
Drowning Doesn't Look Like Drowning - msg
http://mariovittone.com/2010/05/154/
======
btilly
To this should be added some information for would-be rescuers of drowning
people.

The instinctive drowning response is a _climbing_ response. What you see are
twin splashes as the person's arms flail wide looking for something to grab on
to. If they find it the automatic response is to grab it, climb up, and stand
on top. The person doing this is panicked and has massively more strength than
you think. If you are swimming and a young child does that to you, you will go
under water. If you panic, you will get the same reflex, and will drown
yourself.

Therefore if you wish to rescue someone who is drowning, you have 4 basic
options.

1\. The most common response is to go to them and try to rescue directly. If
the water is shallow enough that you can stand, letting them climb up you can
be OK. Otherwise this is suicide. Frequently one drowning leads to multiple
others, and this is exactly how they get started.

2\. Keep your distance and hand them something to climb on. They can't see a
pole to grab it, but if they touch, they will climb, which gives them air.

3\. Wait until the drowning person is unconscious. Then go to them and tow
them in. If you can't stand in the water, and don't have anything to do 2)
with, this is recommended.

4\. (For trained people only.) Swim up _behind_ them, grab them from where
they can't grab you, and lift them up to get air. Talk soothingly to them
until they relax, and then tow them in. If they get hold of you, _DIVE_ so
they let go, back off, circle around, and start again.

If you do not have lifeguard training then I strongly recommend against trying
#4. Unless you know how to do the eggbeater you won't know how to hold them
out of water. And if they grab you, you have surprisingly little time to make
the correct response before you are drowning as well.

Oh yes, and another data point. Drowning is the #1 cause of death in toddlers.
It is quiet. It is fast. Beware of the backyard pool.

~~~
gjm11
Someone who may or may not be btilly posted exactly the above to Mario
Vittone's blog, and got a response from Vittone saying, inter alia, "Your four
points contain some good as well as some dangerous advice. There are often too
many variables for lists of possible rescue techniques - but _waiting for
unconsciousness is a very (very) bad idea_."

(Emphasis mine.)

~~~
sliverstorm
It sounds cold, but if you are not a trained professional, they are in deep
water, and you cannot throw them something, you run the very (very) real risk
of having you BOTH drown and die if you try to save them while conscious. In
case you didn't read the article, if they get a hand on you they will climb
you like a tree and have the strength of a million doses of adrenaline.

What solution do you propose instead?

It's not unprecedented either. In CPR training, you are taught the Heimlich.
You are also taught that you have to ask someone who is choking if they want
help (or you will be sued, regardless if you save them). If they say no, they
don't want help, you can either leave them to die, do it anyway and get sued
for all you are worth (don't count on mercy, the law is 1000% against you), or
wait until they pass out and then do it anyway (you are then protected by the
Good Samaritan law)

~~~
rdl
If someone can _say_ no, they do not need the Heimlich -- at worst, they have
a partially occluded airway, in which case using a finger to try to sweep the
object out, or turning the person face down so the object falls out, is the
correct course of action. (of course, if someone is non-verbally communicating
no, then what you say applies, but I'd still be getting into position, and
gesturing either sweep the mouth themselves, or use a convenient chair to do
it.)

~~~
sliverstorm
I was referring to when they are using non-verbal communication. Of course you
do not do the Heimlich when they can still talk, that is Heimlich 101.

------
spanktheuser
This reminds me of something from scuba certification. After doing all this
scary stuff underwater( like taking the regulator out of your mouth, dropping
it, then recovering and re-inserting with your eyes closed) one of the last
tests was to take off your mask, put it back on, and use your regulator
bubbles to blow your mask clear of water. Easy, I thought. You get to keep
your regulator in the whole time. So you could literally spend 60 minutes
getting this right with absolutely no danger. Frankly, it sounded about as
intimidating as washing your hair in the shower.

Oh, how wrong I was. Despite the fact that I knew I was perfectly safe, the
second my face was immersed in water, I had to fight hard to not panic. I felt
waves of fear threatening to engulf me, and it took every ounce of self
control not to bolt for the surface (which can injure or kill you). Two other
students did bolt for the surface before being grabbed by instructors. I later
learned that this is a very common, instinctive reaction.

I was amazed at how powerful this reaction was, and gained a newfound respect
for the lizard brain.

~~~
lief79
In hindsight, and after taking more advanced courses, it became quite clear
that scuba instruction was all about teaching the students how not to panic. I
hope they make that clear to the instructors, as I only went for personal
instruction.

