Australia is known for the beautiful beaches and abundant inland waterways which cater for our leisure time with a multitude of popular water-based activities. And let’s not forget the ever-increasing numbers of Australians who have a swimming pool at home – around 2.7 million people (or 13% of the population) by one account. Our national love of the water does not come without potentially deadly consequences however…
- We see too many tourists (both local and international) who cannot swim or are weak swimmers enter our surf beaches and be dumped by waves or taken out by rips. If they're lucky enough it will happen at a crowded patrolled beach and they will noticed and rescued by surf lifesavers.
- Rock fishing, which is carried out on rocky outcrops over the sea or from breakwaters, is noted as one of the most dangerous sports in Australia and has resulted in an average of 13 deaths per year. Waves, rough seas and slippery rock surfaces are just three of the more obvious perils which raise the risk of injury or death in rock fishers.
- Installed home water features like outdoor ponds or dams are drowning hazards for inquisitive children.
- So too are activities in flood waters or even attempting to drive along or cross a road in flood.
The tragic end result is that Australia averages 281 deaths per year from accidental drowning incidents.
And what is the definition of accidental drowning? A respiratory deficiency following submersion or immersion in fluid, usually water. Drowning most commonly occurs outdoors during recreational activities in or near the water (such as rock fishing), but it can also occur in the bath at home.
Drowning can cause three outcomes:
- Fatal drowning - death caused by suffocation after submersion in fluid (usually water) or inhaling water.
- Non-fatal drowning with injury or illness – when fluid enters the lungs and disrupts the gas exchange, resulting in inflammation and infection. This can progress to respiratory failure.
- Non-fatal drowning without injury or illness – where some fluid enters the lungs without causing any serious issues.
The outcome for someone who has been immersed and inhaled water (or another fluid) and has minimal symptoms will become obvious generally within two to three hours. As you would expect, any person who has been involved in a drowning episode should be observed in an emergency department to confirm no injury or illness has developed, usually for at least four to six hours.
Drowning statistics worldwide:
- Over the past 10 years more than 2.5 million preventable deaths have resulted from drowning.
- Drowning is the 3rd leading cause of death in children aged 1-14.
- Around 80% of deaths from drowning are males.
- Alcohol use is involved in up to 70% of deaths linked with water recreation.
Drowning statistics Australia:
- Every year on average, 281 people die from accidental drowning in Australia.
- Swimming was the leading activity being undertaken prior to drowning, accounting for a quarter of deaths (25%), followed by boating (18%) and falls (15%).
- The highest incidence of drowning occurs in rivers.
- Men aged 25-34 years are the most at-risk demographic.
Understand the risks of drowning
Unpatrolled beaches:
Multiple unforseen hazards can present risks to the unwary or unprepared - such as rips, tidal and runback currents, unexpected waves, drop offs, sand bars, marine stingers, submerged objects and surf craft.
- Rips are one of the most common hazards at Australian beaches. Rips are fast-moving currents where the water usually flows away from the shore and out to sea.
Lack of safety during water activities:
The absence of safety precautions, including use of lifejackets and buoyancy devices, during water activities is a significant factor in the increased risk of drowning.
Alcohol and drugs:
Alcohol and drugs can impact balance, coordination and judgment, which are then intensified with sun exposure and heat. Alcohol and drugs not only increase the risk of drowning, but reduce the ability of a person to respond to a perilous situation.
Management of a drowning situation
The steps as determined by the Australian Resuscitation Council are as follows –
• Remove the victim from the water as soon as possible but do not endanger your own safety. Throw a rope or something to provide buoyancy to the victim. Call for help; plan and effect a safe rescue.
• In minor incidents, removal from the water is often followed by coughing and spontaneous resumption of breathing.
• In more serious incidents, assess the victim. If unconscious or not breathing normally, commence resuscitation following the Australian Resuscitation Council Basic Life Support flow chart. (ARC Guideline 8).
• Assess the victim on the back with the head and the body at the same level, rather than in a head down position. This decreases the likelihood of regurgitation and vomiting and is associated with increased survival.
