Drowning versus Aquatic Distress by Crunderwood

So inspired by my near drowning this morning and subsequent discharge from hospital, I present to you all…

Drowning versus Aquatic Distress

or

Why Drowning doesn’t look like “Drowning”

Also the science of drowning

Picture this scene: you are standing at the side of a swimming pool and in front of you there are two people in the water. The first is a lady, calling for help, thrashing her arms above her head in visible distress; she needs help and she wants you to come and save her.

The second is another lady; she appears much calmer than the first, her arms are out laterally, pressing down on the water in order to keep afloat. She isn’t calling for help.

Did you realise the second lady only has between 20 and 60 seconds left afloat before she sinks below the surface? She is drowning.

So why does she not meet your expectations of drowning? Well the answer can be summed up in 1 simple word: Television. Due to innumerable television shows and films in which people “drown”, many people are able to recognise the signs of aquatic distress, however they misattribute them to drowning.

So what are the visual clues to drowning?

People who are drowning undergo a physiological response called the Instinctive Drowning Response. There are five main things to look out for in a potential drowning victim:

1. “Except in rare circumstances, drowning people are physiologically unable to call out for help. The respiratory system was designed for breathing. Speech is the secondary or overlaid function. Breathing must be fulfilled before speech occurs.

2. Drowning people’s mouths alternately sink below and reappear above the surface of the water. The mouths of drowning people are not above the surface of the water long enough for them to exhale, inhale, and call out for help. When the drowning people’s mouths are above the surface, they exhale and inhale quickly as their mouths start to sink below the surface of the water.

3. Drowning people cannot wave for help. Nature instinctively forces them to extend their arms laterally and press down on the water’s surface. Pressing down on the surface of the water permits drowning people to leverage their bodies so they can lift their mouths out of the water to breathe.

4. Throughout the Instinctive Drowning Response, drowning people cannot voluntarily control their arm movements. Physiologically, drowning people who are struggling on the surface of the water cannot stop drowning and perform voluntary movements such as waving for help, moving toward a rescuer, or reaching out for a piece of rescue equipment.

5. From beginning to end of the Instinctive Drowning Response people’s bodies remain upright in the water, with no evidence of a supporting kick. Unless rescued by a trained lifeguard, these drowning people can only struggle on the surface of the water from 20 to 60 seconds before submersion occurs.”

So what, then, is Aquatic Distress?

Simply put, aquatic distress is when a person who is not drowning who requires help. They have the mental capacity to realise this and the lung capacity to call for help. One obvious difference between an Aquatic Distress victim and a Drowning victim lies with the ability to help save themselves:
Someone who is experiences Aquatic Distress is able to grab onto ropes, lifebelts and ladders whereas a drowning victim cannot.

The Science of Drowning

As the airways begin to be covered in water, the normal person hold their breath. There is, however, only so long you can hold your breath for before you experience oxygen deprivation: if you are in distress (as you would be) this may be only 30 seconds from when you start holding your breath. Your need for oxygen overrules your conscious knowledge of the water and you start to gasp. You are now drowning.

Your head bobs up and down; covering and uncovering your mouth, however you do not have sufficient time to exhale the water, inhale air then call out before your head drops again. You are aware of your distress however once your lungs have completely exhaled all air, it becomes quite relaxing; like normal breathing however with slightly more resistance.

If your lungs fill with salt water and you are rescued, as long as the water is expelled in sufficient time, you will not generally suffer any long term effects. This is due to the concentration difference between your cells and the saltwater preventing water entering your system. Out with sufficient time, your blood begins to lose water through osmosis, your blood becomes thicker and, once thick enough, can lead to cardiac arrest within 8 minutes.

Freshwater, however, is much more serious. Due to the relatively low concentrations of water in your lung cells, water floods into them the moment it is inside your lungs, rupturing the tissues of the lungs. If the water is expelled, your lungs could then fill with blood resulting in secondary drowning. Water also enters your bloodstream through the exposed capillaries within the lungs. Blood cells begin to burst, upsetting the ion balance. Ventricular fibrillation begins to occur and cardiac arrest follows a mere 22 minutes water. Even if you survive the first few minutes of a fresh water Drowning, you could experience acute renal failure due to the high levels of iron in your blood due to burst blood cells.

Why did I experience near drowning?

We now can include Aquatic Distress into our story about drowning. If you are like me and suffer panic attacks, you may notice that you start to hyperventilate when you have one. Your legs may feel weak and unable to support you. I was standing in the shallow end of a swimming pool with the water barely up to my waist when I had a panic attack. My legs gave out and I began hyperventilating and continued to do so once my mouth went below the surface. Cue drowning. Fortunately, lifeguards at swimming pools are trained to recognise the signs of drowning and were on hand to jump in and pull me out.

What more is there left to say?

If you plan on drowning, aim for saltwater

Sources:
US Coast Guard “On Scene” Magazine (Autumn 2006)
Instinctive Drowning Response, Mario Vittone (May 2010, July 2011)
American Heart Association Guidelines (2010, part 12)

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