shallow water blackout

Sudden Death: Shallow Water Blackout

Shallow Water Blackout (SWB) can occur without warning and even the best swimmers are not spared should it be allowed to strike. Unlike what the name suggests, SWB does not only occur in shallow waters. In fact, it can happen in any body of water and it is difficult for the lifeguards to detect a victim of SWB due to its swift and sudden nature. The only way to prevent SWB from happening is to increase awareness of this little known killer.

SWB explained
SWB is due to hypoxia, which means low oxygen (O2) levels, to the brain. When one is breathing normally, the need to breathe is triggered by an increase in carbon dioxide (CO2) levels. The point at which breathing is triggered is indicated by the dotted line in the figures below. As seen in Figure 1 below, after breathing is triggered, the breathing action that takes place increases the O2 levels and lowers the CO2 levels.

shallow water blackout - hyperventilation

Figure 1: O2 and CO2 levels during normal breathing (Source: Wikimedia Commons)

In contrast, when a swimmer hyperventilates, his/her CO2 levels are at a reduced level. As seen in Figure 2, the O2 levels will enter the blackout zone before the need to breathe is triggered. After the swimmer blacks out and the CO2 levels continue to rise, his/her body will naturally take in a breath. The unconscious swimmer will then take in a lungful of water and drown.

shallow water blackout - normal breathing

Figure 2: O2 and CO2 levels when hyperventilating (Source: Wikimedia Commons)

Prevention of SWB

Firstly, SWB can be prevented by educating swimmers of the dangers of breath holding. While hypoxic training is practiced worldwide, swimmers should be discouraged from performing such training on their own. Recreational swimmers should also avoid engaging in breath holding for fun.

Next, in the event that breath holding exercises are necessary during training, they should be performed under close supervision of a swimming coach. The swimming coach should then take necessary precautions to ensure the safety of the swimmers under his/her guidance.

Lastly, lifeguards on duty do have the responsibility to perform patrols periodically. This is to ensure that all blind spots are covered in the event of a swimmer in trouble being submerged in such areas.

Hopefully, by raising awareness of this silent killer, unnecessary loss of lives can be prevented.


Lifeguard: The Origins

Since the 1800s, lifeguards have been safeguarding the lives and safety of people when swimming first gained popularity as a recreational activity. Based on the data provided by the International Lifesaving Federation, 1.2 million people around the world die drowning every year. The numbers are staggering, considering the widespread availability of swimming and water safety lessons. In an earlier post, we have also shed some light on the truth about the role of a lifeguard in Singapore.

So, how do you become a lifeguard in Singapore?

In order to become a lifeguard, you must first be a proficient swimmer. There is no need for you to possess swimming certificates such as NASSA, SwimSafer or SSPA. Most lifesaving teachers will assess your level of proficiency in swimming and it would be a huge advantage if you are proficient in the breaststroke.

Next, you will have to earn the Lifesaving 1, 2 and 3 certificates that are awarded by the Singapore Lifesaving Society (SLSS). At this stage, you will be equipped with theoretical knowledge of water safety, water and land based rescues and the practical applications lifesaving techniques. These certificates can be awarded concurrently and will serve as the prerequisites for the Bronze Medallion (BM), which is recognised in all Commonwealth countries.

After achieving the Lifesaving 1, 2 and 3 certificates, you will qualify for BM training. At this stage, speed and stamina is key. The practical components are as follows:

  1. Undress (you will be in long sleeved shirt and pants/skirt) and swim 50 meters, then perform clothing tow for 50 meters in 3 minutes 15 seconds
  2. Swim 50 meters followed by a chin tow for 50 meters
  3. Swim 15 meters and tow a submerged casualty to shore in 1 minute 15 seconds, timing stops when you administer the first rescue blow
  4. Initiative exercise where you have to apply your lifesaving knowledge to a scenario set by your examiner

You will also be required to pass a separate CPR test prior to your BM test. There will also be a theoretical component testing your understanding of water safety, rescue principles, survival in water and emergency aftercare.

