Slide Show on Rescue vs. Recovery
~ by Dominique Evans-Bye
Slide Show on Drownings
~ by Dr. Tom Millington
to the time lag involved in the notification, response, and deployment
of search and rescue divers following
a drowning, it is rare that rescue is feasible. However, SAR divers
must understand that it is not beyond the realm of possibility.
is the fourth leading cause of accidental death among the general
population. The majority of drownings occur in fresh
water: swimming pools, bath tubs, lakes, ponds, rivers, streams,
etc. Unfortunately, many drownings result from the application of
what has come to be known as the "deadly formula":
hot weather + alcohol + cold water = drowning. Drowning is caused
by an inhalation of water. Even though a victim may hold his breath,
carbon dioxide build- up in the brain will eventually
force an inhalation of water. Inhaled water is drawn from the lungs
into the bloodstream causing the heart to arrest due
to the excessive amount of water in the blood. Thus
a drowning victim actually dies of a heart attack.
are several stages which occur in a drowning:
Initially, the victim is surprised. He will attempt to keep
his head above water, inhale deeply, and make downward movements
with his arms.
The victim will eventually panic and may become hysterical.
He will hyperventilate and struggle violently resulting
in negative buoyancy.
Submergence occurs accompanied by reflex breath holding.
As available oxygen is consumed from the air remaining
in the lungs the urge to breathe becomes stronger.
After 2-3 minutes a combination of brain depression
due to anoxia (severe oxygen deficiency) and the overwhelming
urge to breathe caused by carbon dioxide build-up results
in the victim breathing underwater. Although unconscious,
in order to prevent the entrance of water into the lungs,
the victim will reflexively swallow water which triggers
retching and vomiting. As a result, most drowning victims
will have a stomach full of water.
As available oxygen is consumed, the urge to breathe
becomes even stronger. Unless a spasm of the larynx
shuts off the flow of water into the lungs resulting
in a "dry drowning", the victim will unconsciously
take a strong deep breath resulting a filling of the
lungs with water and more negative buoyancy.
Due to a lack of oxygen, brain function becomes more
depressed and deprivation of oxygen to the heart results
in cardiac arrest.
effecting a rescue of a drowning victim, it is important
to isolate the time that the victim was last
seen breathing. Once submerged, the victim will begin
to "breathe" underwater in about 3-4 minutes.
After an additional 3-4 minutes, cardiac arrest occurs.
Following cardiac arrest an additional 4-6 minutes
will elapse before irreversible brain damage occurs.
Thus the maximum time of submergence with a
possibility of recovery is approximately fifteen
minutes. However there are two
to a phenomenon of a primitive physiological
response called the "Mammalian Diving
Reflex" (which still exists in man),
a spark of life is maintained and under the
right conditions, a victim can be revived
long after the fifteen minutes have elapsed.
A victim of freshwater drowning has a good
chance of recovery if the following factors
4. The victim has not ingested alcohol.
5. The younger the victim, the better the chance
of recovery (the diving reflex is more
pronounced in children than in adults).
6. The clearer and cleaner the water, the better
the chance of recovery.
best success of recovery involving the Mammalian Diving Reflex involves drownings which occur in cold, clear, freshwater. There
is at present, only one incidence of saltwater drowning survival
where the diving reflex was a factor. This incident involved a forty
minute submersion in Alaskan waters.
It is critical
that Search and Rescue Divers understand that a drowning victim
recovered within one hour of submergence in water below 70 degrees F.
must be immediately resuscitated (CPR) upon reaching the surface. Such a
victim's chances for recovery are good. However, personnel must also
realize that nothing is certain. A victim may be successfully
resuscitated and later die due to excess fluids in the lungs (secondary
is likewise critical that every resuscitated drowning victim be transported
to a medical facility without delay.
to conducting a search for a drowning victim, any witness(es) should
be interviewed to establish the last seen location of the
victim in the water. Each witness should be taken separately to the
exact spot (if possible) from where he last saw the victim and told
to point out the location. Avoid asking the witness to estimate
the distance and avoid also accepting any estimate of distance from
a witness as such estimates over water are extremely difficult to judge
and experience has shown them to be notoriously in error.
