I know we will be getting a lot of backlash and negative comments about this blog because our opinions are probably in the minority as we are rocking the traditional water safety boat. We do however believe that what we have to say is extremely important and should be analyzed objectively by those who read it.

More and more actual drowning scenarios are being caught on security cameras but unfortunately, only lawyers and expert witnesses typically get to see them; water safety advocates who need to see them, don’t. Most of the videos cannot be made public because of confidentiality agreements signed by both parties. We are a few of the fortunate ones that have the opportunity to view these significant videos as a part of lawsuits. But what these videos of actual drownings reveal is surprising, startling, and significant. We have watched numerous total non-swimmers traverse swimming pools in wild, frantic displays that are unique and diverse. One boy pirouettes across the pool kind of like a Spinner Dolphin or a gymnast doing horizontal jumping jacks. Another performs a wild, frantic upside down butterfly with arms coming high out of the water in an attempt to stay afloat. This same victim then spins his arms alternately out of the water in a wild crawl stroke, again with arms high but goes nowhere except eventually to the bottom. Still yet another pushes off bottom of the pool and ballistically comes way out of the water like a Polaris Missile until he fatigues and drowns. And finally, very small children simply drown face down flat, horizontally on the surface with little or no movement. 

What these actual drowning videos show us is that we really cannot predict how potential drownees will act when they are fighting for their lives. We worry that if we continue to teach our lifeguards and parents the traditional signs and symptoms of drowning victims that have been taught for decades, they may create a mental picture of a drowning victim that does not match reality. As a result, our teachings may be counterproductive. While some drowning victims do in fact display a vertical posture with head back, weak kick and arms groping just below the surface, many do not. We do agree that drowning is silent and we do agree with the RID Factor. However, more and more security camera footage illustrates that drowning may not be as instinctive as we have been teaching. As Dr. John Hunsaker has stated, “Victims don’t go to Drowning School,” and apparently they have not read our texts. What we have evidenced on these videos is a variety of frantic, erratic movements in the water lacking meaningful purpose or direction. This piece is not intended to make light of drowning scenarios and the resulting tragedies. Nor is it intended to criticize our colleagues who have worked so diligently to save lives. Our hope is that as technology grows in swimming pools we may be able to scrutinize actual drowning footage to better protect people and save lives. Finding these videos and sharing them whenever possible is the first difficult step in the process.

 

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Comment by Henry on August 22, 2013 at 3:02am

I realise this conversation has reached something of a natural conclusion, but I wanted to echo the thoughts of Mario and others below. I don't think this blog is blasphemy or particularly controversial, as I don't know anyone who has suggested the instinctive drowning response is the only response. In fact, I think the importance of the work of Frank Pia and others is that it raised awareness that the 'wild, frantic displays' you mention are not the only type of drowning.

I'd like to believe that today, we are able to teach lifeguards a fuller picture of what drowning may look like. It can be 'wild' and it can be 'silent'. This is why the research and advancements on scanning, vigilance and attention span are so important.   

As Mario alludes to, I'm not convinced the 'Drowning Ds' has much to do with a lifeguard who fails to act when they watch a person who "spins his arms alternately out of the water in a wild crawl stroke... but goes... to the bottom". It's more likely they weren't watching.   

Of course, I completely agree we should be finding and using videos of drowning incidents as training tools – videos of instinctive and distressed drowning.

