Troubled waters

Most drowning deaths are easily preventable, says a leading expert

Danielle Laxdal and Bassett family
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Reduce your risk of drowning

Winnipeg Health Region
Wave, July / August 2016

The odds are that as many as 20 Manitobans may drown this summer.

And the odds are that each and every one of those deaths would have been preventable, according to Dr. Alecs Chochinov, Medical Director of the Winnipeg Regional Health Authority’s Emergency Program.

“We know that there will be, on average, 15 or 20 people drowning each year in Manitoba,” says Chochinov, who has done research on drowning. “And it’s such a shame, because drowning is largely preventable.”

Of the many accidental ways people can die, the majority of cases involve motor vehicle crashes, overdoses and falls, says Chochinov. But drowning is consistently in the top five. Moreover, drowning “almost always happens to otherwise healthy people,” he says.

Interestingly, the vast majority of people who drown do not do so because they were poor swimmers or because they were involved in circumstances beyond their control. Planes crashing into the water and capsized refugee boats are the stuff of headlines, but represent only a fraction of the total cases of drowning.

Instead, Chochinov says, the reason people drown is rooted in cultural practice and simple, but poor, choices. Simply put, the culture of how people interact with water has to change, he says.

“When I grew up, my parents didn’t think anything of putting five of us into an old Chevy Biscayne with no seatbelts,” says Chochinov. “It took time to change that mentality. The same thing goes today. You see people not wearing their PFDs (personal flotation devices) in boats. You see parents looking at their cell phone, while their young kids are swimming in the lake. People are still diving head-first into water that’s too shallow.”

And of course, there is the use of alcohol. If alcohol is combined with boating or swimming, the risk of drowning goes up exponentially, as alcohol impairs judgment and co-ordination, he says.

In addition to underestimating the danger posed by water, Chochinov says people also lack an understanding about the mechanics of drowning.

As he explains, people need to understand that drowning can happen quickly.

“You can literally see a person swimming, and the next moment, they’ve slipped under the water,” he says. “There’s often no visible drama to drowning.”

One factor that expedites drowning is the loss of energy. “A person who is struggling in the water is using 90 per cent of their energy to stay afloat,” he says. “Screaming for help is a luxury. They aren’t thinking rationally and they’re acting out of pure desperation.”

Another factor is that first gulp of water. “Once they take their first inhalation of water, they’ll start gasping and choking because of the water in their lungs, so it’s impossible to hold their breath,” says Chochinov. “The water can also cause a severe spasm of the upper airway in their body.”

All of this is exacerbated when someone falls into very cold water. Cold water occurs from fall to spring in southern Manitoba, but anyone who has taken a canoe trip up north in the summer knows how cold the water is, even in high summer.

“When you fall into very cold water, something called ‘cold water shock’ can cause you to drown rapidly,” says Chochinov. “In cold water, people drown differently. If they aren’t wearing a PFD, they will become submerged before they have time to become hypothermic. Hypothermia takes time to occur, so if you fell into Lake Winnipeg wearing a PFD and weren’t rescued for a while, if you managed to keep your head above water, you could last for several hours before becoming hypothermic.”

Instead, in very cold water, 90 per cent of people die of asphyxia, often initiated by an immediate gasping response, which may be related to the “mammalian gasp reflex.”

“You often involuntarily take in a big breath when you hit the cold water,” says Chochinov. “You can’t help it, and that first gasping intake of cold water can drown you.”

Susie Strachan is a communications specialist with the Winnipeg Regional Health Authority.

Wave: November / December 2015

About Wave

Wave is published six times a year by the Winnipeg Health Region in cooperation with the Winnipeg Free Press. It is available at newsstands, hospitals and clinics throughout Winnipeg, as well as McNally Robinson Books.

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