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Injury Prevention
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Surf First Aid
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DROWNING PREVENTION
Unintentional drowning is estimated to claim the lives of 295,000 people per year around the world. Surfers represent an important category of bystander rescuers reducing fatal drowning along the coast on both unpatrolled and patrolled beaches
Multiple studies have shown that Surfers likely will get exposed to rescue of Drowning victim, therefore it essential we are prepared.
The mortality rate of Surfers themselves seems to be relatively low in comparison to other ocean activities, though among surfing fatalities drowning is the primary cause.
Key Topics
What is the most common cause of drowning in surfers?
A recent mortality study from Australia shows Drowning is primary cause with cardiac disease following mainly in older surfer age +55. Among 155 fatalities over time period of 16 years, an estimated of 60% had primary drowning as cause of death.
Medical events as epilepsy, heart attacks and rhythm disorders, intoxication, lightning strike, head injuries with loss of consciousness are possible causes of drowning incidents among surfers. Anecdotal, events where leashes get stuck in reef/rocks have been described, leading to fatal and non-fatal drowning.
What are risk factors of drowning for surfers?
The most important risk factor is being in an environment beyond your skill level. It is imperative to have a good understanding of your own limitations, taking into account your level of fitness, surfing capacity and ocean skills.
The same study as previous mentioned, indentified fatal incidents during rising and low tide periods. Older surfers and those who lived 50km or more from the coast, had higher exposure-adjusted mortality rates than younger surfers and those residing closer to the coast.
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 such 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 becoming a drowning victim.
How should you approach the unconscious victim (Beach Setting)?
Approach safely and get professional help as soon as you think someone is unconscious. (call emergency services). After approaching the unconscious person or pulling him/her into a safe location attempt to arouse the victim. If he/she does not respond, assess if the victim is breathing by looking at the chest for movement and listening for air movement. If breathing, put the victim in the recovery position. Wait for help and be sure that they can easily find you.
If NOT breathing: call emergency services, request AED and tell them you have a victim that is not breathing.
Start CPR. Attached AED. 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.
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 or lifeguards 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 lack of Oxygen of the victim. Retrieve the victim in a safe manner to the beach and start resuscitation as above.
A study from Brazil demonstrated in-water ventilation favouring outcome for drowning victim, focusing on early reversal of hypoxic state. The PUMP (heart) is working but tank is empty – early restoration of Oxygenation is essential.
Recent guidance of ILFS suggest to start in the unconcious victim with no evidence of breathing effort, to start 10 rescue breaths in-water if you trained to do so.
Rescue breaths in water are extremely challenging, keep patient’s head out of water (e.g flotation surf board), consider covering mouth – ventilation given over nose. Rescue breath should be given over 1 second with sufficient volume to produce chest rise.
If due ocean condition or rescuer no capacity/skill to provide rescue breaths, retrieve immediately to shore to initiate algorhytm including start 5 rescue breaths.
How should you approach a conscious adult ?
If encountered on the beach, approach safely, be aware of shore break / incoming tide. Call for help and contact emergency services.
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.
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 emergency services.
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 resolve within minutes you should seriously consider a doctors consult. When you have aspirated water in your lungs, deterioration can occur, most often 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.
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/
Surf Healthy
Injury Prevention
The professional clinical team of medical doctors and physical therapists of Surfing Medicine International have collected best clinical evidence on injury prevention exercises that will help you to optimize your warm-up before a surf session.
You will get stronger, become more flexible, improve your breathing technique, and prevent common surfing injuries related to chronic overuse and muscular imbalance.
Surfers perform a large number of repetitive movements, using core and upper as well as lower body muscle power. Almost 1/3 of all surfers will suffer from an injury each year: most of those injuries will be related to paddling, wave riding, and miscellaneous activities like duck-diving, wading and swimming takes.
A good warm-up will help you to prepare the body both physically and mentally for what’s to come and help prevent injuries. Injury prevention exercise training and load management will reduce your risk of injury and help you perform better.
