The art of drowning

DM · 08 January 2003, 19:10

For those of you are going to drown this season, here are a few factoids so you know what is happening.

On average, every year, around 500 people drown in England and Wales, 17 percent in the sea, the rest inland, baths, swimming pools etc. Many are competent swimmers.

Prolonged Immersion Collapse.

When a victim has been immersed for some time, floating vertically, water exerts a pressure on the legs which in turn massages the veins. This maintains an adequate return of venous blood to the heart. When rescued, this pressure is lost and gravity prevents blood returning to the heart causing a sudden drop in blood pressure resulting in a faint or even sudden death. To counter this, lay the victim flat and raise his legs. This is called autotransfusion and returns 2 litres of blood to the core system thereby helping to maintain blood pressure.

More to follow......

Manos · 08 January 2003, 19:22

Very interesting indeed. Post some more

DM · 08 January 2003, 19:24

Immersion into cold water, causes a sharp intake of breath resulting in panic breathing and frequent submersion. Compounded by respiratory distress, compromised buoyancy causes the victim to sink, at the same time, swallowing large volumes of water. In cold water, even strong swimmers may not be able to coordinate breathing and the muscular action of swimming. In these circumstances, water is prevented from entering the lungs by repeated swallowing and laryngeal spasm. This causes a loss of oxygen in the blood. (hypoxaemia) resulting in unconsciousness and eventually death. Water enters the lungs only at the point of death when the larynx relaxes. Drowning can be categorised under five headings.

near drowning
dry drowning
fresh water drowning
salt water drowning
secondary drowning

more to follow.........

DM · 08 January 2003, 19:40

Near Drowning

If a victim is rescued before the point of death, or there is temporary survival, this is described as near drowning.

Dry drowning. (about 10 percent of cases)

As the victim sinks, and unconsciousness deepens, they continue to try and breathe. The impact of the incoming water stimulates the reflex which triggers the larynx and epiglottis to close. With the lungs protected by the epiglottis, water is diverted to the stomach. In most cases of drowning, only one litre of fluid has entered the lungs compared with several litres swallowed.

Fresh water drowning.

A volume of water entering the lungs interferes with the passage of gases between the lungs and bloodstream. This results in haemodilution (Dilution of the blood) and an interference in the acidity(ph) levels of the blood. Under these circumstances, a cardiac arrest may occur 2- 5 minutes after rescue.

more to follow.........

DM · 08 January 2003, 19:53

Salt Water Drowning

This has the opposite effect of fresh water drowning but the same result. Salt water entering the lungs is more solute than blood, therefore water is drawn into the lungs increasing the volume of fluid therein. This, in turn, increases the viscosity of the blood causing sluggish circulation which slows the heart rate to the point of cardiac arrest. This may occur up to 12 minutes after rescue.

Secondary Drowning

Where a drowning victim has been successfully rescued/resuscitated, they may appear to be fully recovered. However, if water has entered the body, rapid absorption will take place, from the stomach into the blood stream, distorting the ph balance of the blood. Death could occur up to 72 hours later. In the case of salt water, residual water in the lungs draws fluid from the blood stream causing pulmonary oedema (shocked lung syndrome) This may occur many hours after rescue.

more to follow.......

Manos · 08 January 2003, 19:56

Hope you don't mind me copying and saving your thread about drowning. Is good reading.

DM · 08 January 2003, 20:02

Mammalian Diving Reflex.

This reflex is little understood and is particularly active in the very young. If a victim is plunged into cold/icy water face first, the result is a near total shutdown of the respiratory, circulatory and nervous systems to a point of suspended animation or apparent death. Victims of this phenomena have been known to recover after 38 minutes submerged and sixteen hours of resuscitation. The moral of this is to never give up resuscitating a drowning victim no matter how dead they look.

more to follow.......

narked · 08 January 2003, 20:07

Freedivers make use of the diving reflex. The reflex does not take effect instantly, so you may need to spend some time in the water before it kicks in, but it helps to reduce your heart rate amongst other things, making the air in your lungs last slightly longer. But as said, not much is known about it's true nature.

