Jonathon Webber

Leisure-related injuries at the beach: An analysis of lifeguard incident report forms in New Zealand, 2007–12

From 2007–2012, New Zealand lifeguards provided first aid to almost 9,000 beachgoers, an average of 1,772 cases per annum; more than the average number of rescues (n = 1,343) each year. This study describes the aetiology of non-drowning related injuries occurring at surf beaches patrolled by lifeguards. The study design was that of a retrospective analysis of data collated during five summer seasons from 2007–2012. Cases included individuals who sustained recreational injuries while at a patrolled beach in New Zealand. Incident report forms, routinely completed by lifeguards in New Zealand, were the data source for this study. Of the 8,437 incidents evaluated, 57% of the patients were males, one half (52%) were aged less than 16 years. Most injuries (82%) were minor, almost half (43%) were to the lower limbs. Half (54%) of the injuries were sustained in the water, one third (32%) were attributed to land-based activities. Cuts/abrasions accounted for almost half (47%) of all injuries. First aid responses for both water and land-based incidents are indicative of the nature and extent of recreational injuries sustained at the beach. The diversity and frequency of such incidents suggests that public education promoting beach safety is warranted.

The 4Rs of Aquatic Rescue: educating the public about safety and risks of bystander rescue

From 1980 to 2014, 87 persons drowned in New Zealand while attempting to rescue others; all incidents occurred in open water and most (80%) fatalities were male. While bystander rescue has been promoted as a way of preventing drowning, little is known about the knowledge base that informs potential rescuers. This study utilized a family water safety programme to promote a resource entitled the 4Rs of Aquatic Rescue. Participants (n = 174) completed a pre-intervention survey and were then provided with information and access to electronic resources on safe bystander rescue techniques. Most respondents (71%) had never been taught rescue techniques, and males were more confident of their rescue ability. Upon completion of the programme, significant differences were evident in respondents’ understanding of rescue safety, but this did not translate to greater confidence or disposition towards performing a rescue. Ways of promoting bystander safety around water are discussed and recommendations for future studies are made.

Surf, sand, scrapes and stings: first aid incidents involving children at New Zealand beaches, 2007-2012

In spite of the popularity of beaches for family recreation, little is known about childhood injuries sustained at beaches. It is the purpose of this study to analyse data from incidents necessitating first aid treatment from reports compiled by surf lifeguards on New Zealand beaches.

Comment on Cerland, L. et al. Incidence and Consequences of Near-Drowning-Related Pneumonia—A Descriptive Series from Martinique, French West Indies. Int. J. Environ. Res. Public Health 2017, 14, 1402

We read with great interest the recent paper by Cerland et al. on the frequency, nature, and consequences of post-drowning pneumonia[...].

Fatal and non-fatal drowning in rivers

In response to the letter from Byard [1] describing two drowning incidents in the Murrumbidgee River in Wagga Wagga, and the author’s own experience with being rescued himself, we commend those involved for executing a safe rescue. Drowning while attempting rescue accounts for 2% of all drowning-related deaths in Australia [2]. In many cases it is the person in distress that survives, and the would-be rescuer who dies [3]. We agree that a better understanding of the omnipresent dangers associated with rivers is needed, as these locations feature prominently in the Australian and New Zealand drowning statistics [4, 5]. Our concern, and reason for corresponding, is the continued use of the outdated terminology “near drowning”. In 2002, the World Congress on Drowning developed the following uniform definition for drowning: “The process of experiencing respiratory impairment due to submersion or immersion in liquid” [6]. With this definition also came the recommendation to discontinue the use of modifiers such as “near”, “secondary”, “wet/dry”, and “active/passive”. Whereas “drowning” was often used to describe a fatal event, based on this uniform definition, which has been adopted by the World Health Organization and Centers for Disease Control and Prevention, the primary definition does not include outcome. From this definition, terms like “fatal”, “non-fatal”, or “drowning with morbidity” can be

First Aid Courses for the Aquatic Environment

First aid in the aquatic environment requires specific skills and knowledge that are not taught in regular first aid education. Some topics are unique to aquatics. Target groups for such courses include persons living, playing, or working near or around the water. First aid courses tailored for the aquatic environment contribute to a competent rescue and resuscitation of a drowning victim and to the safety of the lay rescuer [1] or trained rescuer [2]. By including information on water safety awareness, these courses can also contribute to prevention and reduce the drowning burden. The relevance of an aquatic course was first extensively debated at an expert meeting Do we need a special first aid course for drowning victims during the World Congress on Drowning in the Netherlands 2002. Since 2002, first aid courses for the aquatic environment have been successfully organized around the world. This chapter reviews the importance and need of these courses and what has been learned.

