Article

Readiness to Rescue: Bystander Perceptions of Their Capacity to Respond in a Drowning Emergency

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Abstract

From 1980–2012, 81 persons fatally drowned in New Zealand while attempting to rescue others. Of these, most (80%) were male, and all rescue fatalities occurred in open waters. Festivalgoers (N = 415) attending a cultural event in Auckland, New Zealand took part in a water safety survey that included information on their readiness to respond in a drowning emergency. Many indicated they would jump in and rescue a victim (47%), while less than one third (30%) would get flotation to the victim. Significantly more males responded that they would jump in and attempt a rescue (males 55%, females 40%). Most (62%) estimated that they could only swim less than 100 m; 85% reported having swum that distance in a swimming pool rather than in open water where most rescues take place; and one half (50%) had last swum the distance more than one year ago. Ways of promoting safe rescue knowledge are discussed and further research directions are identified.

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... Second, it is unfortunately not uncommon for the bystander themselves to drown while attempting a rescue [11]. This is due to a number of factors including impulsive and emotive reactions of the rescuer and a lack of necessary skills to assess the situation, associated hazards, and ability to carry out a successful rescue and resuscitation [5,8,[12][13][14][15]. ...
... The World Health Organisation [4] also suggest that the implementation of any drowning prevention intervention should begin with a situational assessment to establish key facts that are essential to proper prioritization and planning of the intervention, the first component of which is to review available data. In this regard, the topic of bystander rescues has only received modest attention in the drowning prevention literature and while fatal bystander rescues undoubtedly occur at an international scale, documentation is somewhat limited, largely due to a lack of accurate, reliable and systematic incident reporting and data availability [5,13,[16][17][18][19]. Recent studies by Brander, Warton [10] and Franklin, Peden [11] summarised the characteristics and global extent of the problem, while focussing on the Australian context, and used quantitative surveys to describe characteristics and experiences of bystander rescues and rescuers in a range of different Australian aquatic environments. ...
... However, SLSA [37] and Brander, Warton [10] found that 60% and 63% of bystander rescuers respectively did not use a flotation device during their most recent rescue. Moran and Stanley [13] also reported that 30% of bystander rescuers did not think they would take a flotation device with them during a rescue scenario. In this study, only two rescue incidents involved the use of a flotation device, both of whom were conducted by (off duty) volunteer surf lifesavers with significant levels of water safety training. ...
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Bystanders who drown during a rescue attempt in aquatic waterways are becoming an increasingly important issue within drowning prevention. In the Australian context, the majority of these incidents occur in coastal water ways. This study documents and characterizes bystander rescuer fatalities within Australian coastal waterways that occurred between 1 July 2004 and 30 June 2019 in order to provide suggestions for future public safety interventions involving bystander rescuers. Data was sourced through Surf Life Saving Australia's (SLSA) Coastal Fatality Database, which collates information from multiple sources. Sixty-seven bystander rescuer fatalities in coastal waterways were reported during the 15-year period, an average of 4.5 per year, which is a significant proportion of the five fatalities previously reported across all Australian waterways. The majority of coastal bystander rescuer fatality incidents occurred in the state of New South Wales (49%), at beaches (64%), in regional or remote areas (71%), more than 1 km from the nearest lifesaving service (78%), during summer (45%), in the afternoon (72%), in the presence of rip currents (73%), and did not involve the use of flotation devices to assist rescue (97%). The majority of coastal bystander rescuer victims were Australian residents (88%) born in Australia/Oceania (68%), males (81%), aged between 30-44 years old (36%), visitors to the location (55%), either family (69%) or friends (15%) of the rescuee(s), and were attempting to rescue someone younger than 18 years old (64%). Our results suggest future safety intervention approaches should target males, parents and carers visiting beach locations in regional locations during holiday times and should focus on the importance of flotation devices when enacting a rescue and further educating visitors about the rip current hazard. Future research should examine the psychology of bystander rescue situations and evaluate the effectiveness of different safety intervention approaches.
... However, many rescues are undertaken by a bystander: member(s) of the public, be they family, friend or stranger, who attempt to rescue someone in distress. 9,10 Unfortunately, bystanders' level of experience with aquatic environments and/or skills involved in undertaking rescues vary considerably 11 and it is not uncommon for the bystander rescuer to drown attempting a rescue, called aquatic victim instead of rescuer (AVIR) syndrome. 9 The WHO has identified that every country should " … train bystanders in safe rescue and resuscitation …" to prevent drowning. ...
... Understanding aquatic rescues in Australia using coronial data and a survey identified, 23 with bystanders trained in safe rescue and resuscitation identified as being less likely to place themselves at risk of drowning. 12 Tragically, every year there are cases of AVIR syndrome, 9,10 a global phenomenon recognised in studies from mainland China, 24 New Zealand, 11 Turkey, 25 the Netherlands 26 and Brazil. 27 A study of Chinese media reports in 2013 identified 225 rescue-related fatal drownings. ...
... 24 In New Zealand, 81 people have fatally drowned while attempting a rescue in the 32 years between 1980 and 2012, with all occurring in natural waterways. 11 In Turkey, 88 incidents claimed the lives of 114 rescuers and 60 rescuees between 2005 and 2008. 25 An analysis of 289 Dutch rescue reports from 1999-2004 found rescues often occurred in dangerous circumstances with multiple victims, deep or cold water, swimming to the victims and the young age (<5 years) of the rescuers. ...