Matt

Manos · 08 January 2003, 20:11

I'm following this bit by bit LOLOL

DM · 08 January 2003, 20:19

The Management of Drowning victims.

Ensure an open airway. Commence CPR, checking for pulses in two places, especially if hypothermia is present
To prevent the risk of post immersion collapse, lift the victim from the water horizontally if possible. Place the victim head down, feet raised and do not allow them to walk. Consider the possibility of spinal trauma.

DO NOT....

apply direct heat to a hypothermia victim, wrap in a space or hypothermia blanket. After prolonged immersion, warming should be a gradual process, however, if immersion was for a short period and the body's core temperature is unaffected, rewarming is less critical and can be carried out quicker.
Hypothermia must be considered in all cases of immersion in cold water. This is a serious complication of drowning which can mimic signs of cardiac arrest e.g. dilated pupils, imperceptible pulse and respirations

more to follow........

Manos · 08 January 2003, 20:22

I'll make a short copy of this laminate it and put it on my RIB as have done for SOS instructions. You never know when you may need it. All this is very good info!!

Charles · 08 January 2003, 20:36

Bloody morbid stuff, but interesting and helpful nonetheless.

DM · 08 January 2003, 20:40

Clinical signs of hypothermia.

Very slow pulse, 40 or less, may be imperceptible
Skin icecold to touch
Pale in colour, cyanosis(blueness) of extremities(lips, earlobes, fingertips etc.)
Widely dilated pupils, slow to react to light.
Slow shallow breathing. Blurring of vision
Irrational behaviour or speech
Gradual loss of consciousness.

Management of Hypothermia.

Ensure open airway. Wrap victim to prevent further heat loss. Allow body to recover gradually. Give hot drink only if the victim is conscious and uninjured. Before commencing CPR in a drowning victim, take the greatest care in taking a pulse. If there is a faint heart beat present, chest compressions will initiate a heart rythym called ventricular fibrillation which needs to be corrected by a defibrillator.

Do Not

give alcohol. strip clothing unless wet, make the victim move . apply external heat.

Thats it for now but if anyone has any queries on this, let me know.

David

Manos · 08 January 2003, 21:15

I've been reading the stuff. Is very informative. Are you a doctor or what?? LOLOL

Will have you on my boat any time. I will also have Flanker (if he's allowed back) LOLOL - ever??

matiboy · 08 January 2003, 22:26

that in this case lets go for the prevention and not the cure !

I remember when I was in my teens doing the dinghy sailing open meetings year round, (aprox 20 years ago), before the days of dry suits and wetsuits in the dinghy world

I was always concerned when it blew a hooly that I would end up in the brinny one cold day, generally if you capsized you could clamber on the top of the hull and try and right it without getting to wet

well it had to happen, took a dip one cold winters day, the shock is something you cannot control, you just have to rely on your buoyancy aid, it would be impossible to swim as you simply pant and gasp uncontrollably until the initial shock is over, very scary

this is why so many people come a cropper jumping into water even on a hot summers day , because of the shock

wear a dry suit or even better dont fall in !!!

crazyhorse · 08 January 2003, 22:59

Well very morbid but true,I thought dry drowning was after you have been recovered,and with sea water in your lungs it can grow a flem sort of substance that can coat the lungs.?I heard a story about a guy who died of dry drowning 1 wk later when he refused to go to hospital after a submerging and he felt ok although he took in some sea water, a wk later at home with his son he shot a football , he dives for it and the Plazma/Fungi stuff coated his lungs and he suffocated becouse of it.

The other thing I have been told is if you have to go in the brineee and have no choice and are going to jump from a height,then cup your nose between finger and thumb tightley,as you hit the water your body will try and breath in and if you can live for more that 40seconds your chances of survival go up 20 fold.Any preparatory you can do to let your body know it going to be cold like rinsing your head and other areas will help significantly,when you hit the drink.

Great topic.

