The term ‘silent drowning’ gets featured in the media from time to time, often with headlines designed to catch the viewer or reader’s eye such as ‘Drowning isn’t like it is in the movies – know the signs’. So what is ‘silent drowning’, how does it fit in with everything else we know about drowning, and are we all ready to ‘know the signs’?.
Notable research in this area started in the 1970s with the pioneering work of Frank Pia, who published a number of papers based on a video study of drownings at Orchard Beach, New York (‘On Drowning: A Training Aid’). This research outlined the ‘instinctive drowning response’, the definition of which still forms many of the descriptions of a drowning casualty today.
CCTV is now commonplace and had led to more and more drowning incidents being caught on camera which, combined with more recent research, continues to develop our understanding of how drowning victims behave. The images below show two swimmers, the first a non-swimmer and the second a tired swimmer, both exhibiting the classic signs of the instinctive drowning response -, bobbing in the water, and reaching their arms up and then out to the side pushing down on the water. In both of these cases the casualties (who were both rescued) did not call for help.
However, it is important to recognise that no two drowning incidents are the same, and that swimmers of differing ability and health, and in different drowning situations, will behave differently.
So there is a danger in some media reports that would seem to suggest all incidents of ‘silent drowning’ occur in this way.
Since 2011, the RLSS UK community education programmes have used three simple categories to help members of the public to recognise a drowning casualty, and also to identify the level of danger posed by a casualty to a rescuer.
- A Panicking Casualty is in a desperate state, and is likely to have already started the drowning process. The casualty may be vertical in the water, bobbing up and down, and/or making actions such as waving their arms out of the water and to their side in an attempt to push themselves upwards. In the early stages of the drowning, or if the casualty has some buoyancy support, they may attempt periodic or frantic communication, or they may not be able to communicate at all due to the need to breathe in the moments that their mouth is clear of the water, or as a result of inhaling water into their throat. Whichever of these actions the casualty performs, the identifying factor is that their actions and communication (noisy or silent) is ineffective, and without intervention the casualty is likely to drown.
- A Non-Panicking Casualty may not yet have started the drowning process, but has recognised that they will need help to get out of the water or to prevent their situation from worsening. The casualty may still be able to swim or float, or may have a buoyancy aid, which helps them to keep their airway clear of the water and to stay calm. The identifying factor for a non-panicking casualty is that communication will be effective, and this enables a wider range of rescue techniques to be used.
- An Unconscious Casualty may have fatally drowned or suffered from some other medical condition in the water. They casualty may be at any level in the water, from the surface to the waterbed. Without immediate rescue and first aid the casualty will not survive.
The above shows that not all drowning casualties behave in the same way. It is important that when supervising activities in water to be aware of all the signs of a drowning casualty and act immediately using training you have been given.