Article
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Objective: To examine fatal drowning associated with aquatic rescues and prior self‐reported experience of undertaking an aquatic rescue in Australia. Methods: Previous aquatic rescue experience was sourced through the 2013 Queensland Computer Assisted Telephone Instrument Survey and compared to data on rescue‐related fatal unintentional drowning between 1 January 2006 and 31 December 2015. Results: Twenty‐three per cent (n=294/1291) of survey respondents had previously performed an aquatic rescue. Males (X2=35.2; p<0.001) were more likely to have performed a rescue; commonly at a beach/ocean/harbour location (X2=13.5; p<0.001). Females were more likely to have rescued a child (0‐4 years of age) (X2=29.2; p<0.001) from a swimming pool (X2=34.3; p<0.001). Fifty‐one people drowned while performing an aquatic rescue (Males=82.4%; 25–44 years of age=53.0%; beaches=54.9%). Conclusions: Drownings are prevented by bystanders; this is not without risk to the rescuer. Most people perform only one rescue in their life, often at a younger age, on an altruistic basis, of family members or young children. Community‐wide rescue skills, taught at a young age, with consideration for coastal, inland and swimming pool environments, may prevent drowning. Implications for public health: There is a need to train people early in their life on how to undertake a safe rescue and provide resuscitation, including promoting regular updates, in particular if supervising children.
... Bystanders are frequently involved in rescues in water environments and consequently play a significant role in saving lives [11][12][13]. The initial response and action of a bystander is often what saves lives, not only by rescuing someone from the water itself, but in assistance provided after the rescue, such as the application of CPR [11,14]. ...
... However, the majority of bystanders are not trained or experienced in water-based rescue or medical assistance and often place both themselves and the rescuee(s) at risk while performing a rescue [9,15]. Unfortunately, it is also not uncommon for the bystander 'rescuer' to drown [10,12,[16][17][18]. Furthermore, while every drowning is associated with significant emotional, societal and economic costs [19][20], drownings involving bystander rescuers often tend to receive more media exposure due to the altruistic and emotive nature of the rescue situation [21][22][23][24]. ...
... The advantage of surfers as bystander rescuers is that they have flotation devices (surfboards) and for the most part are competent swimmers. In contrast, in a New Zealand-based study, [12] assessed peoples' readiness and capacity to form a rescue and found that nearly half (47%) of the survey respondents indicated they would jump in and attempt to save someone despite almost two-thirds (62%) identifying themselves as weak swimmers. Both cases highlight the need for bystanders to be prepared to react to, or undertake a rescue situation in the safest way possible. ...
Article
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An issue of growing importance within the field of drowning prevention is the undertaking of aquatic rescues by bystanders, who sometimes drown in the process. The main objectives of this study were to describe characteristics of bystanders making rescues in different Australian aquatic environments, identify the role of prior water safety training in conducting bystander rescues and provide insights into future public education strategies relating to bystander rescue scenarios. An online survey was disseminated via various social media platforms in 2017 and gathered a total of 243 complete responses. The majority of bystander rescues described took place in coastal waterways (76.5%; n = 186), particularly beaches (n = 67), followed by pools (17.3%; n = 42) and inland waterways (6.2%; n = 15). The majority of respondents were males (64.2%; n = 156) who rescued on average approximately twice as many people in their lifetime (6.5) than female respondents (3.6). Most rescues occurred more than 1 km from lifeguard/lifesaver services (67%; n = 163), but in the presence of others (94.2%; n = 229). The majority of bystander rescuers had water safety training (65.8%; n = 160), self-rated as strong swimmers (68.3%; n = 166), conducted the rescue without help from others (60%; n = 146), did not use a flotation device to assist (63%; n = 153), but were confident in their ability to make the rescue (76.5%; n = 186). However, most considered the situation to be very serious (58%; n = 141) and felt they had saved a life (70.1%; n = 172). With the exception of pools, most bystanders rescued strangers (76.1%; n = 185).While Australia clearly benefits from having a strong water safety culture, there is no clear consensus on the most appropriate actions bystanders should take when confronted with a potential aquatic rescue scenario. In particular, more research is needed to gather information regarding bystander rescues undertaken by those without prior water safety training.
... The remaining factors (i.e., parents' educational background, distance between the place of residence and the nearest lake, proximity of lake beaches) were completely unrelated to swimming skill metrics (Podstawski, Gizińska & Kolankowska 2014). Some studies have reported on rescue competency among adult populations (Moran & Stanley 2013;Pearn & Franklin 2009) and youth (Mora 2008), but none have studied the rescue capacity of young adults. Perceptions of rescue competency and confidence among high school students (N = 2202) were analyzed by Moran (2008), who found that most students (60%) reported having either no rescue skills (35%) or poor skills (25%). ...
... A study of 3,000 beachgoers in New Zealand found that one-third of adult males (34%) and one-quarter of adult females (24%) reported being able to swim more than 200 m (McCool, Moran, Ameratunga & Robinson 2008). A survey of festivalgoers in a multicultural setting reported that more than a third (39%) of respondents thought they could swim more than 100 m, and only a small proportion (<7%) reported not being able to swim at all (Moran & Stanley 2013). Caution needs to be exercised when using self-reported swimming competency as a measure of protection against drowning. ...
