EMS Beat: Drowning in Sorrow

By Albee Bockman, AEMT-P

The summer season is a time for family, food, fun, and frolicking! Included in that fun is enjoying all the outdoor water activities that beautiful Sullivan County has to offer. Unfortunately, if we do not respect “Mother Nature,” we may find ourselves in heaps of trouble.
As a Professional Health Care Provider for over 40 years, I have experienced numerous tragedies involving water. Sadly enough, the majority were – – avoidable.
Drowning is the third leading cause of unintentional death worldwide. It accounts for seven per cent of all injury-related deaths. The highest drowning rates are among children 1-4 years old, followed by children 5-9 years old. Overall, children, males, and individuals with increased access to water are most at risk of drowning. In America alone, drowning is the second leading cause of unintentional injury death in children aged 1 to 14 years.
Of course, there are several ways one might succumb to a water tragedy. For instance, we experienced severe flood disasters in Sullivan and Delaware counties over the last several years, tourists canoeing in the Delaware River along Route 97 have had their share of tragedy, and, of course, infants and young children left unsupervised or alone with another child around water are at risk.
Let us now talk about what actions we can take to prevent drowning. Firstly, for those of us that have the luxury of owning an inground or above ground pool, town ordinances now require fencing around swimming pools and locked gates. So lock ‘em’ up!!! Kids are soooo curious and can be very mischievous. It only takes a second for a tragedy to happen. Think about it!
Secondly, teaching water safety and safe rescue skills to school-age children. These efforts must be undertaken with an emphasis on safety. And last, but not least, we must have effective disaster preparedness planning and early warning systems in our communities.
The last thing I want to discuss is a term known as “Mammalian Diving Reflex”. This is the body’s physiological response to submersion in cold water and includes selectively shutting down parts of the body in order to conserve energy for survival.
In plain English, this is what I mean: Humans and other mammals have reflexes that are activated when our face is cooled – – like when you dive into water or if we hold our breath. This enables our body to manage and tolerate a lower level of oxygen.
Three main changes occur in the body. First, our heart enters into what is known as bradycardia – – slowing of the heart rate by anywhere from 10 to 30 per cent. Secondly, peripheral vasoconstriction occurs. This is a narrowing of our blood vessels which reduces blood flow to the limbs ensuring that our brain and heart receive oxygen to the max. Thirdly, a blood shift occurs allowing blood plasma and water to pass through our organs and to the chest cavity to protect the organs from the increase in pressure. The combination of these three reflexes can preserve a human body submerged in water for possibly up to one hour or more. This means . . . the colder the water, the younger the person, and the least amount of time submerged, that life can be saved with little to no brain or organ deficit!!! There are many, many cases where people have survived drowning for up to an hour-and-a-half when these conditions are met.
There is a saying in our field of Paramedicine, “You’re not dead till you’re warm and dead.” Aggressive treatment by Paramedics such as intubation, cardiac care, pharmacological intervention, and body core warming have proven successful in the saving of human lives from drowning incidents.
Have a happy, healthy, and safe summer season, Hurleyville!!!