the witness has pointed out a location, divert his attention. Have him
stand with his back toward the area he indicated or if necessary,
remove him from the area while the interviewer solicits additional
information from the witness. Out of view of the witness put a swimmer
into the water (diver in free-diving gear) and have him
swim to the location that the witness indicated. Do not allow
the witness to watch the swimmer as it will affect his judgment with
respect to the last location of the victim. With the swimmer
in place, return the witness to where he indicated he was when
he last viewed the victim. Confirm with the witness that the swimmer
is in the exact location. If the witness wishes, allow him
to relocate the swimmer. Once the location is confirmed have the swimmer
mark the location, deploy divers, and commence the underwater search.
still water, a drowned body will drop straight down. However, most bodies
of water of any significant size will have some water movement
which will tend to move the body along as it descends. In
the ocean, where strong currents may exist, a drowning victim may be
moved a considerable distance prior to reaching bottom.
In moving water such as a river, the location of a body
will depend on several factors: depth of water; the volume of moving
water; velocity of the water; and bottom contour. In swift
moving water, a body may be transported several miles.
locating a submerged drowning victim, unless entangled, the searcher
will invariably discover the body to be in the classic drowning
position. Which is to say, in a jackknife position with
buttocks high and head, arms and legs below trunk due to the absence
of gas pockets in these areas of the body. Depending upon
the relationship of the time of the "find" with respect to
the time of drowning, the body may begin to re-float. A
variety of factors will influence body re-float time including:
depth; water temperature; type of water (fresh water, salt water, brackish
water); organisms and wildlife in the water, clothing worn;
any amount of air trapped in the victim's lungs; amount,
type, and time of last food ingestion; any added weight; or mode of
death (drowning vs. boating accident, etc.). In water warmer
than 70 degrees F, a body may re-float in approximately one day;
in water colder than 38 degrees F, a body many never resurface.
thought must be devoted to the method of recovery of the body prior
to the actual find. The body can be placed into a body
bag and buoyed to the surface (refer to the chapter on recovery and salvage), or alternatively the diver can swim the body
on the surface for hoisting aboard a watercraft, or swim
the body into shallow water for bagging. At any rate, the body should
be placed into the body bag out of the view of onlookers,
witnesses, and especially family members. Divers should
then await the arrival of Coroner's officials prior to transporting
the body to shore. It will be important for the coroner
to know at what depth the body was found, the position of the body,
any conditions which existed such as entanglements, etc.
and any modifications which were performed to the body
and/or its clothing during the recovery.
primary causes of scuba diving deaths are listed as follows:
1. Physical and/or psychological problems (cardiovascular
problem, hypothermia, sea sickness etc.)
2. Environmental Condition (surf, cave, etc.)
3. Buddy system failure
4. Equipment difficulties (misuse of, lack of, lack
of knowledge concerning, etc.)
5. Running out of air
6. Ascent difficulties
locating the victim of a scuba diving accident, the searcher
will most likely find the body to be face up. Unfortunately
most divers are found with their weight belts on. The weight
of the belt combined with that of the tank will
cause the diver to come to rest on his back with his hands and feet floating up. Of course, this will not be the
case in the event of entanglement nor when the diver is
to recovering the body of a deceased scuba diver, take time
to make a mental inventory of the diver's equipment
and it's condition:
Mask: In place? Flooded?
Fins: Both on?
Snorkel: Attached to mask?
Wet Suit: Fully suited? Condition?
Regulator: Reading of pressure gauge at depth?
Tank: Valve open? How much?
7. Weight belt: Belt on? Quick release inaccessible
Other miscellaneous equipment: Speargun,
Buoyancy Control Device: Properly
Should you discover
any necessary equipment to be missing, mark
the body with a surface buoy and check the
immediate area around the body. Chances
are, any missing equipment will be
located. Prior to recovery of the diver,
turn off the air in the tank. Do not
manipulate the diver's equipment in any
other manner except as is necessary to facilitate recovery. (i.e.:
removing weight belt) Send all equipment
involved in a scuba death to the Coroner's
office with the body.