... One Australian study found that more than half of fit adults tested in a simulated drowning incident on dry land could not throw a lifeline accurately (Pearn & Franklin 2009). Other studies have identified a lack of lifesaving training (Gulliver & Begg 2005;Moran 2008Moran , 2009Moran & Stanley 2013). A nationwide water safety survey of youths in New Zealand found that one-third (35%) claimed that they had no rescue ability, and more than one-half (59%) expressed doubts about their ability to perform a deep-water rescue (Moran 2008). ...
Article
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Despite the popularity of aquatic recreation and its well-promoted prophylactic and therapeutic values, not a lot is known about how socio-cultural background influences the acquisition of water competency. The aim of this study was to assess the influence of socio-economic and environmental factors on the swimming and rescue skills of male university students (n = 521) aged 19-20 years residing in the Region of Warmia and Mazury, Poland. An anonymous questionnaire was used as a diagnostic tool to elicit information on participants’ social backgrounds (such as parental income and level of education). Participants provided self-estimates of swimming and rescue competency that included non-stop distance swimming, familiarity with selected swimming strokes, and their estimated rescue ability. The results suggest that students’ self-estimated swimming competency, the distance they could swim non-stop, and the capacity to swim various strokes increased in association with higher levels of educational background of the father, higher levels of monthly income, and increased size of residential agglomeration. The level of rescue skills also improved with increases in the educational background of both parents, the size of residential agglomeration, and the monthly budget. No significant differences were found in rescue competency levels when analyzed by the mothers’ educational experience. Levels of both swimming and rescue competencies were lower than those reported in comparable studies. Socio-economic status (such as a lack of discretionary time and income for families with a lower socio-economic status) and place of residence (such as lack of facilities in small villages and towns) mediated the opportunity to acquire water competencies or gain experience with aquatic activity. Methods for addressing socio-economic barriers to the acquisition of swimming and rescue competency are discussed and recommendations for further research are made.
... A recent comparative analysis of drowning incidents in 60 countries reported that falling into open water accounted for almost half (43%) of fatalities in New Zealand, and one-third (33%) of fatalities in Australia (Lin, Wang, Lu, & Kawach, 2014). While most open water drowning events are preventable, many require the intervention of others and, in some circumstances, the consequences of such intervention can itself result in loss of human life (Moran & Stanley, 2013). From 1980 to 2014, 87 persons drowned in New Zealand while attempting to rescue others (Water Safety New Zealand [WSNZ], 2014). ...
... Importantly, male beachgoers were more confident of their ability to rescue their child even though they reported no more lifesaving training than the females that took part in the study. Festivalgoers (N D 415) attending a cultural event in Auckland, took part in a water safety survey that included information on their readiness to respond in a drowning emergency (Moran & Stanley, 2013). Many indicated they would jump in and rescue a victim (47%), while less than onethird (30%) would get flotation to the victim. ...
... Perhaps of greatest concern was the finding in the pre-intervention survey that very few respondents (9%) identified the need to stay clear of the victim in the rescue phase, a standard mantra in lifeguard training and lifesaving instruction. When asked what they would do if they saw someone in trouble in the water, only one-quarter (26%) of participants gave the correct response of immediately getting flotation to a victim, and more than one-quarter (29%) gave the most dangerous response that they would immediately dive in and rescue the person, a better response to that previously reported where almost half (47%) would dive in as an immediate response (Moran & Stanley, 2013). ...
Article
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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.
... Bystanders are individuals who witness someone in trouble and offer assistance. The study of risk factors associated with bystander rescue is a fledgling area of study (Franklin et al., 2010;Franklin and Pearn, 2011;Moran and Stanley, 2013). These rescues are often impulsive acts without full assessment of the hazards and an overestimation of the rescuers own abilities, which can result in highly dangerous situations for both the rescuer and rescuee(s) (Pearn and Franklin, 2012;Moran and Stanley, 2013). ...
... The study of risk factors associated with bystander rescue is a fledgling area of study (Franklin et al., 2010;Franklin and Pearn, 2011;Moran and Stanley, 2013). These rescues are often impulsive acts without full assessment of the hazards and an overestimation of the rescuers own abilities, which can result in highly dangerous situations for both the rescuer and rescuee(s) (Pearn and Franklin, 2012;Moran and Stanley, 2013). Indeed, it is not uncommon for bystanders to become drowning victims (Franklin and Pearn, 2011). ...
... Furthermore, White and Hyde (2010) found that the less risk perceived by beachgoers, either due to swimming confidence or assessment of conditions, the more willing they are to bathe outside of patrolled areas. This implies that along with natural beach hazards, the beliefs and behaviour of beachgoers and bathers, both experienced and inexperienced, often do not correlate with real world risks (Short and Hogan 1994;Ballantyne et al., 2005;Sherker et al., 2010;Hatfield et al., 2012;Williamson et al., 2012;Moran and Stanley, 2013;Shaw et al., 2014;Walton, 2014). ...
Article
This study describes the demographics, occurrence, location, primary hazards and outcomes involved in rescues performed by surfers on Australian beaches. Conservative estimates suggest that the number of rescues conducted by Australian surfers each year is on par with the number conducted by volunteer surf lifesavers. Surfers perform a considerable number of serious rescues in both lifesaver/lifeguard patrolled (45%) and unpatrolled (53%) beach locations. Rip currents represent the major physical hazard leading to rescue (75%) and the dominant emotional response of people rescued is one of panic (85%). Most surfer rescue events occur during conditions of moderate waves and sunny, fine weather with the highest proportion of rescues occurring on quiet beaches with few people around (26%). Swimming is the activity associated with most rescue events (63%), followed by board riding (25%). Males aged 18–29 represent the largest demographic of people rescued. Surfers with prior water-safety training are more likely to perform a higher number of rescues, however ability to perform rescues is not associated with formal training, but rather number of years’ experience surfing. Seventy-eight percent of surfers were happy to help, while 28% expressed feelings of annoyance or inconvenience, generally towards unwary swimmers. Results of this research suggest that 63% of surfers feel they have saved a life. This value may be enhanced through improved training of surfers in basic water safety rescue techniques.
