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Doc Talk: Struggling to stay afloat, the signs of drowning are subtle

This illustration from the World Health Organization report on drowning shows the countries were it is a top cause of death for children ages 1-14. (WWMT/World Health Organization/Global Report on Drowning)

Think of someone drowning, and the imagination supplies a victim yelling, splashing or waving their arms in distress. For years, such dramatic scenes on the water have played out on television shows and movies, but Dr. Thomas Rohs said forget what you’ve seen on the screen, the signs drowning are very subtle.

“They’re struggling so much they can’t," said Rohs, a trauma specialist and the trauma medical director at Borgess Medical Center. "They’re very short of breath; they can’t breathe. So, if they get anything out, it would be a little bit surprising.”

Rohs said someone who is truly in trouble will start running out of energy, making splashing and waving very difficult. If their head is back and face is up, that might be a sign they’re gasping for air.

The World Health Organization said drowning is the third leading cause of unintentional injury death worldwide, accounting for 372,000 deaths with more than half of the victims under age 25. The U.S. Centers for Disease Control and Prevention reports that the annual average for death by drowning in the United States is 3,536 - or about 10 deaths a day. And one in five of those who died were children age 14 and younger.

The WHO calls unintentional drowning a vastly neglected public health issue, and in 2017 published a 116-page report on prevention. The report targets 10 ways to prevent drowning, including teaching children to swim, installing barriers to control access to water, and training bystanders in safe rescue and resuscitation.

That would includes knowledge of the signs of drowning, which can include coughing, chest pain, trouble breathing and feeling extremely tired or irritable, because the brain is not getting enough oxygen.

“People think of somebody yelling and something very dramatic," Rohs said. "That’s just not how it goes down.”

Adults could struggle in the water for up to a minute before going under. For kids, it might be only seconds. In the cold waters of Lake Michigan, muscles stop working faster, making it even tougher to stay afloat. That’s why Rohs reiterated that it is crucial to pay attention to those in the water.

“Once someone’s gone under either [adult or a child's] brain may sustain brain damage by oxygen deprivation fairly quickly, within just a couple of minutes," Rohs said. "Even people who survive may have substantial anoxic brain injury and have functional problems for the rest of their life. So, you don’t have very long.”

If you think someone is truly in trouble, call for additional help immediately. Then, Rohs suggests, throw that person something that floats. If you aren’t properly trained to rescue someone, you could be putting your own life at risk by approaching a distressed swimmer on your own.

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