~~~
callahad
Cave training places an extremely strong emphasis on controlling panic. In
open water, if you bolt to the surface you might get bent, but there are
chambers for that. In a cave, you either swim out, or you drown. You don't
even have the option of a quick, merciful DCS hit. Keeping a clear head is
essential when your own self-rescue is on the line.

~~~
siculars
I just went for my Cavern Diver Cert and am not ashamed to say I had to
withdraw, washout as it were.

The odd thing was that the place I was taking the Certification allowed fun
divers with only an Open water Cert to dive the caverns (with guides, of
course). After my experience, there is absolutely no way I would ever, ever,
ever advise anyone to ever go cavern/cave diving without the appropriate
instruction and cert level. If for only the reason of exposure to cave(rn)
panic inducing situations. It is the lack of exposure that will bring on a
massive panic attack at the absolute worst moment that can kill not only the
diver, but the entire group.

Personally, I had a weighting issue. As in I was too heavy. the instructor
told me to use 10% bodyweight + 6 lbs. as the weight. 175 lbs, head to toe 7mm
wetsuit, one AL80 tank @ 2500 psi, fresh water - anyone know the algo for
figuring weight with these variables? Haven't done my peak performance
buoyancy yet... My trim was off, we went over a cliff with an overhang, I was
in the process of calling the dive at this point as my trim was positioning me
vertically. As soon as I hit vertical my belt slid right off into the 150 ft
abyss taking a fin with it and I started ascending quicker than I would have
liked. At that point my self rescue brain kicked in with my Rescue diver
training. I absolutely made sure i was breathing, put my right hand above my
head to protect from the overhang, made sure my reg was in my mouth, my mask
was on and tried to deflate my bcd but could not get the proper positioning. I
was also tied up in the line. The safety instructor saw all this, was able to
hang onto my leg and flaire out to increase drag on the way up.

Needless to say, I made it out alive. I have a new respect for diving and the
cardinal rules that you learn in your Rescue class that are the key
ingredients in what makes an accident an accident.

[edited for buoyancy variables]

~~~
Tuna-Fish
> Personally, I had a weighting issue. As in I was too heavy. the instructor
> told me to use 10% bodyweight + 6 lbs. as the weight. 175 lbs, head to toe
> 7mm wetsuit, one AL80 tank @ 2500 psi, fresh water - anyone know the algo
> for figuring weight with these variables?

This was a total failure from your instructor. You do not try to calculate the
correct weighting -- there is too much of individual variance. Instead you
just measure. Get in shallow water and add weight until you are comfortable.
(Make sure you are not either almost too heavy or almost too light, both can
be problematic.).

Even small things like differences in what you ate last night can have serious
effect on the amount of weighting you need. (too much gas in intestines...)

------
sev
Less than a year ago me and a few friends of mine were about to drown and I
had accepted it before I got out. A few of my friends were at shore, I was
able to wave and yell for a bit, because I had realized I was going to drown
before I actually did start to (there was a rip current and so it was pulling
my friends and I backward very quickly). From my perspective, it was amazing
to me that:

1) I was Yelling and screaming, and my friends at shore continued to stare
toward me like everything was completely normal.

2) I was not thinking clearly that the noise from the ocean and waves would
not allow my friends at shore to hear me.

3) I was stupid enough at that moment to waste energy by waving and yelling
rather than trying to stay afloat.

4) Knowing how to swim well in a pool had little to do with knowing how to
swim well in the ocean.

5) During the panic, I did not try to lay on my back on the water, knowing
salt water keeps you afloat without much movement necessary

6) Having friends with you is no benefit at all during such a situation. In
fact, it's usually a bad thing, because everyone is fighting for their lives,
and no one cares what they need to push down to pull themselves up.

Admittedly, we had had a few drinks and lots of food before we went in.
Luckily we all survived, but we had all accepted the worst possible outcome. I
was able to get out without a lifeguard, but needed to go call one for 2 of my
friends who were in worse conditions than I was.

If you ever get stuck in a rip current, swim diagonally toward shore.

~~~
krolley
And importantly, learn to recognise a rip so that you never get in one. As I
remember as a kid growing up in Australia, you can tell a rip when you can see
the curl and break of a wave on either side of a part of a wave, but not in
the middle. This is caused by the water that is flowing from the beach back
out to sea.

Also, if you get tired don't fight the rip because you will risk drowning.
Float on your back and wait for help.