... Females were consistently reported as being more risk averse, and males more confident in the water (Howland et al., 1996;Gulliver & Begg, 2005;Moran 2003;Moran & Stanley, 2013;Stanley & Moran, 2017); however, little is known about perceptions of drowning risk among older age groups. One study has reported that younger adults were less likely than older adults to agree that injuries in or on the water were preventable, and that they could personally do anything to improve their safety (Titchener et al., 2011). ...
... The questionnaire, designed to be completed in 5-10 minutes, consisted of 27 closed-ended and two open-ended questions based on previously validated studies (Moran, 2003(Moran, , 2006(Moran, , 2008McCool et al., 2009;Moran & Stanley, 2013;. ...
Article
Full-text available
New Zealand has an aging population and, despite falling drowning tolls in all other age groups (WSNZ, 2019c), older adults have continued to drown in both increasing numbers and proportion. The reasons for this are not well understood since very little drowning research has focused on older people. A water safety survey (N = 389) seeking information on older adults’ aquatic recreational practices and perceptions of safety was conducted at the end of the summer season, 2019. Most adults (86%, n = 335) reported some aquatic activity in the previous year, but those aged 65+ years (66%) were significantly less likely than younger age groups to engage in aquatic recreation. Respondents aged 65+ years were less likely (74%) to perceive they could swim more than five minutes non-stop. We discuss the implications of lower perceived swimming and floating competence and less frequent participation in aquatic activities on risk of drowning.
... Further research focussed on other essential competencies including: swimming and floating competence in open water simulation (Kjendlie et al., 2013;Kjendlie et al., 2018); swimming and floating competence in clothing (Moran, 2014b;2015;Rejman et al., 2020); safe exit competence (Moran, 2014c); stationary surface competence (Moran, 2019a), and lifejacket competence (Moran, 2019b). Rescue competence has also been studied in an effort to promote safe practice of bystanders in an emergency situation (Pearn & Franklin, 2009Moran & Stanley, 2013;Moran et al., 2016;Petrass & Blitvich, 2018), and a 12-week water safety intervention was conducted and evaluated to provide evidence of the effectiveness of such an approach for improving water safety competencies (Petrass & Blitvich, 2014). ...
... This overestimation of competency is consistent with the findings of previous studies (for example, Moran et al., 2012;Petrass et al., 2012) although, perhaps surprisingly, no gender differences were evident. While other studies have found that, in comparison to females, males were more likely to overestimate a range of water competencies (for example, Gulliver & Begg, 2005;McCool et al., 2008;Moran, 2008Moran, , 2011Moran, , 2014cMoran, , 2015Moran et al., 2012;Moran & Stanley, 2013;Rejman et al., 2020), for the water entry competencies in the current study, this was not the case. The inaccuracy in predicting personal competency is concerning given most participants considered they were proficient swimmers (78%) and most reported having been taught to enter the water safely (80%). ...
Article
In high income countries, jumping and diving into water are a small but persistent cause of death and serious injury especially among male youth and young adults. Although water entries maintain a high media profile, little is known about what entry competencies and underlying water safety knowledge youth bring to this practice. Undergraduates enrolled in aquatics (N= 76) completed a survey before attempting 7 entry jumping and diving tasks. While safety attitudes and self-reported behaviours were generally good, considerable variation in practical entry competence was evident. Most completed a deep-water compact jump (87%) and PFD jump (88%) with ease. Many completed a crouch dive (57%) and standing dive (53%) into deep water with ease, but only 33% completed a standing dive from a block/bulkhead (height) with ease. Ways of addressing weaknesses in knowledge, attitudes, and behaviours are discussed and recommendations made to enhance the teaching of safe water entry.
... Females were consistently reported as being more risk averse, and males more confident in the water (Howland et al., 1996;Gulliver & Begg, 2005;Moran 2003;Moran & Stanley, 2013;Stanley & Moran, 2017); however, little is known about perceptions of drowning risk among older age groups. One study has reported that younger adults were less likely than older adults to agree that injuries in or on the water were preventable, and that they could personally do anything to improve their safety (Titchener et al., 2011). ...
... The questionnaire, designed to be completed in 5-10 minutes, consisted of 27 closed-ended and two open-ended questions based on previously validated studies (Moran, 2003(Moran, , 2006(Moran, , 2008McCool et al., 2009;Moran & Stanley, 2013;. ...
... Further research focussed on other essential competencies including: swimming and floating competence in open water simulation (Kjendlie et al., 2013;Kjendlie et al., 2018); swimming and floating competence in clothing (Moran, 2014b;2015;Rejman et al., 2020); safe exit competence (Moran, 2014c); stationary surface competence (Moran, 2019a), and lifejacket competence (Moran, 2019b). Rescue competence has also been studied in an effort to promote safe practice of bystanders in an emergency situation (Pearn & Franklin, 2009Moran & Stanley, 2013;Moran et al., 2016;Petrass & Blitvich, 2018), and a 12-week water safety intervention was conducted and evaluated to provide evidence of the effectiveness of such an approach for improving water safety competencies (Petrass & Blitvich, 2014). ...