• The victim should not be routinely rolled onto the side to assess airway and breathing. Assessing the airway of the victim without turning onto the side (i.e. leaving the victim on the back or in the position in which they have been found) has the advantages of simplified teaching, taking less time to perform and avoids movement.
• The exceptions to this would be where the airway is obstructed with fluid (water or blood) or particulate matter (sand, debris, vomit). In this instance the victim should be promptly rolled onto the side to clear the airway. The mouth should be opened and turned slightly downwards to allow any foreign material to drain using gravity (Guideline 4).
• Vomiting and regurgitation often occur during the resuscitation of a drowned victim. If the victim has been rolled to the side to clear the airway, then reassess their condition. If breathing commences, the victim can be left on the side with appropriate head tilt. If not breathing normally, the victim should be promptly rolled onto the back and resuscitation recommenced as appropriate (Guideline 4).
• Avoid delays or interruptions to CPR. Do not empty a distended stomach by applying external pressure. Do not attempt to expel or drain clear water or frothy fluid that may re-accumulate in the upper airway during resuscitation.
• Victims who appear to have been successfully rescued and resuscitated require close monitoring to detect a relapse into cardiopulmonary arrest. This can occur in the minutes or hours following return of spontaneous circulation and breathing, due to persisting lung damage and hypoxic injury to the heart.
• Call an ambulance for all victims of an immersion event, even if seemingly minor or the victim appears recovered.
Staying safe in and around water
Patrolled beaches:
Swim at a patrolled beach between the red and yellow flags.
Safety Equipment:
Wear a lifejacket when using water craft and while rock fishing (& wear appropriate shoes).
Don’t rock fish alone:
Don’t go rock fishing solo and always let family and friends know when and where you’ll be. Keep a careful eye out for your fishing friends and also the sea!
Supervision:
Children must be supervised at all times in, on and around water.
Buddy System:
Always swim with a buddy and keep a look out for each other.
Swimming skills:
Learn and practise swimming, water safety and gain lifesaving skills. Do not swim where conditions are beyond your capabilities. If in doubt, stay out of the water.
Stay alert:
Avoid combining alcohol and/or drugs and water activities. Be aware some medications may also have side effects that can affect alertness, judgement and decision-making.
Learn CPR:
CPR has been shown to save lives and improve outcomes in drowning victims. The quicker CPR is commenced, the greater chance of a better outcome.
Weather forecast and water conditions updates:
The Bureau of Meteorology has developed ‘dangerous surf warnings’, to inform beachgoers, including rock fishers, of the risks along the coast. Make sure you know the forecasted weather and conditions before you go.
References:
ACOEP, 2021. The truth about drowning, https://acoep.org/blog/2018/05/30/the-truth-about-drowning/
Roy Morgan - Swimming pool ownership increases in Australia: http://www.roymorgan.com/findings/7811-australian-swimming-pool-ownership-september-2018-201811230555
United Nations General Assembly, April 28, 2021: Resolution on Global Drowning Prevention (A/75/L.76)
Australian Injury Prevention Network: https://aipn.com.au/injury-resources/injury-topics/drowning/
Australian Resuscitation Council - Guideline 9.3.2 - Resuscitation of the Drowning Victim: https://resus.org.au/guidelines/
Australian Institute of Health and Welfare: https://www.aihw.gov.au/getmedia/ee440856-4360-4ede-b3a0-85bb8903f4dd/phe205-drowning.pdf.aspx
CDC, 2020. https://www.cdc.gov/homeandrecreationalsafety/water-safety/waterinjuries-factsheet.html
Surf Life Saving Australia: https://sls.com.au
SafeFishing - rock fishing safety tips: http://safefishing.com.au/?page_id=55
Water Safety, 2020. https://www.watersafety.nsw.gov.au/Pages/rock-fishing/rock-fishing-safety.aspx
World Health Organisation, Geneva, 2017: Preventing drowning: an implementation guide. Licence: CC BY-NC-SA 3.0 IGO