Upon clearing the BM, you will be eligible to apply for lifeguarding positions. This is subject to in-house fitness criteria and in some cases, you will need to be AED certified. Embark on your journey to become a lifeguard and you will be part of a noble group that safeguards the lives of others.

Lifesaving, Sea

Who to Save First – Mum or Wife?

So your mum and your wife decided to fall into the sea at the same time. Who should you save first? This classic question never fails to come up at some point of your life. So, here is a comprehensive answer that you can provide that will in one way or another, make both your mum and wife speechless. Do note that my answer is provided from my point of view as a qualified lifesaver, and can be applied in an actual situation to increase the likelihood of preserving lives.

Think before you act!

After being alerted to the situation, you have to assess the situation first:

  • How far are the victims away from you?
  • Who is the weaker swimmer?
  • Are there any rescue aids available?
  • Are you fit enough to perform the rescue?

The rule of thumb is to save the person with the higher chance of survival first. Generally, this means that you should save the person nearest to you, the weaker swimmer or who is injured first. If one of them has already become unconscious (what were you doing??), you should save the one who is conscious first.

Another thing to take note of is whether there is anything near you that can aid you in your rescue. Anything that floats and can provide support can be used to perform the rescue. All you have to do is to throw the “float” to them. If there is only one of it, throw it to the nearer person since it is far easier than to throw it far. If there is a rope that is long enough, you may even use it to perform the rescue. This means that technically, you can don’t enter the water and still save both of them!

The smart aleck who asked you the question may follow up and say “What if they are equal distance away?”

Reply: “Have you ever heard of a ‘double chin tow’?”

Basically, a “chin tow” is a form of rescue that involves you towing a conscious casualty to safety. “Double chin tow” just means you tow 2 people at one go.

Smart aleck: “What if your wife is pregnant? That is 2 lives vs. 1 life”

This is where you cook up some excuse and stop entertaining this person, regardless of whether that is your mum or your wife.

Making an informed decision is not as easy as it seems. There are more considerations that you will learn by taking up lifesaving courses. Lifesaving tests include an “Initiative Test”, where you have to exercise your best judgement to decide who to save first. So, if you want to be fully-prepared to tackle this in real life, or just to answer this question, you may wish to take up lifesaving lessons. Alternatively, leave a comment with your question and we will do our best to answer you.


The Truth about the Role of a Lifeguard in Singapore

Has the thought that “the lifeguards are a waste of resources as they merely sit on their chairs doing nothing” ever crossed your mind? If that’s the case, here are some facts that might change your mind about the importance of a lifeguard in preventing death by drowning in Singapore.

Based on statistics from the Singapore Lifesaving Society in 2010, a total number of 356 reported lifesaving rescues were performed and the total number of deaths by drowning cases heard in the Coroner’s Court was 42. Considering that Singapore is a water locked nation, this is hardly shocking news as most people will come into contact with large bodies of water from time to time.

A lifeguard seeks to prevent potential drowning cases at all times but is always ready for any emergency situations. All lifeguards are trained to identify the different categories of swimmers and are able to provide water safety advice. For example, when encountered with a weak swimmer attempting to swim at the competitive pool, the swimmer would be advised to use the training pool instead as it would be a much safer alternative.

Despite having put in some effort in making the waters a safer place for swimmers, lifeguards are on a constant lookout for emergency situations such as when a swimmer sustains an injury and panics. It is only when such situations arise that they tap on their arsenal of lifesaving techniques. Unlike what is usually depicted in dramas, where lifeguards dive in regardless of the situation, lifeguards are trained to perform rescues using techniques that can guarantee their own safety while achieving the objective of rescuing the casualty.

Hopefully, this article was able to shed some light on what a lifeguard is really doing on his chair while on duty and clear up some misconceptions regarding the profession.