... This overestimation of competency is consistent with the findings of previous studies (for example, Moran et al., 2012;Petrass et al., 2012) although, perhaps surprisingly, no gender differences were evident. While other studies have found that, in comparison to females, males were more likely to overestimate a range of water competencies (for example, Gulliver & Begg, 2005;McCool et al., 2008;Moran, 2008Moran, , 2011Moran, , 2014cMoran, , 2015Moran et al., 2012;Moran & Stanley, 2013;Rejman et al., 2020), for the water entry competencies in the current study, this was not the case. The inaccuracy in predicting personal competency is concerning given most participants considered they were proficient swimmers (78%) and most reported having been taught to enter the water safely (80%). ...
Article
In high income countries, jumping and diving into water are a small but persistent cause of death and serious injury especially among male youth and young adults. Although water entries maintain a high media profile, little is known about what entry competencies and underlying water safety knowledge youth bring to this practice. Undergraduates enrolled in aquatics (N= 76) completed a survey before attempting 7 entry jumping and diving tasks. While safety attitudes and self-reported behaviours were generally good, considerable variation in practical entry competence was evident. Most completed a deep-water compact jump (87%) and PFD jump (88%) with ease. Many completed a crouch dive (57%) and standing dive (53%) into deep water with ease, but only 33% completed a standing dive from a block/bulkhead (<1m height) with ease. Ways of addressing weaknesses in knowledge, attitudes, and behaviours are discussed and recommendations made to enhance the teaching of safe water entry.
... Given that males account for 80% of the drowning statistics in New Zealand [7] and other developed countries [16], the accuracy of male risk appraisal processes remains questionable. Similar findings and concerns about male underestimation of risk have been expressed in previous studies of adults [17], of boat users [18], of new settlers [19], of youth [20], and of rock-based fishers [5,6]. ...
... The lack of swimming competency as measured by the estimated distance swum, the lack of recency of having swum that distance, and the infrequency of having done the distance in open water (reported in Table 2) suggest that male preparedness for the task of in-water retrieval in an open water environment may be illusory. This latter finding concurs with those of a previous study on bystander readiness to rescue which found that males may be at greater risk of drowning as would-be rescuers because of their confidence (rather than competence) in being able to perform a rescue or extricate themselves from trouble without assistance [17,23]. ...
Article
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Background While the circumstances surrounding drowning incidents in high income countries are well known, little is known about how members of the public perceive the risk of drowning and their role in drowning prevention. Objective The purpose of the study was to analyze caregiver/parent perceptions of the risk of drowning in terms of risk (threat) appraisal processes and coping appraisal processes. Method This study utilized Protection Motivation Theory (PMT) to analyse parent’s perception of the risk of drowning as part of an evaluation of a water safety program. Participants ( N = 174) completed a pre-intervention survey that sought information on their water competency, open water experience, previous instruction, and perceptions of drowning risk. 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. Conclusion Considerable variations in risk (threat) appraisal and coping appraisal processes in respect of the risk of drowning were evident. The implications of the findings on water safety education are discussed. Ways of promoting water safety and drowning prevention are examined and recommendations for future research studies to address limitations of the study are made.
... Although most parents (67%) in this study reported that they could swim, and many (58%) perceived their swimming ability to be good/very good, most (55%) estimated that they could only swim 25 m or less. The self-reported competency level of parents in this study was much higher than that reported in two studies of other New Zealand-based population groups where only 13% of youth (15-19 years) (Moran, 2008a), and 7% of festival goers (Moran & Stanley, 2013) estimated they could swim up to 25 m. Another international study found that 6% of tertiary students indicated they could swim 50 m or less Stallman et al., 2010) although the participants were physical education students where one would anticipate a higher proficiency level. ...
... These perceptions were reflected in lower swimming distance estimates. As shown in other studies (McCool et al., 2008;Moran & Stanley, 2013), New Zealand European parents were more likely to estimate being able to swim longer distances than all other ethnicities. For those who identified as Maori, a wider gap was evident between how well they thought they could swim when compared with their estimated swimming distance. ...
Article
Analysis of drowning and rescue statistics suggests that some population groups (such as males, youth, and minority groups) are at greater risk than others. This study reports on the perceived water competency of minority groups, and its potential to mitigate the risk of drowning when swimming in open water. Of the 194 Maori and Pasifika adults that took part in the study, most (91%) believed they could swim, and over two-thirds (70%) considered their competence to be good/very good, although most (72%) estimated they could swim 25m or less. Most participants reported undesirable attitudes which could account for the over-representation of these minority groups in drowning statistics. Significant gender differences were evident for all risk perceptions.This study suggests that males from disadvantaged lower SES minority groups may be at greater risk of drowning because of their lack of competency and their tendency to overestimate this, with regard to swimming and rescue competence in open water environments.
... The loss of rescuer life in drowning emergencies has been described by Franklin and Pearn (2011) as the aquatic-victim-instead-of-rescuer (AVIR) syndrome. In many developed countries, it is a small but persistent cause of drowning mortality (Moran & Stanley, 2013). In China, rescuers' mortality rates were similar to those being rescued; a majority of rescues were person to person (Zhu, Jiang, Li, Li, & Chen, 2015). ...