~~~
demallien
Also, rips have a sandy colour to them, as they are carrying out all the
churned up water back out into the stiller deep water.

If you are on a patrolled beach, and you find yourself in a rip, the easiest
thing to do is just roll on to your back and wait for help to arrive - maybe
waving a hand in the air occassionally. You certainly don't need to worry
about getting swept out to sea, never to be seen again - lifesavers check rips
roughly about once every 15 seconds or so (and no, I'm not exagerating - they
know where the rips are, and they know that these are a big source of danger).
If you are an ok swimmer you might try swimming parralel to the beach to get
out of the rip before turning into the beach again. If you're a strong swimmer
you can probably swim back diagonally, although if you're a strong enough
swimmer for this you probably never thought of yourself as being in trouble
anyway, so you probably don't need the advice.

~~~
sev
> lifesavers check rips roughly about once every 15 seconds or so > (and no,
> I'm not exagerating - they know where the rips are, and they know that these
> are a big source of danger)

Where I was at, they didn't even see us drowning for approximately 5 minutes.
Where one of our group members had to go tell the lifeguard that people were
drowning for them to notice.

It was 5:30 in the evening, so maybe that was part of the problem, I'm not
sure.

------
patio11
The drowning response is also why you are strongly advised to not get into the
water to assist a drowning victim and why trained rescuers who do so violently
manhandle drowning victims (if you administered similar aid on land it would
look like a violent assault featuring a choke-hold delivered from behind).
Drowning victims are virtually incapable of cooperation in their own rescue
and their panicked struggles have the very real potential of drowning would-be
rescuers.

I pulled someone out once (in flagrant violation of the above advice) -- my
(possibly inaccurate) recollection is that he made no noise whatsoever between
entering the water and exiting it beyond the sound of the first splash.

~~~
btilly
When I received lifeguard training 2 dozen years ago, I was taught ways of
rescuing people that don't involve the use of force, and the person teaching
the class strongly recommended against learning the more violent approaches
that were once used.

As I recall, her claim was that they were less effective, and carried a
significant risk of causing injury.

~~~
whatusername
Risk of Injury is much better than drowning alongside then.. (But I'm not a
lifeguard -- so I'll shutup)

// I was somewhat shocked when I did an L2 First Aid course a couple of years
back. The Ambulance Officer running the class talked about CPR -- push much
harder than you think you should. A couple of broken ribs will heal. A stopped
heat beat wont.

~~~
CWuestefeld
Yes. I was advised by an Army medic that effective CPR _will_ break ribs.
Also, you need to blow really hard for the breathing to be effective -- you
need to see the chest actually move upwards as a result of your blowing. If
you've had CPR training, hopefully you had an opportunity to use a real
Resusci-Annie (sp?), which has sensors indicating that your doing both the
chest compression and the breathing with sufficient force.

That same medic also told me that generally the victim will vomit, probably
right into your mouth.

~~~
JshWright
Typically the crunching sensation you feel is tearing of the cartilage that
connects the ribs to the sternum. Unless you're doing CPR on a little old lady
with osteoporosis, that cartilage is going to tear before the ribs break.

------
tumult
_The captain was trained to recognize drowning by experts and years of
experience. The father, on the other hand, had learned what drowning looks
like by watching television._

It is so strange to me that television continuously presents things which are
disconnected from reality, and people, who watch television for hours a day,
end up using it as a replacement for life experience. I cannot really blame
people for this; I think most people (here in America, at least) see most of
their lives through television, so it's only natural that it's where most of
their 'experience' comes from. But it's still dangerous. And things like this
(choking, injuries/wounds, freezing, etc.) are all presented in such an
unrealistic way, but with such consistency, that people never even question
whether or not that's how it is outside of television and movies.

I wish television producers were more responsible. It's made us into a nation
of incorrectly trained, mislead incompetents.

Article is light on HN content, though.

~~~
CWuestefeld
_television continuously presents things which are disconnected from reality,
and people, who watch television for hours a day, end up using it as a
replacement for life experience._

Aside from their absurd depiction of computers and other high tech, which go
without saying...

Hollywood depiction of violence is inaccurate, and I think partly responsible
for some common fears. On one hand, you'll see hand-to-hand combat go on
seemingly forever, with the combatants absorbing huge amounts of damage, yet
continuing on without any apparent loss of stamina.

