EARLY DETECTION OF A PERSON AT RISK OF DROWNING. IMPLICATIONS ON TRAINING AND PERFORMANCE OF...

© L.M. Pascual-Gomez - E.S.S. 2011

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Luis M. Pascual-GomezPrimary School Teacher, Certified Swimming and advanced Life Saving

Instructor

Instructing Team Director of Escuela Segoviana de Socorrismo. Segovia (Spain)

www.sossegovia.com

Early Detection of a person at risk of Drowning

Implications on training and performance of professional Lifeguards.


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Escuela Segoviana de SocorrismoSegovia Lifesaving School

Luis M. Pascual-GomezPrimary school teacher. Certified swimming and Lifesaving Instructor.

Instructing Team Director of Escuela Segoviana de Socorrismo (Segovia Lifesaving School), Segovia (Spain)


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About us

• ESS is a non-profit organization, a group of Lifeguards and LS Instructors founded in 1996 with the aim to improve LS performance and teaching.

• ESS is based at Segovia an historical city 100 km from Madrid, and organizes courses of: LS and LS Teachers First Aid, BLS, AED, Psychological First Aid, and refreshing courses for LS and LS Teachers.


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About us

• Organized 6 International Congresses from 1997 to 2004 whose papers are available at our web page:

www.sossegovia.com

• Our blog is one of the most visited LS blogs in Spain.

• http://sossegovia.blogspot.com

• Profiles at SN: Facebook, Tuenti• Twitter: @Sossegovia

http://www.sossegovia.com/

http://sossegovia.blogspot.com/


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About us

• ESS generated over 20 innovative works in the field of LS training and Drowning prevention.

• Works locally (Segovia county) and regularly collaborates with and belongs to other Spanish organizations who work nationwide.


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About us

• ESS Technical Team has nationwide prestige in Spain as they have produced innovative but strong evidence-based work in the field of aquatic Lifesaver training.

• ESS 2010 annual income was 10.500 €, but the remaining money for activities was only 2.100 €.


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About us

• ESS Technical Team members do activities and research for free and are paid only for their classes on LS courses.

• ESS has performed several yearly campaigns on water safety and drowning prevention: child safety; safety pools; safety reservoirs; education about LS tasks and performance, etc.


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Luis M. Pascual-GomezPrimary School Teacher, Certified Swimming and advanced Life Saving

Instructor

Instructing Team Director of Escuela Segoviana de Socorrismo. Segovia (Spain)

www.sossegovia.com

Early Detection of a person at risk of Drowning

Implications on training and performance of professional Lifeguards.


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Background - I• The Aquatic Professional Lifeguard takes up 95%

of its working time on prevention and surveillance tasks to detect drowning victims.

• Lifeguard training-specific on drowning prevention:– Bathers aquatic environment behaviour.– Incidents and accidents.– Epidemiology; Aetiology, Development; Physio-

Pathology, etc..


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Background - II

• The time a drowned victim remains in anoxia determines its chances of survival.

• Shortening the time to detect and intervene is esential in a water incident.


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The Hot Spots

Research Area

Application Area


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Aims / Objectives / LOs• Analyze over 400 bathers’ behaviour,

performance and swimming skills’ in water (pool) through direct observation and video recording, to propose categorizing them into 5 levels.

• Correlate our observations with literature statements to propose effective measures to improve Lifesaver’s strategies on Risks Prevention, Surveillance and Early Drowning Detection.

• LO: At the conclusion, participants should better appreciate our proposal as a powerful prevention, surveillance and drowning observational assessment and teaching instrument.


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Bathers’ Observation


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Aquatic “Incidents”

An event that causes distress and momentary loss of breathing, floating or movement control.

•Contacts or disturbs between swimmers–Disorientation or control loss

•Splashing and swell.–Discomfort, apnea reflex.

•Accidental water swallowing–apnea reflex, choking cough.

•To be out or deep o do not reach the edge.–Control loss due to fear and distress.

•Accidental falls, tiredness, discomfort, illness, stroke or seizure, etc.


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Swimmers’ Categories

Swimmers had been classified regarding:

1. Aquatic abilities and motor skills and performance.

2. Body and head positions in water.

3. Behaviours and displacements paths on water

surface.

4. Self-confidence on aquatic performance.

5. Response to incidents.


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Swimmers’ Categories

5. Response to incidents.

• Detection of swimming failure features.

• Signs that indicate a drowning process start-up.


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Movement tracks

Displacement paths gives information related with self-confidence and self-perception of performance in water.