... In an attempt to ascertain the level of public knowledge of safe rescue techniques, festivalgoers (N = 415) attending a cultural event in Auckland, New Zealand took part in a water safety survey that included information on their readiness to respond in a drowning emergency (Moran & Stanley, 2013). Many indicated they would jump in and rescue a victim (47%)the most at-risk option -while less than one third (30%) would get flotation to the victimthe most effective and low risk option. ...
Article
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Brenner, Moran, Stallman, Gilchrist and McVan, (2006) recommended that “swimming ability be promoted as a necessary component of water competence, but with the understanding that swimming ability alone is [often] not sufficient to prevent drowning” (pg. 116). Tradition and expert opinion are no longer enough. Science can now help us select essential competencies. What does research evidence show us about the protective value of specific individual personal competencies? Since the term “water competence’’ was coined by Langendorfer and Bruya (1995), and adapted for drowning prevention by Moran (2013), it has gained in use. It is indeed more inclusive than “swimming skill’’ alone. It re-emphasizes the need for a broad spectrum of physical aquatic competencies as well as the integration of cognitive and affective competencies. The purpose of this article is to a) define water competence, b) support each competence recommended as essential with examples of research evidence, and c) suggest areas requiring further research.
... Although most parents (67%) in this study reported that they could swim, and many (58%) perceived their swimming ability to be good/very good, most (55%) estimated that they could only swim 25 m or less. The self-reported competency level of parents in this study was much higher than that reported in two studies of other New Zealand-based population groups where only 13% of youth (15-19 years) (Moran, 2008a), and 7% of festival goers (Moran & Stanley, 2013) estimated they could swim up to 25 m. Another international study found that 6% of tertiary students indicated they could swim 50 m or less Stallman et al., 2010) although the participants were physical education students where one would anticipate a higher proficiency level. ...
... These perceptions were reflected in lower swimming distance estimates. As shown in other studies (McCool et al., 2008;Moran & Stanley, 2013), New Zealand European parents were more likely to estimate being able to swim longer distances than all other ethnicities. For those who identified as Maori, a wider gap was evident between how well they thought they could swim when compared with their estimated swimming distance. ...
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Little is known about people's perceptions of how much swimming competency is required to provide protection from drowning, especially in open water environments where most drowning incidents occur. This study reports on parental perceptions (n = 309) of swimming competency of themselves and their children and parents' beliefs on their safety when swimming in open water. Most parents (58%) considered themselves good/very good swimmers, although more than half (55%) considered that they could swim 25 m or less. Most parents (87%) reported that their children could swim, with more than one-half (52%) believing that their child's swimming competency was good/very good, yet most (74%) considered their child could swim only 25 m or less. Most parents (59%) and almost all children (81%) had never actually swum their reported distance in open water. In spite of these low levels of competency, one-half (51%) of parents thought their children were safe/very safe in open water. We discuss the implications of holding an overly-optimistic belief in the protective value of minimal levels of swimming competency for open water safety. Further exploration is recommended regarding the differences between real and perceived swimming competency especially among at-risk groups such as male children and adults. Introduction Water competence has long been regarded as a critical safety factor in the prevention of drowning. Recent work has identified the dynamic interaction of person, activity, and environment and the consequent changing competency base required for the prevention of drowning in recreational activities (Langendorfer, 2011). From a drowning prevention perspective, levels of water competence need to be flexible to allow for the differences between people, activities, and environments. The person who can float for a set time or swim a certain distance in a warm pool wearing only a swimsuit may not be able to repeat those same competencies to the same level of competency in a cold, open water environment fully clothed. Further, how people perceive their swimming competency in open water influences their perception of their safety and their potential risk of drowning. The purpose of this paper is to explore the perceptions of swimming competency and drowning risk that informs people's understanding of their safety and that of
... Although most parents (67%) in this study reported that they could swim, and many (58%) perceived their swimming ability to be good/very good, most (55%) estimated that they could only swim 25 m or less. The self-reported competency level of parents in this study was much higher than that reported in two studies of other New Zealand-based population groups where only 13% of youth (15-19 years) (Moran, 2008a), and 7% of festival goers (Moran & Stanley, 2013) estimated they could swim up to 25 m. Another international study found that 6% of tertiary students indicated they could swim 50 m or less Stallman et al., 2010) although the participants were physical education students where one would anticipate a higher proficiency level. ...
... These perceptions were reflected in lower swimming distance estimates. As shown in other studies (McCool et al., 2008;Moran & Stanley, 2013), New Zealand European parents were more likely to estimate being able to swim longer distances than all other ethnicities. For those who identified as Maori, a wider gap was evident between how well they thought they could swim when compared with their estimated swimming distance. ...
Article
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Little is known about people’s perceptions of how much swimming competency is required to provide protection from drowning, especially in open water environments where most drowning incidents occurs. This study reports on parental perceptions (n = 309) of swimming competency of themselves and their children, and parents beliefs on their safety when swimming in open water. Most parents (58%) considered themselves good/very good swimmers, although more than half (55%) considered that they could swim 25 m or less. Most parents (87%) reported that their children could swim, with more than one half (52%) believing that their child’s swimming competency was good/very good, yet most (74%) considered their child could swim only 25 m or less. Most parents (59%) and almost all children (81%) had never actually swum their reported distance in open water. In spite of these low levels of competency, one half (51%) of parents thought their children were safe/very safe in open water. The implications of an overly optimistic belief in the protective value of minimal levels of swimming competency for open water safety are discussed. Further exploration of the difference between real and perceived swimming competency, especially with at-risk groups such as males, are recommended.
