1. Lesson 16: Submersion Incidents Emergency Reference Guide p. 70-75

2. Objectives Describe general sequence of events during drowning Describe safest & most efficient means of removing submersion victim Describe emergency treatment & 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 & 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 & struggles while holding breath Heart rate speeds up, blood pressure rises Involuntary swallowing of water common. Drive to breath overwhelms the person & he/she breathes in water

6. How Submersion Leads to Death (cont’d.) 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? Ensure at least one qualified, responsible adult is trained in water related emergencies Swim only in safe areas (check area first) Know how to swim & have appropriate level of fitness Never swim alone For boating activities, wear appropriate approved life jackets (PFDs)

8. Preventing Submersion Incidents (cont’d.) Wear an appropriate & properly fitting helmet for whitewater boating, water skiing, etc. Do not dive into shallow water All water entry feet should be first, unless water is > 7 feet deep & 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

9. Recognizing a Submersion Emergency Timely recognition is key. The way a person behaves in water is your best clue –The manner in which he/she is breathing –Position of the body –How the person uses arms & legs –Ability to make progress in water

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

11. Recognizing a Submersion Emergency (cont’d.) “Passive” Drowning Victim –Not breathing –No arm or leg motion –Horizontal, or vertical, could be face down or submerged –No forward progress

12. Reach, Throw, Row, Go Attempting to save drowning victim requires training & 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.

13. Reach, Throw, Row, Go (cont’d.) Reach with arm, paddle, or pole Throw, rope, buoy, life preserver Row out to victim & reach to help Go (swim) only, if you are excellent swimmer & have training in water rescue. Don’t allow one victim to become 2!!!

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

15. Activity Using your backpacks, assemble material that could be used to help save someone who is in the water about 25 feet from land Practice attaching a buoyant object to a piece of rope. Practice throwing it to someone who is 25 feet from the shoreline Throw the rope beyond the person without directly hitting him/her

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

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

18. Guidelines for Evacuation Aspiration (sucking water into the lungs) 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,” the after effect of water entering lungs, may take several days to develop

19. Questions??? What else could you add to your First Aid Kit?