Biomechanics and Medicine in Swimming XI

Table 2: Key messages of open-water Drowning Prevention: Care of
Others
1.
Help and encourage others, especially children, to learn swimming
and water safety survival skills
2. Swim in areas with lifeguards
3. Set water safety rules
4.
5.
Always provide close and constant attention to children you are
supervising in or near water
Know how and when to use a life jacket, especially with children
and weak swimmers
6. Learn first aid and CPR
7.
Learn safe ways of rescuing others without putting yourself in
danger
8. Obey all safety signs and warning flags
dIscussIon
From an original database containing over 60 messages related to care of
self and care of others during swimming-related, open water recreation,
the Task Force agreed on 16 key messages that would most foster drowning
prevention. Learning swimming and water safety survival skills was
the dominant message in both Care of self and Care of others categories.
The collective reasoning supporting this dominance was that being able
to swim reduced the chance of a serious incident in or near the water, but
the Task Force reiterated that swimming ability alone was no guarantee
of safety. Most people learned to swim in a pool or calm water setting,
but this does not fully prepare swimmers for open waters such lakes, rivers
or beaches and even good swimmers can encounter life-threatening
problems. Swimming safely in any open water therefore requires special
caution since different types of open water have changing risks such as
cold, currents and high waves (Golden & Tipton, 2002).
Task Force members concurred in the belief that swimmers should
never underestimate the risk of drowning or overestimate their ability
to cope with those risks during aquatic activity (Michalsen, 2006). Thus
water safety was deemed to be more than just swimming competency;
it was also about having the knowledge and attitudes to be safe in and
around water. In the case of caring for others, it was further reasoned
that encouraging others, especially children, to learn swimming and water
safety survival skills was a prime responsibility, especially for parents
and caregivers.
Another strongly supported message in both Care of self and Care of
others categories related to swimming with lifeguard supervision (ranked
second and sixth respectively). While recognizing that no water is ever
completely free from risk, evidence of the efficacy of lifeguard supervision
in drowning prevention is compelling (for example, Branche &
Stewart, 2001). Lifeguards are trained to promote safe behavior around
the water and to prevent drowning by helping those in distress through
the provision of rescue and medical assistance. A key part of the safety
actions advised by the Task Force was for people to check with the lifeguards
for safety advice about the location before entering the water.
They also noted that, when caring for others even at a life-guarded location,
the onus of supervisory care was still primarily that of the parent or
caregiver. Furthermore, that supervision should be close, constant, and
without distraction.
Several important messages focused on the personal application of
safety rules in the Care of self category. These included: always swim with
others (ranked second), obey all safety signs and warning flags (ranked
third), never mix swimming with alcohol (ranked fourth), and know the
chaPter6.medicineandwatersafety
weather and water conditions before getting in the water (ranked seventh).
The safety value of swimming with others was predicated on the
knowledge that many drowning deaths involve people swimming alone
and that immediate assistance in the event of difficulty and the ability
of others to signal or call for help would minimize the risk of drowning.
The fourth-placed ranking given to never mixing alcohol with swimming
reflected the incidence of alcohol-related drowning fatalities, and
because alcohol exacerbates cold water immersion effects, and impairs
judgment.
The message to obey all safety signs and warning flags (ranked third
in Care of self and eighth in Care of others) was grounded in the importance
of informing the public of potential hazards in order that they
can make informed decisions about their safety. Safety signs may contain
prohibition notices (such as surfing only or no swimming), warning
signs (such as strong currents or deep water) or mandatory signs (such
as wear a lifejacket) (Sims, 2006). Flags are often used to show areas patrolled
by lifeguards (such as red and yellow flags), restricted areas (such
as black and white quartered flags for surfing only), or flags indicating
weather and water conditions (such as red flags for dangerous conditions
or closed beaches).
The use of lifejackets (PFD’s), traditionally associated with boating
and land-based fishing safety, ranked fifth in both categories and was
deemed important in open water swimming activity especially where
immersion was likely to lead to involuntary submersion (Brooks et al.,
2006). It was especially noted that lifejackets provided safety in the water
especially for children, weak, tired or injured swimmers.
In the Care of others category, the Task Force strongly supported
messages related to supervision skills, notably the setting of water safety
rules (ranked third), the provision of close and constant attention of
children (ranked fourth), as well as the lifesaving skills of learning first
aid and CPR (ranked sixth) and safe rescue techniques (ranked seventh).
In the latter, because would-be rescuers sometimes become victims in
multiple drowning tragedies, caution about personal risk was a focal
point in discussion and advice for intervention focused on the acquisition
of non-immersion, non-contact rescue techniques.
Results of this project should be treated with some caution in light
of several methodological limitations. Firstly, the self-appointed Task
Force may not have been wholly representative of the drowning prevention
community. High income level countries whose incidence of
drowning are highly related with frequent recreational water use were
over-represented compared to low income level and regions whose
drowning rates may not be linked to aquatic recreation. Secondly, members
were more likely to be involved in surf and ocean settings than lakes
and river recreational activities. Fourthly, lack of universally agreed terminology
and language constraints placed limitations on the meaning of
messages. We anticipate that various cultures and languages will need to
interpret the recommendations with caution so as to reduce the risk of
loss of meaning in translation. Finally, the group was not sanctioned nor
funded by any global organization so participation was voluntary and
constrained by other professional commitments and personal resources.
These limitations notwithstanding, the generic water safety messages
provide a comprehensive, concise and universal framework for communicating
open water drowning prevention messages at an international,
national, regional, and community level.
conclusIon
The recommendations have established informed, consistent, and concise
messages that promote safe recreational use of open water. It is
hoped that they will improve the clarity of communication between
drowning prevention organizations and the public they serve as well as
provide a framework for safety messaging that is applicable to a range of
communities and settings with the ultimate goal of saving lives.
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