Shallow waters

Deep Waters

Pool width

Near edge

Erratic, free spaceStandingPool

laps

Floating on their

back


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Classification: 0 to 4 levels

Brief description 0 1 2 3 4Face/Head Up Up

Tilted. Submerged face, but not head

Submerged Submerged

Body Vertical (90º)Feet on the ground

Tilted (>45º) Nearly horizontal Horizontal Horizontal

Propulsion No, or only waving arms

Supporting arms,legs barely move,

breaststroke

Arms and legs,mainly breaststroke

Arms and legs,crawl, breaststroke

Arms and legs,crawl, breaststroke,

backstroke

Breathing UncoordinatedUncoordinated

Adapted to the movement but not totally coordinated

Coordinated. Can do static and

dynamic apnea

Coordinated and adapted to the

movement

Movement Tracks

Standing,shallow water

Shallow waters:erratic.

Deep waters:near edge

Central deep pool area: erratic

looking for free space or in pool

width

Pool laps. Stops on the edge to turn.

Pool laps

IncidentsTurn head and

body moving away, arms protect face

Twist head, increase supporting movements, can’t

move body

Foresee incidents, reacts keeping in motion, protective

apnea

Are aware of others’ activities.

Avoid interactions, stopping o

changing direction

Avoid interactions actively.

Stop floating and recover movement

Other Aquatic Skills

NoOccasionally mayfloat on their back

Achieve static apnea, float on

their back

Able to jump on foot standing from

the edge

Dive headfirst and swim underwater

Self-Confidence

Very bad PoorPoor/Medium

(Occasionally Good)Medium to Good Good to Very Good


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Why do the swimmers fail?

Just a few factors have a considerable bearing on the development of a risk-drowning situation:

1. Swimmers that don’t know how to put the face, eyes or head under the water, and don’t use goggles.

2. Swimmers that don’t know to achieve apnea or hold their breathe underwater.

3. Swimmers whose basis skills are weak or lack self-confidence (floating, propulsion and breathing mechanics).

4. Swimmers that react increasing the supporting swimming movements to stay afloat, (instead of stopping, holding their breath and recovering their normal movements)..


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Why do the swimmers fail? - I1. Swimmers that don’t know how to put their face, eyes or head under the water, and/or don’t use goggles, 2. Swimmers that don’t know how to achieve apnea or hold their breathe underwater.•Are highly affected for “wet face” reflex, losing breathing

control.

•Reflex apnea may cause that they can’t react properly and became distressed or panic.


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Why do the swimmers fail? - II3. Swimmers whose basis skills are weak or lack self-confidence (floating, propulsion and breathing mechanics):•Would be frightened because they feel that their abilities

are too weak to keep them safe.

•Altered breathing mechanics, and protective apnea may appear.

•Became distressed disordering the swimming movements, while legs remain motionless..


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Why do the swimmers fail? - III

4. Swimmers that react increasing the supporting swimming movements to stay afloat, (instead of stopping, holding their breath and recovering their normal movements).•Arms increase supporting movements, while legs are

motionless.

•Breathing control is highly affected and protective apnea appears when face becomes submerged.

•Disorder their movements as much as would became submerged due its inefficacy.


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On the “Borderline”

Those features are on the borderline between safety and a distress or drowning episode and could be easily observed and detected daily when a trained Lifeguard is aware of how they are produced.• Disorder or chaotic swimming movements.

• Change to a vertical body position.

• Arms increase supporting movements.

• Motionless legs.

• Altered breathing mechanics.


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Discussion-I

Improving Lifesavers’ daily routine

• Classification rationalizes and eases observation and surveillance tasks, reducing observational stress and tiredness.

• Easily recognizable behaviour and motor patterns which are daily observable.

• Significantly reduces the time to detect, assist and perform a rescue of a swimmer in trouble.

• Movement paths help on the early detection of silent or passive drowned bathers.


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Discussion-II

Improving Lifesavers’ training

• There is enough evidence to justify those finding and the suggested training method would be included into the compulsory syllabus of Lifeguards’ instruction.

• Easily understandable with simple audiovisual support.

• Highly useful and locally adaptable for Lifeguards’ prevention strategies.


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Discussion-III

Improving bathers’ safety• The relationship between: in-water self-confidence;

self-perception of the performance and a risky behaviour is three-way and we can either act overall or on each one.

Performance Self-Perception

In waterSelf-Confidence

Behaviour andRisk-Taking


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Discussion-IV

Improving swimmers’ training and prevention

• Swimmers’ training should focus on improving aquatic abilities and reacting properly to incidents.

• The general strategies for drowning prevention anywhere would find valuable a guide to detect a person showing slightest signs of a drowning process, rather than actually drowning.


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Limitations

• Most pools have no drowning events over several seasons.

• Drowning process were not observed but minor incidents or distressed swimmers during the research.

• Should consider contrasting observations in open water.


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Thank you.

I would be very happy to expand on this concepts later on.

www.sossegovia.com

EARLY DETECTION OF A PERSON AT RISK OF DROWNING. IMPLICATIONS ON TRAINING AND PERFORMANCE OF...

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Transcript of EARLY DETECTION OF A PERSON AT RISK OF DROWNING. IMPLICATIONS ON TRAINING AND PERFORMANCE OF...