Episode Transcript
Interviewer: What does a drowning look like? It's probably not what you imagine and we'll talk about that with Dr. Scott Youngquist next on The Scope.
Announcer: Health information from expects, supported by research. From University of Utah Health, this is TheScopeRadio.com.
Interviewer: So I think when you think of somebody drowning, you picture somebody flailing their arms, really struggling, and it's like really obvious that somebody needs your help but that might not be the case. Dr. Scott Youngquist is an emergency room doctor at University of Utah Health Care. What does a drowning really look like?
Dr. Scott: Well, you'd be surprised. It's remarkably undramatic in nature and most of the time it's not recognized by people who are watching swimmers. A good trained lifeguard will notice the signs of drowning but the fascinating thing is that 50% of kids who drown do so within 25 yards of a parent. In fact, 10% of those drownings occur while the parent is watching so they're not recognizing this as a drowning at all. It just looks like the kid's in the water and seems to be doing fine.
They're expecting some sort of thrashing, screaming cries for help and things like that. And certainly if somebody is crying for help, they need help and we need to get to them. But there is this subtle drowning that occurs that will not be recognized by most people who don't have some training. There's a prototypical behavior that's very quiet and virtually silent that occurs and if you can recognize that, you can jump in and help the person.
Interviewer: And this is stuff that lifeguards are trained to see?
Dr. Scott: Yes, a good lifeguard should be trained to recognize these signs.
Interviewer: Well, let's jump into what some of the signs are. Does it vary whether you're in the pool or the ocean or a lake?
Dr. Scott: It probably varies to the extent that the ocean will have particular risks like rip tides and things like that that need to be recognized. So one thing in a current based water body like the ocean is that you may notice somebody who's swimming and not making any headway may be a sign of drowning. Whereas in a pool, that may be a less common sign.
Interviewer: Sure. All right, so let's talk about some of the things that lifeguards look for, they usually look for drowning, you know, that somebody is drowning.
Dr. Scott: Okay. Well, during the drowning response, as it's called, which doesn't look like drowning at all as we expect, it occurs silently and rapidly. The person often is not kicking their legs so the legs are still. The person holds their face near the top of the water usually with their head tilted back and their mouth at the level of water. And they'll be bobbing up and down opening their mouth, trying to gasp for air and they won't be able to scream because of the work required to try to get air in as they bob up to the surface.
Their arms are often extended out from them and they're used to push down against the water and bring them toward the surface. And this is actually a non-voluntary response. It's something that's hardwired and reflexive in the sort of the lower parts of our brain to try to help us survive a drowning event.
So their head's back, their mouth is open, they may have hair over their eyes and forehead. So if you see somebody who's swimming and their hair is completely covering their eyes, that's abnormal. People normally remove that from their eyes so they can see where they're going, what they're doing, so that can be a subtle sign as well.
Their eyes may be closed. Their eyes, if open, will have a glassy appearance, they seem to be not fixed on any particular object or looking around. They're just kind of staring off into space. They may be hyperventilating or gasping as I said, and they often appear to be climbing an invisible ladder using those arms to try to pull themselves up into the top of the water and get some air.
They may be trying to roll onto their back and as I mentioned before trying to swim without making any headway, particularly in the ocean. So those are the signs. As I say, they're subtle, they can be indistinguishable from somebody who's just sort of floating on their back and their legs are down below them, but are the things to watch for.
Interviewer: And again, I think it's important to stress that it could be a very calm event.
Dr. Scott: Absolutely.
Interviewer: Like you wouldn't know the struggle going on unless you look for some of those signs.
Dr. Scott: That's how I think it occurs when a parent turns around finds a child at the bottom of the pool. And they last saw them just a few seconds before and they seemed to be swimming normally. Actually, they were drowning beforehand, they just didn't recognize it. And they finally recognize it when they're at the bottom of the pool.
Interviewer: Yes. What causes drowning most of the time? Is it just exhaustion and unable to be able to hold yourself above water? Is it cramping, you know, the whole don't go swimming two hours when you've eaten?
Dr. Scott: Yes. Some of it is the skill level of the swimmer. So kids can drown in very small amounts of water, toilet water, small, little pool with a foot of water can be enough for a toddler to drown. In fact, I remember in Los Angeles riding along with paramedics to a drowning where a kid had drowned in one of those small plastic backyard pools. Had to be pulled out of there and even though the kid didn't have any swimming skills, the parents thought he's probably find to be unattended for a little while in the small amount of water but somehow got face down and drowned.
So there's an age dependency to it. Alcohol is a big risk factor for drowning in adults. So drinking and swimming is a terrible idea, more than eating before you get into the water. If you're going to swim out to a buoy or something like that then obviously you don't want to cramp or a rip tide or something like that can make it impossible for you to get back in and you fatigue. But those are the main risk factors.
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