1. Lesson 16: Submersion Incidents

2. Objectives Describe general sequence of events during drowning
Describe safest and most efficient means of removing submersion victim
Describe emergency treatment and long term care for drowned patient
Describe when evacuation is necessary
Describe how to prevent submersion incidents

3. Submersion Incidents Overview
Submersion incidents include death and near death from drowning
Drowning one of the most common forms of accidental death
Most submersion incidents are easily preventable
What activities have a drowning risk?

4. Submersion Incidents Overview
Drowning risk activities
Fording streams
Seining for bait
Swimming
Snorkeling
Scuba diving
Surfing
Boating
Backpacking
Ice fishing
Ice skating

5. How Submersion Leads to Death
Non-swimmer can go under in > 1 min, as can hypothermic or injured person
Person panics and struggles while holding breath
Heart rate speeds up, blood pressure rises
Involuntary swallowing of water common. Drive to breath overwhelms person and they breath water

6. How Submersion Leads to Death
Most people experience laryngospasm, involuntary constriction of muscles of upper airway to keep water out of lungs
Laryngospasm leads to asphyxia which is inadequate intake of oxygen
Unconsciousness results
Respiratory arrest, then cardiac arrest
Laryngospasm relaxes, water enters lungs

7. Preventing Submersion Incidents
What steps can be taken to prevent submersion incidents?

8. Preventing Submersion Incidents
Ensure at least one qualified, responsible adult is trained in water related emergencies
Only swim in safe areas (checked)
Know how to swim and have appropriate level of fitness
Never swim alone
For boating activities, wear appropriate approved life jackets

9. Preventing Submersion Incidents
Wear an appropriate and properly fitting helmet for whitewater boating, water skiing, etc
Do not dive into shallow water
All water entry feet first unless water is > 7 feet deep and unobstructed
Do not participate in water activities if under the influence of drugs/alcohol
Exercise care when crossing streams
Do not stand in fast moving water
Limit poor swimmers to shallow water

10. Recognizing a Submersion Emergency
Timely recognition is key. They way person behaves is your best clues
The way they are breathing
Position of the body
How the person uses arms and legs
Ability to make progress in water

11. Recognizing a Submersion Emergency
“Active Drowning Victim:
Struggles for breath
Can’t call for help
Arms to sides, alternately moving up and pressing down, ineffective
Vertical body position
No forward progress

12. Recognizing a Submersion Emergency
“Passive” Drowning Victim
Not breathing
No arm or leg motion
Horizontal, or vertical, could be face down or submerged
No forward progress

13. Reach, Row, Throw, Go
Attempting to save drowning victim requires training and skill
Be sure to know where the rescue equipment is prior to starting activity
Remember to monitor safety of all members of group
Follow reach, throw, row, go guidelines.

14. Reach, Throw, Row, Go Reach with arm, paddle, poll
Throw, rope, buoy, life preserver
Row out to victim and reach to help
Go (Swim) only if you are excellent swimmer and have training in water rescue.
Don’t turn one victim into 2!!!

15. Diving and Spinal Injury
Diving headfirst into shallow water is a major cause of sports related injuries.
If person exhibits signs of spinal injury in water and is breathing, minimize his movement
Have a responder who is trained in water rescue provide inline stabilization
If breathing is absent, provide CPR

16. Activity
From packs, get material that could be used to help save someone 25 feet from land
Practice piecing together a buoyant object and rope, and making a throw out to someone 25 feet away

17. Caring for a Drowned Person
When checking patient look for
Unconciousness
Airway
Breathing
Circulation
Disability
Environmental conditions
If patient is not moving or breathing, begin rescue breathing and CPR

18. Caring for a Drowned Person
If patient has suspected back/neck/head injury, provide inline stablization
May have to be performed in the water. Water rescue course will teach that
Care for shock, hypothermia or other conditions that may arise

19. Guidelines for Evacuation
Aspiration of even small amounts of water requires prompt medical care, even if patient responds to resuscitation
GO FAST for patient that was unconscious, no matter how short a time
GO FAST if any signs of respiratory distress. Problems can become life threatening
Secondary drowning aftereffect of water entering lungs may take several days to develop