Drowning Doesn’t Look Like You Think It Does: How To Recognize It

Summer is an invitation to take a splash in the ocean, a lake or swimming pool — something millions of Americans will do this Fourth of July weekend — and tragedy often ruins the fun. More than 3,700 Americans drowned in 2017, according to the U.S. Centers for Disease Control and Prevention statistics, more than 700 of them under the age of 14.

About 10 people drown every day in the United States, where drowning is the fifth-leading cause of unintentional injury death, according to the CDC. About one in five people who die from drowning are children 14 and younger, and for every child who dies from drowning, another five are rescued, the agency said.

The CDC said the annual death toll doesn’t include an additional 332 people who drown every year in boating-related incidents.

The five states with the highest downing death rates in 2017, the latest year for which statistics are available, are:

1. Hawaii, 3.2 drowning deaths per 100,000 population
2. Louisiana, 2.1 drowning deaths per 100,000 population
3. Florida, 1.9 drowning deaths per 100,000 population
4. Arkansas, 1.8 drowning deaths per 100,000 population
5. Idaho, 1.7 drowning deaths per 100,000 population

One of the problems with drowning is it doesn’t look at all like the dramatic scenarios depicted on television and in the movies. Real-life drowning happens quietly, and there are no flailing arms and frantic calls for help. People can’t simply stop drowning long enough to take in a breath of air and call for help. The human body isn’t built that way.

Children can drown right in front of parents, as little as 10 feet away. That happened in New York a few years back, when a boat captain and former lifeguard trained to recognize what’s called Instinctive Drowning Response saw what the parents of a 10-year-old girl couldn’t see from a few feet: Their daughter was drowning. He was able to save the girl because he knows what drowning looks like.

Drowning is the second-most common cause of accidental death among children 14 and younger, according to the federal Centers for Disease Control and Prevention. About 750 children drown each year, 375 of whom do so within 25 yards of a parent or adult. More startling, the CDC said 10 percent of parents watch their children drown because they don’t know it’s happening.

Before people drown, they may thrash around in the water — a sign they’re in “aquatic distress,” which may or may not happen before a drowning. They’re normally able to assist in their own rescue by grabbing lifelines, throw rings and other devices.

A true drowning victim, like the little girl saved by the boat captain, is most often helpless. That’s because the body instinctively responds to drowning, according to lifeguard Francesco Pia, who came up with the name, Instinctive Drowning Response, to describe the process.

Rescuers have as few as 20 seconds and up to a minute to save a person from drowning.

Here are five tips for recognizing drowning, as originally published in the Coast Guard’s On Scene magazine and shared by Slate.com:

1. In all but rare circumstances, people are physiologically unable to call for help. The respiratory system is designed for breathing, and speech is a secondary function. “Breathing must be fulfilled before speech occurs,” the article said.

2. A drowning person’s mouth alternately sinks below the surface of the water and then reappears, but the mouth is never above the surface long enough to exhale, inhale and cry for help. A drowning person will exhale and inhale quickly before their mouths start to sink below the surface of the water again.

3. Drowning people can’t flag down help. “Nature instinctively forces them to extend their arms laterally and press down on the water’s surface,” the article said. “Pressing down on the surface of the water permits drowning people to leverage their bodies so they can lift their mouths out of the water to breathe.”

4. When they’re drowning, people lose control of their arms. They’re struggling to stay afloat in the water, and “cannot stop drowning and perform voluntary movements such as waving for help, moving toward a rescuer, or teaching out for a piece of rescue equipment,” the article said.

5. While they’re drowning, people will remain upright in the water, and there’s no evidence of a supporting kick.

Some signs to look for also include:

• The drowning person’s head is tilted back with the mouth open;
• Eyes appear glassy and empty, unable to focus, or may be closed;
• Hair may be over the forehead or eyes of the drowning person;
• The drowning person won’t be moving his or her legs;
• The drowning person may be hyperventilating or gasping;
• The person may be trying to swim in a particular direction, but isn’t making headway;
• The person may try to roll over the back;
• The person may appear to be climbing an invisible ladder.

Young children are especially at risk because they can slip quickly away from their parents and go into water without understanding how dangerous it is, according to Parent.com. The most important thing is to get the drowning child out of the water as quickly as possible. If the child isn’t breathing, flip the child over on his or her back and begin rescue breathing while someone else calls for help. Don’t stop performing CPR until medical help arrives, even if the child is unresponsive.

Here are the steps you should follow:

1. Open the child’s airway by gently tilting back the head with one hand and lifting the chin with the other. Put your ear the child’s mouth and nose, and look, listen and feel for signs the child is breathing. Do you feel air or your cheek? Is the infant’s chest moving? While you’re doing this, call the child’s name and check for a response. Can you hear breathing (gasping for air isn’t breathing)? If the child isn’t breathing, what you do next depends on the age of the child.

2. For a child under 1 year, cover the infant’s nose and mouth with your mouth and breathe out two shots of air, each lasting about a second, and look for the chest to rise and fall. If the child or person is older, pinch the child’s nose, and seal your lips around the mouth. Give two, slow, full breaths, about a second each, then wait for the chest to rise and fall.

3. Check for a pulse once you see the person’s chest rising and falling. To check for the pulse, put two fingers on the child’s neck to the side of the Adam’s apple. To find an infant’s pulse, feel inside the arm between the elbow and shoulder. Wait five seconds, and if there still is no pulse, give one breath every three seconds. Check for a pulse every minute, and continue rescue breathing until the child begins breathing or help arrives. When you resume rescue breathing, be sure to tilt the child’s head back and lift the chin.

4. If you can’t find a pulse, you’ll need to begin chest compressions. For infants, visualize a line between the child’s nipples and place two fingers just below the midpoint, then apply five quick, half-inch compressions in about three seconds. After each one, give one breath using the rescue breathing technique. Among older children, use the heel of your hand — or both hands if the person is a teenager or adult — and apply five quick, one-inch compressions to the breastbone (just above where the ribs come together) in about three seconds. After five compressions, perform rescue breathing and give one full breath. For all ages, continue the cycle of five chest compressions followed by a breath in one minute until the person begins breathing on their own or help arrives.

Drowning hazards aren’t limited to big bodies of water, though. Infants and toddlers can drown in as little as two inches of water, including in bath tubs, buckets and containers, toilet bowls, diaper pails and wading pools, according to Parent.com.