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Swimming is dangerous. Know your limits
September 19, 2019 | 10:10 AM
by Gautam Viswanathan
 
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There’s nothing quite as relaxing as splashing around in a pool, particularly if all you want to do is have some fun.

As an adult, you can surely relate to the relief you feel when you first dive in, your stress and worries being carried away by the water as it ebbs and flows around you. As you glide around effortlessly, you spot a group of children – no more than four or five years old – splish-splashing around in the shallow end, one of their fathers keeping an eagle eye on them.

While the children continue to frolic in the water, one of the more precocious ones begins to tiptoe towards the deep end, his eyes widening with excitement and naughtiness as he attempts to do what he’s been repeatedly told not to.

As he unsteadily toddles towards the deeper end of the pool, immersing more and more of his little body in the water as the floor continues to steadily slope downwards, his father is on hand to grab him under his armpits and out of the water. His devious plan foiled, the child utters a squeal of annoyance before his dad gives him a stern talking-to.



Squinting into the sunlight, as he looks up at the tall form of his father, this little four-year-old does not understand the dangers of swimming without preparation, and it’s up to their parents to tell them the consequences of swimming in deep water before they are ready to do so.

Across Oman, as well as other countries around the world, we unfortunately hear stories of children drowning because they did not know how to swim. Worse still, there have been cases of children drowning because there was no one supervising them – their parents occupied elsewhere, when they should’ve been near their children – with any assistance sent their way coming far too late.



All too often, we come across tales of children who drown in lakes and wadis while on family picnics, in wells when they go to meet their relatives in their hometown, or perish when the currents of the sea prove to be too strong for them.

Swim the right way

This week T Weekly speaks to doctors, swim coaches and lifeguards in Oman about the importance of learning to swim the right way, and what action must be taken should you find someone drowning.

Dr Francy Pulikkan, an internist at Burjeel Hospital in Muscat, described what happens to the human body when drowning begins to take place.

“People panic in the water because they know they are about to drown,” he said. “This is the body’s natural mechanism. Once water enters the lungs, then its ability to perform is reduced, because the function of the lungs is to exchange air. If water enters the body, air exchange does not take place. Oxygen is needed for survival and enters the body through the lungs, with carbon dioxide being breathed out.

He went on, “When you start drowning, water enters the lungs, so air cannot enter the blood, because there is water there. This leads to hypoxia or low oxygen content in the blood. Since oxygen is required for all bodily functions, including brain function, as soon as water enters the lungs, the oxygen supply to the brain is cut off and that is how people die due to drowning.

“As and when more and more water enters, the level of oxygenation reduces, and the intensity of the effect of drowning is increased. There is a loss of brain function, and this is when panic sets in. This results in breathlessness and ultimately, death. This is how it progresses,” he explained.

What do you do however, if you see someone who is drowning and requires help? Dr Pulikkan says that if you are able to safely reach the person then please do not hesitate to do so. Bringing the drowning person to shallow waters or onto land will help them once again get better access to fresh oxygen, which will get their body working again and reduce their immediate sense of panic.

If, however, you find that the person is unconscious, then you need to start cardiopulmonary resuscitation (CPR) straightaway. CPR involves chest compressions for adults, at a rate of between 100-120 compressions per minute, with the chest being compressed to a depth of between five and six centimetres each time.

This does not force the water out of the body, unlike what’s often shown on TV, where David Hasselhoff in his red lifeguard trunks runs in slow-motion towards an unconscious person who’s just been pulled from the sea. What it does do is re-establish the flow of oxygen to the body.

“When you see someone drowning, please get him out of the water immediately or take him to the shallow end so that his head is above water and he can get access to air,” said Pulikkan. “If the patient is non-responsive, please start CPR, but if you think you’ll be able to force the water out of the patient, then you are likely to be wrong: this is not like they show it in the movies. If the patient does not respond, perform CPR immediately. It is not to bring the water out of the chest but to improve oxygenation and increase blood circulation in the body.”

Dealing with drowning

The Nautilus swimming club in Muscat, which runs swim classes for children and adults, say that only people who know how to deal with those who are drowning should go to rescue them. While it is, of course, undeniably noble to attempt to save someone who is drowning, a person who is unfamiliar with how to assist in such a situation might actually drown themselves.