Crazyhorse

Manos · 08 January 2003, 23:08

A small story. I was in Plymouth last year BSc degree waiting for the results in the summer (end of June) some 20 years ago.
My wife (girlfriend then) and my self decided to get a small SIB I had and venture it to Whitesand Bay (hope spelling is OK) any way, the day was VERY WARM (it was one of the warmest summers in the UK), the sea was flat as a miror all the way and when we approached the bay it looked like Greece. It looked fantastic!! There were a lot of people jumping in and out of the water and after we anchored offshore our SIB (very proud we were for the little thing) I decided to jump (dive) into the water contrary to what my wife was saying. So, as soon as I heat it I felt like I was fainting, a feeling to breath overcome my will and there I was a few mins (possibly I was anconsious) later lying on the beach with a croud of people on top of me. It sea was FREEZING and the outside temp was about 30 deg C.
What you both say is absolutely spot on. And what David did here is very hellpful.
Have a good night 01:00 am in Greece right now.

crazyhorse · 08 January 2003, 23:13

And you Manos and david and anybody else as crazy as us Goodnight.

Daniel · 09 January 2003, 00:21

Very informative david - thanks.

Just to add my 'story' i once jumped into a Tarn (mountain lake) @ 2000 ft in the lake district when camping up there. Seemed like a good way to wake myself up and have a wash - very, very, nearly drowned with the symptoms you describe here - uncontroable panting type breating, muscle spasams, panic etc. etc.

Anyway, i'm still here, amusingly some of this is on video and none of the group realised the problem and thought i was messing about!

Good night all!

Mike Garside · 09 January 2003, 06:02

Yup, it's almost a year ago today that I made the most inexscusable cock-up. Escaped by the skin of my teeth with, if it hadn't been so white, a face red with embarrassment.

Please forgive me, this is a long post, but if you read it and after having a good laugh, don't ever do what I did, the tale might have served a useful purpose.

I was working on Magellan Alpha, putting her to bed on her mooring in the Percuil River outside Falmouth. We were off on holiday and I was just making sure all was secure before we went. It was blowing a gale - F8 - in the Carrick Roads and there was nobody out on the water at all.

When I had finished my check list I hopped back into my Avon Redcrest tender and started the little Yamaha Malta outboard and set off back to the shore 200 yards away. I was wearing oilies but not a lifejacket and I had a rucksac on my back. I was also sitting on the leeward side of the SIB as spray was coming like mad over the windward side.

The inevitable happened. The wind got under the boat and over we flipped. The shock of the icy water totally took my breath away but I grabbed onto the upturned SIB and got a grip of my senses quite quickly. I was more concerned that nobody had seen me do such a stupid thing than I was worried about my situation.

I got in position to flip back the SIB and as I did it the wind took it and blew it away. I hadn't tied the painter to my wrist, I couldn't believe it. I quickly pulled off my rucksac, boots and jacket and set off swimming after the tender. I am a strong swimmer but I quickly realised that the cold was overcoming me and I was losing contact with the little craft.

At that point, with the cold fast sapping my energy, I said to myself, "Garside you have finally made the ultimate cock-up. You are going to drown. For a two-time circumnavigator, you are a total waste of rations!"

Luckily I spotted one of the very few mooring buoys still in the river close by and I swam to that and grabbed it. Then I saw a few more and was just working out my route to shore from buoy to buoy when I realised I was losing the plot. I did the only thing left I could think of. I yelled out "HEEEEELLLPPP".

At that moment, incredibly, I saw a guy running down to the water's edge and launching a row boat. He was with me in a few minutes and I shot out of the water and over the stern. I was so full of adrenaline then that I then felt no cold and we even managed to row to the far shore where we recovered the tender and on the way back even found my jacket, boots and rucksac floating together where I had capsized. The tide was ebbing fast but the SW'ly gale had kept them in one place.

I suffered no after effects other than injured pride. But I learned three lessons...

1 Always, however, good a swimmer you are, wear a life jacket. Something in all my years at sea I have never done.
2 Do not sit on the leeward side of a small boat if there is any chance at all it might capsize.
3 Make sure you tie the SIB to yourself if righting it in a gale!

As I said, I am a strong swimmer, but that day I pushed my luck to far. I'm 58 now. In a few more years I may not be quite so lucky; I certainly won't be as resiliant.

And, believe me, drowning is no way to go.