The injury prevention training consists of 3 levels. The first level exercises are focused on warming up and training purposes when training facilities are not available. You can do the quick version of level 1 before your surf session, right at the beach. Or you can use the level 1 exercises for training. Levels 2 and 3 are designed for more intense training of surf specific characteristics: mobility, stability, strength, breath control.
Download your PDFs on Surfing Injury Prevention for free:
While following the injury prevention program, focus on your technique first before you progress to heavier exercises. Make sure you put emphasis on what your body needs (Mobility? Stability? Strength?) and feel free to combine exercises of all levels. If you have questions or requests on this programme, please get in touch with us using the contact form at the bottom of this page.
Q & A
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Risk Assessment in Surfing
Risk assessment before going into the water
- Before getting into the water, let someone know! Ideally, you should always go surfing with a partner, especially if you are not a very experienced surfer. But this isn’t always possible, in which case make sure you tell someone that you’re going surfing, including the location and the time you expect to be back.
- When choosing a surf spot, make sure to inform yourself about the local weather and surf forecast and before paddling out, give yourself some time while standing on the shore to observe the current conditions. Be honest with yourself regarding the suitability of the conditions for your skill level.
- Factors you should consider include, but are not limited to: familiarity with the surf spot, especially with regards to possible local hazards (e.g. potentially dangerous rock formations, shallow reef, occurring rips), suitability of your equipment (board, leash and wetsuit) for sea and weather conditions, compatibility of your surfing skill level AND fitness for the wave conditions, time of day (how much daylight is left), UV exposure and sufficiency of current UV protection, etc.
- Also, when surfing at an unfamiliar spot, asking locals about surfing conditions and potential hazards can give you a big heads up and make your surf experience safer and a lot more fun.
- These simple steps may seem trivial, but constitute basic measures of precaution you can take before going surfing.
Risk assessment while in the water
- The best surfer in the water is the one having the most fun AND keeping safe!
- Sea and wave conditions can rapidly change, so make sure you stay observant of your surroundings during your session.
- Things you should be looking out for include, but are not limited to: constantly changing tide levels and the possible exposure of low lying sea bed e.g. reef and rocks, changing daylight levels, rapid change in size or power of waves, rip tides and currents, surrounding fellow surfers and their skill levels (do you trust them to behave safely around you?!), marine threats (jellyfish, urchins, men in grey suits), and remember to also assess yourself, especially regarding your own personal health and well-being – How are you feeling? Are you having fun? Are you feeling tired or fatigued? How long since you last had something to eat and drink? Are your muscles starting to cramp up? Could you be suffering from low blood sugar, dehydration, hypo- or hyperthermia? Do you feel safe?
- We all love pushing ourselves to our limits, but unnecessary, avoidable accidents can overshadow even the perfect surf day, so it is therefore important to know when you’ve had enough and consequently head back to shore, when the current conditions start to make you feel unsafe.
Emergency plan for an accident during the session
- Hopefully you will never need to use an emergency plan, but it is very important to have one ready at hand. It goes without saying that an emergency plan should be organised before entering the water and that various precautionary measures should therefore be taken in advance.
- Things you might want to incorporate in your emergency plan include, but are not limited to: Someone knows where and when you are going surfing at all times, you have identified the best way to exit the water safely by yourself or while helping someone else, you know how to perform basic CPR (ideally you have already mastered and internalized the BSLS (Basic Surf Life Support) and/or ASLS (Advanced Surf Life Support) course J), you have a first aid kit nearby, you have a phone handy, you know the local emergency contact numbers and the location to the nearest hospital.
Didn’t find the question or answer you were looking for? Now is your time: ask your question!
Surf First Aid
Wherever you go.
The SURF FIRST AID app was specifically developed to help surfers and watersports enthusiasts keep themselves and others healthy and safe. We believe that nobody should die in conditions where prevention and first aid could have been the difference between life and death. That is why you can get this app for free.
The app gives every waterman and woman the possibility to learn about different aspects of surf-relevant first aid and safety topics, take multiple quizzes and learn on the go, and provide rapid access to local emergency numbers around the globe for the travelling surfer.
We want to build a strong global community of surfing first responders, ultimately making the ocean, beaches and reefs worldwide a safer place for everyone.
Together we can achieve this goal!
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