Coach Irina Samakar of the Nautilus swimming club said, “It is extremely dangerous to swim up to the drowning person by yourself, especially if you are not a good swimmer and you don’t know how to rescue people from the water. The person in panic could drag you down as well. You need to throw that person any floating item which will keep him on the surface, then scream and call for help.

She went on to say, “If you are confident enough and decide to rescue someone by yourself, don’t allow that person to hold your arms or any other part of your body. It is better to swim to the person from behind and grab him by the hair or ears. You need to then get that person to a safe place, away from the water, while keeping his nose and mouth out of the water, so that he will be able to breathe.”

There might not, however, always be someone to aid you when you’re drowning, particularly if you’re swimming out in open water. Coach Irina did provide guidelines for those who find themselves in trouble. A professional competitive swimmer herself, Irina won medals at the Belarussian and Lithuanian national championships in the 100m and 200m back stroke.

She was also a finalist at the Polish and Ukrainian championships, while representing Belarus’ national swim team in 2008 and 2009, having also won many medals at other European competitions. She currently holds a Master’s degree in sports from her native Belarus.

“It depends on whether the person has any basic skills in swimming or experience of being in the water,” explained Irina. “If you have some, it’s going to be easier, of course. First of all, do not panic! Don’t try to scream - you will not be able to make loud sounds anyway. All you need is to breathe, so lay down on your back in a starfish position - legs, and arms spread wide, take a deep breath and exhale slowly keeping some oxygen inside. It will help you to be on the surface for a long time. Then, you can call for help, but keep breathing and continue to float.”

Don't overestimate your swimming skills

“If you don’t have a lot of swimming experience, try to avoid deep water because you need to be able to stand on the floor of the pool in case anything happens,” she said. “A person can slip or lose the balance and fall at the shallow end as well. Panic is one of the worst things that can happen. Without proper experience, a person can even sink and drown someone next to him. You need to be careful and not overestimate your swimming experience.”

Safety protocols that people must keep in mind do vary from public pools, where regular inspections are made, to private installations, where homeowners themselves may be responsible for ensuring their setups are up to scratch.

When it comes to swimming and boating in open water, though, that is when people have to be even more careful. Out at sea, the tides are often unpredictable and underestimated by some. It is those who do not treat the sea seriously that are most likely to face trouble in the water.

For years, Awantha Geethadewa, a trained swim coach and lifeguard, has been teaching both children and adults to swim. He has set out some guidelines which are simple and straightforward to follow.

“Take swimming lessons from a qualified instructor if you're not a strong, competent swimmer,” said Awantha. “Don't swim if you've been taking stimulants, and don’t swim alone or allow others to do so. Stay out of the water during thunderstorms and other severe weather. Don't exceed your swimming ability. Know your limits and stick to them.”

He added, “Check the water level before diving into a pool, ocean, pond, reservoir, or lake. Always dive with your arms extended firmly over your head and your hands together. Don't dive into unknown bodies of water, like lakes, rivers, quarries, or irrigation ditches. Jump feet first to avoid hitting your head (and breaking your neck or back) on a shallow bottom, hidden rock, or other obstruction.”

Double safety needed for children

Safety is doubly important when it comes to looking after children. While adults might have read about or seen such practices put into effect, children may not be aware of what constitutes safe swimming and how bending the rules could see them end up in deep water.

“Never leave a young child alone in a bathtub, wading pool, swimming pool, lake, or river. If you must answer the phone or get a towel, take the child with you,” said Awantha. “Be aware of backyard pools in your neighbourhood or apartment building. Your child could wander off and fall in. Enrol children in swimming lessons taught by qualified instructors, but remember, the lessons won't make children ‘drown-proof.’ Teach your older children that they risk drowning when they overestimate their swimming ability or underestimate water depth.”

Taking swimming lessons is something Irina Samakar agrees with. She teaches children across several age groups for Nautilus, alongside a group of several other skilled coaches. Swimming in a pool, however, is far safer than swimming in open water, which requires much improved preparation. Those who do swim in oceans, lakes and wadis have to be far more alert because of the unpredictable nature of the waters.