... Self-assessment of ability is very important because research indicates that adult men, children, and their caregivers often underestimate water incidents (Morrongiello et al., 2013). Other studies reported that men are more likely to overestimate more water abilities than women (Moran and Stanley, 2013;Rejman et al., 2020). Studies analyzing the personal water competency conclude that most think they swim well, while twice as many men and women think they can swim longer than 200 m and feel safer in open water (Stanley and Moran, 2016). ...
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The aim of this study was to determine the gender differences between students' actual and perceived water abilities, how respondents assess risk in the described situations, and whether there are gender differences for those situations. The cross-sectional study was conducted on 150 students aged 19–20 years (males, n = 88; females, n = 62) from the faculty of sport and physical education, University of Novi Sad. Using calculated frequencies and estimates, students' self-assessment and actual measures of their swimming and survival skills and their perceived risk of drowning are described. Based on the results, Mann-Whitney U tests were applied. The differences between independent variables (gender) were analyzed according to dependent measures (water competency). To determine the significance of the relationship between actual and perceived skills, Spearman-rank correlation coefficients were calculated. The results of this study confirmed gender differences between students' actual and perceived water abilities, and that the male and female students had inaccurate perceptions of their own perceived and real water abilities. Both male and female students, with high precision, assessed their ability to swim long distances (rs = 0.601; rs = 0.694) just as female students assessed their ability to float (rs = 0.698). Male students greatly overestimated their backstroke swimming, while female students underestimated their ability to dive into the water. Both groups overestimated underwater swimming and underestimated their surface dive skill. Also, there was gender differences between students in assessing the risk for described situations.
... Such cases are often altruistic in nature, with rescues typically involving a child or loved one [10]. However, there is often a mismatch between willingness to perform an aquatic rescue and the skills needed to do so, particularly in open water, where most drowning incidents occur [13]. This indicates the need to provide training to potential bystander rescuers on rescue safety, something many report as never having been taught [14]. ...
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Drowning is a public-health threat and a leading cause of injury-related death. In Turkey, drowning results in 900 fatalities annually, and the rate is rising. As data on rescue-related drowning are scarce, this retrospective study explores the epidemiology of fatal drowning among rescuers in Turkey. As there are no routinely collected death registry data on drowning in Turkey, data were sourced from media reports of incidents between 2015 and 2019. Rescuer fatalities were analysed by age, sex, activity prior to rescue, location, incident day of week and season, and place of death. Statistical analyses comprised X2 tests of significance (p < 0.05) and calculation of relative risk (95% confidence interval) using fatality rates. In total, 237 bystander rescuers drowned (90% male; 35% 15–24 years). In 33% of cases, the primary drowning victim (PDV) was successfully rescued, while in 46% of cases the rescue resulted in multiple drowning fatalities (mean = 2.29; range 1–5 rescuers). Rescues were more likely to be successful in saving the PDV if undertaken at the beach/sea (X2 = 29.147; p < 0.001), while swimming (X2 = 12.504; p = 0.001), or during summer (X2 = 8.223; p = 0.029). Risk of bystander rescue-related fatal drowning was twice as high on weekdays compared to on weekends (RR = 2.04; 95%CI: 1.56–2.67). While bystanders play an important role in reducing drowning, undertaking a rescue is not without risk and can lead to multiple drowning incidents. Training in rescue and resuscitation skills (especially the prioritization of non-contact rescues) coupled with increasing awareness of drowning risk, are risk-reduction strategies which should be explored in Turkey.
... Current notions of water safety are largely described as cautious behaviours on, in or around the water (Gulliver & Begg, 2005); water safety knowledge, attitudes, and behaviours/practices (Moran, 2003(Moran, , 2006(Moran, , 2007(Moran, , 2008(Moran, , 2009McCool et al., 2009;Moran & Willcox, 2010); swimming competency and ability Maynard, 2013;Stallman et al., 2008); water safety messages ; risky behaviours/perceptions and drowning risk (McCool et al., 2009;Moran, 2010Moran, , 2011; safe assistance and lifeguard rescue/self-rescue methods; (Moran, 2008;Moran & Stanley, 2013;Franklin & Pearn, 2011;Moran & Webber, 2014); active adult supervision (Moran, 2009) and; aquatic readiness and water competence (Quan et al., 2015;Langendorfer, 2015;Stallman et al., 2017;Kjendlie et al., 2010). ...
Article
Māori (the indigenous peoples of Aotearoa, New Zealand) are intimately connected to wai (i.e., water) yet are overrepresented in New Zealand’s drowning statistics each year. On average Māori account for 20-24% of all preventable and non-preventable drowning fatalities, despite comprising only 15 percent of New Zealand’s population. Drowning remains a significant issue posing a threat to whānau (i.e., families) through premature death being imminent and whakapapa (i.e., genealogy) being interrupted. There is limited research that has examined Māori and indigenous understandings of water safety within the literature and limited studies that have investigated the issue of Māori drowning from a distinctly Māori or indigenous approach. This paper proposes a theory of Māori water safety depicted as the Wai Puna model and draws on three core concepts pertinent to a Māori worldview: whakapapa, mātauranga (i.e., Māori knowledge and ways of knowing) and tikanga (i.e., customs, practices). Wai Puna provides the foundation for conceptualising Māori water safety in a New Zealand context and a way forward for other indigenous communities around the world to redefine water safety and drowning prevention from their distinct worldviews that reflect their unique beliefs and attitudes to water and thus to water safety.