Comment by John Kelly on July 27, 2013 at 10:44am

Tom, certainly there are lifeguards who don’t “get it” as you say, and one obvious question is where is their management. In my experience I would attribute at least some of those who don’t “get it” not to their training but rather as learned behavior from working within a larger system for management who don’t “get it”. Too often I see management looking to only to determine the minimum requirements rather than what is reasonable or responsible. Those lifeguards understand they are there to simply fulfill a requirement rather than a purpose. Even lifeguards that do “get it” are facing new challenges and hazards as pool designs become more complex and are designed to incorporate a broader spectrum of clientele, including many more non-swimmers. There is a lack of any consistency in the industry regarding requirements for the direct supervision of young children and non-swimmers by their parents and caregivers.  Pools are being designed with many more visual obstructions than historically were present and horizontal separations between water depths are all but gone with often only an 8” wing walls separating water of vastly different depths. Features such as benches, ledges, and underwater stairs are being incorporated into shallow water creating abrupt changes in depth that were never present in older pools. Spa like jets are being incorporated into swimming pools at perimeter benches that can entrain air obscuring visibility and that can push weak swimmer who fall of the bench out into the pool rather than allowing them to reach a handhold at the perimeter of the pool.  Certainly we need well trained lifeguards who get it, they are an important layer of protection, but well also need to make sure we are designing safer pools, are requiring more involvement of parents and caregivers in the direct supervision of young children and non-swimmers, and using additional layers of protection where possible.

Comment by Mario Vittone on July 26, 2013 at 3:04pm

"in part because they may be looking for a certain drowning posture or scenario that is not being presented to them."

"...in part because the "may" be."  

While I appreciate what "may" be happening - I just can't find any evidence or studies that suggest that the reason that lifeguards do the "D's" is some over-instruction on drowning presentation.  In the videos I've seen, it is usually complete guard inattention and failing to scan (or be able to see) the bottom.  The guards at the pool with Yonni G. weren't looking for the wrong thing.  They weren't looking at all.

"When you don't know - go."  Certainly.  "When in doubt - check it out." You bet.  But what are you suggesting we teach?  That you just never know what you are going to get so we aren't going to teach you anything?

I believe that teaching them what is common - what we "usually" see, and then informing there intuition with as many videos of actual drownings that we can get our hands on is prudent.

Then again - I believe that 16 (long before full cognitive function has developed) is far to young a brain to load up with lifesaving responsibility.

Comment by Tom Griffiths on July 26, 2013 at 2:42pm

Thank you all for your thoughtful comments. However, please allow me to clarify my position. I failed to mention that my videos and concerns focus on swimming pool lifeguards, not ocean lifeguards.

Sorry for leading some of you astray. Most Surf Lifeguards “get it” while many swimming pool lifeguards never will. This is mostly because beach lifeguards know they are going to have critical incidents, make rescues and perform resuscitation. Conversely, many if not most pool lifeguards never expect to get wet on the job and certainly don’t expect to make rescues and perform resuscitation. I believe pool lifeguards should be taught the Ellis & Associates and NASCO mantras like “When you don’t know, GO!,” “ When in Doubt, Check the out!,” “More than 10 (seconds) GET THEM,” and others. Too many swimming pool lifeguards fall victim to the Drowning Ds:

Disguise, Disbelief, Denial and Delay…in part because they may be looking for a certain drowning posture or scenario that is not being presented to them.

Comment by Mario Vittone on July 26, 2013 at 2:25pm

Their channel has caught four drowning/distress events.  Good for training I would think.

Comment by Mario Vittone on July 26, 2013 at 2:19pm
Comment by Traci Tenkely on July 26, 2013 at 8:41am

The more we know the better we can train regardless of whether or not the behaviors are the same. A first year guard relies on initial training, "textbook" answers and whatever information or examples their instructor or manager has given them - they do not have experience or cognitive ability to understand all of the factors they may face. Most of the time they are young without real life experience or a sense of responsibility for other's behaviors. In this instance, the more examples they can be shown or scenarios they can be introduced to the better. As they age and gain more experience, I often see complacency. They have seen the same people day in and day out without incident so in their mind nothing bad will happen. I completely agree with Shaun that "we see what we expect to see and ignore the rest.  If we teach lifeguards to expect drowning to look a certain "textbook" way, then lifeguards may discount any behaviors that are not textbook." The more we can show our staff the more they will be willing to look for.