Protection Motivation Theory (PMT), Risk of Drowning, and Water Safety Perceptions of Adult Caregivers/Parents

Results: In terms of risk appraisal processes, more females, Asian peoples, and those with lower self-reported swimming and rescue competency perceived greater severity of drowning risk and greater vulnerability to that risk when swimming in open water. In terms of coping appraisal processes, males, non-Asian peoples and those with self-reported good swimming and rescue competencies were more likely to report confidence in the self-efficacy of their preventive actions.

Is drowning a mere matter of resuscitation

International data severely underestimates actual drowning numbers. Almost all victims are able to help themselves or are rescued in time. This study aims to report the occurrence of Drowning Chain of Survival actions and resuscitations needed in a fully operational lifeguard service. METHODOLOGY Data was collected from Dec-2009 to Mar-2015 by lifeguards at a 6km-long beach in Brazil. The Drowning Chain of Survival links were summarized into 3 main action-response sections: Prevention; rescue; and provide care. Rescues were classified by severity. RESULTS Lifeguards reported 1,565,699 actions during the study period. Preventative actions comprised 1,563,300(99.8%) and 2044 (0.1%) involved recognizing a person in stress/distress and rescuing them. Of those requiring rescue, 355(0.02%) needed medical assistance due to respiratory symptoms, isolated respiratory arrest, or cardiopulmonary arrest. Those cases were classified by severity as: Grade 1 = 234(65.9%), grade 2 = 78(22%), grade 3 = 22(6.2%), grade 4 = 7(2%), grade 5 = 4(1.1%), and Grade 6 = 10(2.8%). From all 2044 rescues, 14(0.7%) were grade 5 and 6 and needed respiratory or cardiorespiratory resuscitation. An estimative incident rate for each day at a lifeguarded beach revealed: 1 rescue for every 4.227 beach attendances, 1 drowning for every 24,338 beach attendances, and 1 instance of CPR being performed for every 617,142 beach attendances. The prevalent misconception that majority of drowning require resuscitation is perpetuated by the media and publishers. We are only just seeing the tip of the iceberg and urgently need to look at the problem in its entirety. Considering all the intervention undertaken by lifeguards in a fully operational system, the incidence of resuscitation being performed is only one in every 112,000 lifeguarding actions (0.0009%).

Reply to letter: Neurocognitive and behavioral outcomes in a nearly drowned child with cardiac arrest and hypothermia resuscitated after 43 min of no flow-time: A case study

Citation for published version (APA): Venema, A. M., Webber, J., Schmidt, A. C., Sempsrott, J. R., Szpilman, D., Queiroga, A. C., ... Tipton, M. (2018). Reply to letter: Neurocognitive and behavioral outcomes in a nearly drowned child with cardiac arrest and hypothermia resuscitated after 43 min of no flow-time: A case study. Resuscitation, 122, e7-e8. https://doi.org/10.1016/j.resuscitation.2017.07.017

Pediatric non-fatal drowning events: do they warrant trauma team activation?

To the Editor, We read with interest the article by Chotai et al. discussing traumatic injuries and the involvement of trauma teams for drowning events involving children. We agree that the routine activation of trauma teams in drowning cases may be unwarranted, and criteria should be reviewed. As the authors rightly state, drowning is a leading cause of death worldwide, especially in pediatric populations. Our concern, and reason for corresponding, is the continued use of outdated terminology in the title and text of this article; namely the term “neardrowning”. In 2002, the World Congress on Drowning developed the following uniform definition for drowning: “The process of experiencing respiratory impairment due to submersion or immersion in liquid.” With this definition also came the recommendation to discontinue the use of modifiers such as “near”, “secondary”, “wet/dry/delayed”, and “active/passive.” Whereas “drowning” was often used to describe a fatal event, based on this uniform definition, which has been adopted by the World Health Organization, International Liaison Committee on Resuscitation and Centers for Disease Control and Prevention, the primary definition does not include outcome. From this definition, terms like “fatal”, “non-fatal”, or “drowning with morbidity” can be used to better describe the event. The use of outdated terminology is unfortunately not a rarity in peer-reviewed literature, as a systematic review we recently performed and are seeking publication of, found that 32%of drowning-related articles over the past 6 y included nonuniform terminology. We see this as an opportunity for education and hope that readers, authors and journal editors can work towards improving the use of uniform drowning terminology in practice and research so that patient treatment and data collection may be optimized. This includes using the correct terminology in education programmes, medical reports, publications and the media.