On the other hand, guns are depicted as instant killers. A single shot, even
in an extremity or the belly, is immediately incapacitated and no longer a
factor (except possibly at the end of the battle when we discover they've been
playing dead). In reality, there's _nothing_ that a single shot will do to
_immediately_ incapacitate someone, short of outright destruction of the CNS.
Even a shot to the heart, femoral artery, etc., leaves at least several
seconds of consciousness during which a determined attacker could get off
another shot of his own. And according to my self defense firearms instructor,
in a conflict it's likely that you won't even notice you're shot immediately,
or at least not be aware of the severity.

------
whatwhatwhat
When I was a child (about 7 years) I nearly drowned at a public swimming pool
full of people. My family was there including my mother, smiling at me from
all of 5 feet away.

After I ran out of air and strength... it was actually my (then 9 year old)
brother who saved me.

As a child I was simply infuriated with my mother, that she would sit there
smiling acting like everything was okay while I was fighting for my life. I
guess I know why now.

Thanks for this article -- it won't be forgotten.

~~~
ergo98
Same thing happened to me, and it was my older her sister who pulled me out. I
can vividly remember looking up and out of the water.

------
qeorge
This hits home. I had a high school friend drown last week, at 11:30 AM, on a
crowded beach. I still don't know much about it, but the description sounded
quite similar to this:

 _Tweedy said he saw someone playing in the water. He looked again, and ocean
waves were rolling the man over._

[http://www.starnewsonline.com/article/20100630/ARTICLES/1006...](http://www.starnewsonline.com/article/20100630/ARTICLES/100639975?Title=Bystanders-
brother-tried-to-revive-Ocean-Isle-Beach-drowning-victim)

RIP Carter

------
mootothemax
Three years ago I came close to drowning. I'm a strong swimmer, spent many
years in a canoe, and am very comfortable being underwater.

I went white water rafting with some friends, and we lost it on a tricky
section of water. Our instructor was stuck standing on a rock by the raft, and
I was in the water holding on to the raft. Fine, except that I was facing the
rapid waters head-on, unable to speak and breathe. And still I held on to the
raft. It took the instructor screaming that he was willing to break my hand by
stamping on it - and then giving my hands a swift warning kick - before I
would let go, float away and recover myself.

It was truly scary at the time to think that whilst I'm rational, good with
water etc, when in that mildly uncomfortable situation, my brain wanted to
hold on, even if it meant I was taking on water. I'm not sure why the threat
and warning kick were so effective, but am hugely thankful I got away with
nothing but a bit of a bruised mind :)

~~~
c1sc0
Last year I came close to drowning because of massive cramping at the end of a
one-hour training in open water. The frightening part is that it took _myself_
a long time to realize I was drowning: I probably was a bit drowsy from
hypothermia. I remember going through 'left foot cramping, just continue,
you'll be fine' all the way through cramping up of my upper legs & finally
abdomen until I realized I was in trouble. I concur that once you are in
trouble it is _very_ difficult to signal anything to bystanders.

Lessons learned: swim parallel to the coastline & don't swim alone. When you
start to cramp up start to swim more conservatively, change styles, when it
gets really bad, assume a fetal position & focus on floating, don't try to
swim. The cramps will eventually go away, _then_ you can slowly start moving
again. Watch out for hypothermia.

------
charliepark
In Boy Scouts, we learned the rhyme "Reach, Throw, Row, Go", regarding the
order of assistance to provide.

We also learned that if the victim tries to climb you, to submerge a bit (so
they let go) and punch him (or her, sure) in the nuts, and to then rescue him.

------
16s
It's authoritative knowledge such as this that makes the Internet worthwhile
(if you can find it among all the garbage). I had _no_ idea what drowning was
like before reading this. Thanks for writing this blog post!

------
siculars
Swimming is so fundamental to a persons survival that, according to Judaism,
it is one of the four obligations a father owes his children:

“Teach them Torah, teach them a trade, teach them to swim and find them a
wife.”

------
seldo
I almost drowned when I was about 8 years old and I remember it very clearly.
I did exactly as is described -- I was face up, mouth just at the water level,
arms flat, completely quiet. My parents -- who had two older children and
spent their whole lives by the water -- spotted me and pulled me out.