It's also the impact these images can have on lifeguards. We brought a near drowing victim into our staff training this year to show the ultimate consequence of not seeing or recognizing a victim soon enough. This young man drowned at 22 months and is now an 8 year who lives without verbal communication or the ability to lead a normal life without 24-hour care. His family was willing to share their story and the impact it had on our staff was huge. It's one thing to talk about in training, review textbooks and play pretend with scenarios. It's a whole new outlook to watch the surveillance video, analyze what went wrong and how it could be prevented and then to meet the person and the family affected by the outcome.

The more we know, the more we see, the better we can do.

 

Comment by John Whitmore on July 26, 2013 at 6:04am

After 20 years of actual guarding in pools, open water, and surf beaches I have performed literally hundreds of rescues. I agree that there are so many behaviors exhibited by someone drowning that the only true commonallity is that they submerge at the end. I think that the most important thing I learned on recognizing drowning was when I guarded a surf beach in southern California. There were thousands of people on the beach, wading, and in the surf line. How do you possibly watch them all? I found that people move in predictable patterns when they are in control of their actions and more comfortable in their environment. I think someone noted that we should know what "swimmers" look like in order to spot someone that is not swimming effectively. My "eye" learned to spot irregular or wrong patterns of motion as something to focus on. My analysis was then to determine if they are either a poorly skilled swimmer or someone in trouble. (Usually the poor swimmers got in trouble over time so they drew more of my attention). My evaluation was then on the effectivness of their motions and whether those motions would bring them to safety. If in doubt, I would go to the rescue. Most of the time, by the time I got to the person they had gone from poor effective ability to serious trouble. Lifeguards have to develop an eye and they must think through their analysis of a swimmer's ability accurately and quickly.

 

Of course, the swimming environment and the actions of other swimmers can change the state of a swimmer's effectiveness very quickly. A wave crashes into them, they suddenly cannot touch the bottom, they fall off a float, they get dunked by another swimmer, and even if they just get splashed in the face are just some examples.

 

The bottom line is that the more video we study, the more we can bring these images into our training programs, the better lifeguards are going to get at spotting a swimmer in distress.

Comment by John Kelly on July 25, 2013 at 6:08pm

Certainly as more and better quality video of actual drowning incidents becomes available additional insight into observed responses will help shape our understanding of drowning incidents. As Mario said I do not believe it is generally implied that all drowning incidents exhibit the exact same observed responses. The human mind is very complex so even if a true instinctual response exists it does not imply that learned behaviors, personal experiences, or external stimuli cannot result in various responses. I have seen non-publicly available videos of drowning incidents that do exhibit the so called instinctual response and I have read witness statements from lifeguards who describing similar but different responses. Unfortunately many drowning incidents go unnoticed or unregognized by parents, lifeguards, or other swimmers. I believe the important messages are that drowning incidents, particularly those involving weak and non-swimmers, are often not readily apparent to those who observe them. These are some responses that have been recognized through many drowning incidents, but many drowning incidents may simply mimic weak or non-swimmers at play. Lifeguards are an important layer of protection, but we must recognize their limitations and require additional layers of protection for non-swimmers (i.e. direct supervision, lifejackets, etc) 

Comment by Mario Vittone on July 25, 2013 at 3:05pm

I don't have any backlash or negative comments, Tom - just to observe that saying something that guys like Hunsucker has been saying for decades is hardly blasphemy or brave and important as Gary suggested.  There are a long line of people who have been saying this for a long time.  I too have seen videos not for public consumption and seen all manner of actions relating to distress and drowning - but let's not pretend that access to videos as an expert witness means any of us have seen more drownings than dozens of lifeguards we all know with careers at busy beaches.   We don't have a look behind some secret door that no one else has access to.

 Lifeguard's have had access to those events as they happen since there have been lifeguards.  Hunsucker is correct, no one goes to victim school.  No one goes to burn your hand on the stove school either, but when kids touch the burner, they always seem to pull their hands back and away from the heat.  Some things don't need to be learned.

Do all drownings look the same?  Of course not, and I have never heard, read, seen, or been told that they do.  I do believe (as with everything) that there is something called "typical."  I wonder what it is?  I'm guessing it's not jumping jacks and dolphin spinning.  

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