8 hours after the drowning incident. This is why you want to be in the hospital to observe the amount of oxygen in your blood and other vital signs such as heartrate, blood pressure and temperature.

7. What is the definition of drowning?

The international standardized definition by the World Health Organization: Drowning is the process of experiencing respiratory impairment from submersion/immersion in liquid. Drowning outcomes are classified as death, morbidity and no morbidity. Agreed terminology is essential to describe the problem and to allow effective comparisons of drowning trends. Thus, this definition of drowning adopted by the 2002 World Congress on Drowning should be widely used. https://www.who.int/violence_injury_prevention/other_injury/drowning/en/

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