Even those who swim near the shore are in danger of being pulled further away by the currents of the sea, while those who attempt to wade across strong-flowing wadis could soon see themselves forced downstream with little or no time to react.

Swimming in natural water bodies

“The first danger of swimming in natural bodies of water is that they are open areas. We never know where the bottom is and how deep it is there,” she explained. “It is hard to know the flow of water in the ocean and in wadis, as it is not regulated, and extremely cold water may cause cramps. In this situation it is difficult to swim, and moreover, a person who doesn’t know what this is can start panicking. Water flow, creatures of the underwater world and rocks can make the situation even worse.”

Irina added, “In the swimming pool, you have a clear idea of where you are in the water, where the edge is, and you can stop and hold a line or wall at any moment. You can’t do the same in open water. But the main difference is the space of the water area. In open water, it is difficult to see the bottom, you can’t see the outline of the area, and it is extremely easy is to lose orientation, sometimes it’s impossible to work out where the shore is.”

But while some parents , like the father mentioned in the beginning of this article, do keep a watchful eye on their children while they’re having a swim, others unfortunately fail to do so. Worse still, and this is quite common, some parents leave their little children unaccompanied in the water and do not pick them up for several hours. With no one there to watch these kids, they could get into trouble in the water and not know how to get out of it.

Don Pradeep Kumar, himself a trained lifeguard and swim instructor for many years, says this is a concern parents need to address by ensuring they pay more attention to their family responsibilities. “They think the swimming pool is the best place to leave their children while they socialise by the pool or leave to do some other work such as shopping. This is really dangerous, and we don’t allow this in our health club, but some parents do it anyway,” he admitted.

“We cannot police everyone who comes, but some parents still just leave their children in the pool and then do whatever they want to do,” he added. “Our advice is not to leave children unattended. It would be better for them to help their children learn to swim, rather than leave them alone in the water. If something happens to their child, nothing can replace that loss.”



How to perform CPR

Should you need to save someone from drowning, the chances are that you might need to perform CPR (cardiopulmonary resuscitation) to resume the supply of oxygen to people who have lost consciousness while drowning.

The Red Cross has provided steps on how to perform CPR, should it be required. In addition, many hospitals and clinics will teach CPR to those who wish to learn.

Before giving CPR

1.Check the scene and the person. Make sure the scene is safe, then tap the person on the shoulder and ask, ‘Are you OK?’ to ensure that the person needs help.

2. Call emergency services for assistance. If it's evident that the person needs help, call (or ask a bystander to call) for emergency services, then send someone to get an automatic external defibrillator. If an AED is unavailable, or a there is no bystander to access it, stay with the victim, call emergency services and begin administering assistance.

3. Open the airway. With the person lying on his or her back, tilt the head back slightly to lift the chin.

4. Check for breathing. Listen carefully, for no more than 10 seconds, for sounds of breathing. (Occasional gasping sounds do not equate to breathing.) If there is no breathing begin CPR.

Red Cross CPR steps

1.Push hard, push fast. Place your hands, one on top of the other, in the middle of the chest. Use your body weight to help you administer compressions that are at least 2 inches deep and delivered at a rate of at least 100 compressions per minute.

2. Deliver rescue breaths. With the person's head tilted back slightly and the chin lifted, pinch the nose shut and place your mouth over the person's mouth to make a complete seal. Blow into the person's mouth to make the chest rise. Deliver two rescue breaths, then continue compressions.

Note: If the chest does not rise with the initial rescue breath, re-tilt the head before delivering the second breath. If the chest doesn't rise with the second breath, the person may be choking. After each subsequent set of 30 chest compressions, and before attempting breaths, look for an object and, if seen, remove it.

3.Continue CPR steps. Keep performing cycles of chest compressions and breathing until the person exhibits signs of life, such as breathing, an AED becomes available, or emergency services or a trained medical responder arrives at the scene.

Note: End the cycles if the scene becomes unsafe or you cannot continue performing CPR due to exhaustion. Courtesy - Red Cross

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