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Around four hundred observations of adult swimmers during ten summer seasons were analyzed and then sorted according to their skills and behaviour. Underwater observation proved essential to understand how bathers manage to remain afloat and how they react to potential water incidents. Results: Our analysis showed that bathers could be classified according to the following criteria: - Aquatic abilities, motor skills and performance. - Body and head positions in water. - Swimming movement tracks. - Response to “incidents”. - Signs indicating failure to control buoyancy. - Signs indicating a drowning process. Thus, we described and defined five categories of swimmers’ ability levels including risks factors involved, as well as surveillance criteria focused on detecting when a swimmer starts to lose control. A six-hour teaching module was specifically developed and incorporated into our lifesaving courses including strategies to improve drowning prevention and surveillance: guides to advise bathers on safe behaviours, swimming movement patterns and early drowning recognition tips. Additionally, psychological training on social skills was included in order to improve the relationship between professional Lifeguards and pool users. This module has been implemented in ESS lifesaving training courses since 2003, reaching over 345 lifeguards in our new or refresher courses. Follow-up questionnaires completed around a year after the above-mentioned training activities resulted in over 90% effectiveness of professional performance regarding swimmers’ surveillance and early drowning detection. Discussion: Our results show a direct relationship between aquatic expertise and the possibility that bathers’ reaction is not being effective enough to overcome a drowning episode and also suggest a clear relationship between real or perceived performance and the actual behaviours of swimmers at a pool. Certain factors have a considerable bearing on the development of potential drowning situations: - Not knowing how to move and control the face, the eyes or the head underwater. - Not knowing how to do the apnoea technique or hold breath underwater. - Beginner or very basic swimming skills or lack of self-confidence. - Increase of water treading movements to keep afloat. - Not being able to react to incidents properly. Our classification has proved highly useful to improve lifeguards’ professional response to potential drowning situations as it significantly reduces the necessary time to detect, assist, or perform the rescue of swimmers in trouble. It is easily understandable with an appropriate but simple audiovisual support and adaptable to all kinds of bathers and pool conditions. Moreover, our study clearly shows that most people at risk do not wave their arms or shout for help; on the contrary, they move their arms underwater trying to remain afloat, gasp for breath or present reflex apnoea.
Citation preview
© 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.
© L.M. Pascual-Gomez - E.S.S. 2011
2
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)
© L.M. Pascual-Gomez - E.S.S. 2011
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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.
© L.M. Pascual-Gomez - E.S.S. 2011
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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
© L.M. Pascual-Gomez - E.S.S. 2011
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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.
© L.M. Pascual-Gomez - E.S.S. 2011
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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 €.
© L.M. Pascual-Gomez - E.S.S. 2011
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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.
© 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.
© L.M. Pascual-Gomez - E.S.S. 2011
9
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..
© L.M. Pascual-Gomez - E.S.S. 2011
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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.
© L.M. Pascual-Gomez - E.S.S. 2011
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The Hot Spots
Research Area
Application Area
© L.M. Pascual-Gomez - E.S.S. 2011
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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.
© L.M. Pascual-Gomez - E.S.S. 2011
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Bathers’ Observation
© L.M. Pascual-Gomez - E.S.S. 2011
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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.
© L.M. Pascual-Gomez - E.S.S. 2011
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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.
© L.M. Pascual-Gomez - E.S.S. 2011
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Swimmers’ Categories
5. Response to incidents.
• Detection of swimming failure features.
• Signs that indicate a drowning process start-up.
© L.M. Pascual-Gomez - E.S.S. 2011
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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
© L.M. Pascual-Gomez - E.S.S. 2011
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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
© L.M. Pascual-Gomez - E.S.S. 2011
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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)..
© L.M. Pascual-Gomez - E.S.S. 2011
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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.
© L.M. Pascual-Gomez - E.S.S. 2011
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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..
© L.M. Pascual-Gomez - E.S.S. 2011
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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.
© L.M. Pascual-Gomez - E.S.S. 2011
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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.
© L.M. Pascual-Gomez - E.S.S. 2011
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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.
© L.M. Pascual-Gomez - E.S.S. 2011
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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.
© L.M. Pascual-Gomez - E.S.S. 2011
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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
© L.M. Pascual-Gomez - E.S.S. 2011
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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.
© L.M. Pascual-Gomez - E.S.S. 2011
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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.
© L.M. Pascual-Gomez - E.S.S. 2011
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Thank you.
I would be very happy to expand on this concepts later on.
www.sossegovia.com
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