The thing I remember most is that the overriding sensation was not panic, but
calm -- a weird, fatalistic calm. I was gong to die: "oops". It really is an
odd physiological response, and you have absolutely no control over it.

~~~
whatwhatwhat
It's surprising how many people have had a close call with this.

I'm not sure exactly on my recollection, however, I had a similar incident and
my reaction was not anything calm. I was angry and very frustrated. My guess
is that it probably depends on the person and situation

~~~
ssp
_It's surprising how many people have had a close call with this._

It does explain why psychics often talk about how something happened in your
childhood involving water. That always seemed pretty unlikely to hit to me,
but I guess not.

~~~
eru
And it still counts as a hit, when your best friend or brother had the near-
drowning experience instead. Also lots of other things can happen with water.
My sister made the unpleasant acquaintance of boiling water once.

------
sofal
Mario later on in the comments references some DVDs that show real life
examples of drowning behavior: <http://www.pia-
enterprises.com/watersafety.html>

It really is too bad that with all the web technology today, videos like these
are not available for free. Seems like they'd help save some lives if they
were.

------
mvittone
Thanks everyone for the comments and for sharing this article. You guys are
great. ~ Mario Vittone

------
dtf
Interesting instructional video: <http://www.youtube.com/watch?v=ndbGvjqEweA>

------
gcv
So when the brain perceives drowning, it basically shuts down and starts doing
self-destructive things? The article says that a rescuer being pushed down by
someone who is drowning can end up in trouble too — and this is a real risk to
a rescuer who normally swims and dives like a fish?

I don't mean to sound skeptical, I'd just like a little clarification. I never
understood how swimmers can possibly drown unless hypothermic or completely
exhausted. If this is the case, then it's horrible that we haven't evolved out
of this destructive "drowning response instinct".

~~~
randallsquared
You call it destructive, but it sounds like it's nearly optimum for getting
back out of water you just fell into. "Grab the riverbank or a tree; climb up
it." That's simple and effective. The only time it causes further problem is
when you're on a boat and fall in, or otherwise find yourself suddenly away
from the shore.

~~~
thaumaturgy
Right. I can't swim a lick. Once, while on a solo backpacking trip very much
in the middle of nowhere, many tens of miles from the next person, and while
navigating a river canyon, I fell into the cold water, well over my head.

Somehow my toe touched something on the bottom and I rocketed out of the water
like an explosion. The next thing I knew, I was flopped over onto a large rock
like a fish, a few feet from where I fell in.

I still have no idea exactly how that all happened, but near as I can guess I
gave the best leap of my life and scrambled the rest of the way up.

I really need to learn how to swim. :-(

~~~
Tichy
Sign up for a course today, in fact, do it right now, it is probably just a
few mouse clicks away?

------
ajuc
I've been in situation like described - I, my father, my uncle and my 2 step
sisters were swiming in a pond, the pond wasn't very deep - I could stand on
the bottom, but the bottom was muddy and feet were falling throught this
bottom sometimes even like 10 cm down - I could barely take a breath when
standing in the deepest places.

My step sister was walking in the water, when she steped on more muddy bottom
and fall under water. She was quiet and doing strange things with her hands,
nobody reacted for a while, then I walked to her and give her hand (I was able
to stand on the bottom there, but only barely). It looked funny and not
dangerous at all - like she just were playing in water, uncle and father
didn't know anything is wrong.

To this day I thought that she wasn't really drowning - because she was
supposed to do the show like in TV.

------
jodrellblank
So, at the start, if someone is ladder-climbing-panic-drowning, then they are
floating, have air, and have energy ... why are they drowning? What triggered
the ladder-climb-panic mode?

~~~
whatwhatwhat
Possibly some kind of instinctual trigger. Think about the moment where the
entire body was fully EXPECTING a lung full of air... and ready for it... but
for whatever reason you become submerged and cannot get it.

You aren't unconscious yet because you still have plenty of oxygen, but your
instincts have been triggered on a more primitive level -- possibly initiated
as the lungs failed to function as expected.

------
krschultz
Ugh, this entire post is lifted from the original source and then a link is
posted at the bottom. The person who actually wrote this great article is
getting none of the revenue. Go to the original instead at gCaptain.

~~~
chaosmachine
The person who actually wrote the article is Mario Vittone. Looks like he just
cross-posted to another site.

~~~
mvittone
I appreciate the traffic to either site. I wrote the post on gCaptain almost a
year ago - it just never really got any play until now. Links to gCaptain are
great. It's a professional site owned by a friend of mine. I'm still active
duty Coast Guard so my site doesn't generate revenue. I'm just very glad to
get the word out about this important subject. Thanks again everyone!