... 21e23 Hazardous water conditions that led to the initial person drowning often persist and place the well-intentioned rescuer at risk for becoming an additional drowning patient. 24 Rescue by untrained persons should be attempted without entering hazardous conditions by reaching out to the drowning patient with a paddle or branch; throwing a rope, buoy, cooler, or any floating object; or rowing a boat, canoe, or paddleboard to the patient. Trained rescue personnel should operate according to their level of training, expertise, equipment, and comfort level. ...
Article
The Wilderness Medical Society convened a panel to review available evidence supporting practices for acute management and treatment of drowning in out-of-hospital and emergency medical care settings. Literature about definitions and terminology, epidemiology, rescue, resuscitation, acute clinical management, disposition, and drowning prevention was reviewed. The panel graded available evidence supporting practices according to the American College of Chest Physicians criteria and then made recommendations based on that evidence. Recommendations were based on the panel's collective clinical experience and judgment when published evidence was lacking. This is the first update to the original practice guidelines published in 2016.
... The perception of lower exertion levels when wearing a lifejacket to support floating and helping others could be viewed as an important experience of the value of wearing a lifejacket and thus a valuable part of lifejacket education. The success of all participants in completing the partner assist wearing a lifejacket and the associated significantly lower estimation of exertion required reinforces the importance of appropriate flotation in rescue scenarios as advocated in recent bystander rescue research (Moran, Webber, & Stanley, 2016;Moran, & Stanley, 2013). The inclusion of a partner assist exercise using lifejackets provides a strong indication of the inter-relationship between practical water competencies, identified by Stallman and colleagues (2017) as Competency 8 -Lifejacket competency and Competency 14 -Recognise/assist a drowning person. ...
Article
Personal flotation devices (PFDs), commonly referred to as lifejackets, have been identified as an extremely effective form of drowning prevention and was identified as a critical distinct water competency by Stallman and colleagues (2017). In this second phase of the Can You Float? study, perceptions and practice of a range of lifejacket tasks among students (N = 40) with known water proficiency were examined. Participants estimated exertion levels before and after practical testing of six simulated survival tasks when wearing lifejackets. All participants completed a 25m sprint swim, 5-minute endurance swim, 5- minute float, and 25m partner assist but many failed to complete a 15m underwater swim (63%) and deep water exit (63%). Students underestimated the level of exertion required to complete the underwater swim and deep water exit. Reasons for, and implications of, this underestimation are discussed and recommendations for the teaching of lifejacket competency in water safety programs are made.
... Little is known, however, about what competencies bystander rescuers possess, particularly those aged 15-24 years, although it is not uncommon for bystander rescuers to become drowning victims with retrospective studies of such incidents reported in Australia [5]; the Netherlands [20]; Turkey [18,19] and the United States [17]. A more recent study that examined public perceptions of their capacity and readiness to respond to an aquatic emergency in New Zealand found that many participants (ages not reported) may not possess the necessary competencies to safely assist others [8], which can result in highly dangerous situations for both the rescuer and rescuee(s). If this finding is consistent with young people aged 15-24 years, then this could highlight a potential drowning risk factor for this age group. ...
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Drowning is an important public health issue with major impacts on young adults aged 15–24 years, yet little is known about the causal factors for drowning for this group. As young adults recreate with peers in unpatrolled aquatic environments, the capacity to perform effective and efficient rescues seems pivotal. This study examined perceived ability of young adults to perform a rescue; determined the level of aquatic rescue knowledge; and measured the effect of an aquatic rescue intervention. In total, 135 participants completed pre- and post-intervention surveys and rescue practical testing. Wilcoxon matched pairs signed rank tests were used to assess significant differences pre- and post-intervention and Mann–Whitney tests used to compare groups. Pre-intervention, participants had a low level of rescue knowledge (Mdn = 50) and the relationship between perceived rescue ability and practical rescue testing was weak (rs = 0.33, p ≤ 0.001). Post-intervention, ability to perform a contact tow demonstrated significant improvement (z = − 9.09, p < 0.001, r = − 0.79) and rescue knowledge also improved significantly (Mdn = 100, z = − 9.42, p < 0.001, r = − 0.81). Many young adults lacked both the physical capacity and knowledge required to safely perform a rescue, a factor that may place them at increased drowning risk if they attempt an aquatic rescue. As a rescue based intervention can significantly improve competency of young adults regardless of previous experience and/or qualifications, research needs to consider how best these competencies can be promoted and/or developed with this high risk group.
... None could climb out with ease over the 0.41 m bulkhead after the clothed swim. This overestimation of aquatic competency by males is consistent with the findings of previous studies ( Brenner, Saluja, & Smith, 2003;Gulliver & Begg, 2005;Howland, Hingson, Mangione, Bell & Bak, 1996;McCool, Moran., Ameratunga, & Robinson, 2008;Moran, 2008Moran, , 2011Moran, Stallman et al., 2012;Moran & Stanley, 2013). , Vol. 8, No. 4 [2014], Art. 4 http://scholarworks.bgsu.edu/ijare/vol8/iss4/4 ...
... [8][9][10] Hazardous water conditions that led to the initial person drowning often still exist and place a well-intentioned rescuer at risk for becoming an additional drowning patient. 11 Rescue by untrained persons should be attempted without entering hazardous conditions by reaching to the drowning patient with a paddle or branch, throwing a rope, buoy, cooler, or any floating object, or safely rowing a boat, canoe, or paddleboard to the patient. Trained rescue personnel should Recommendation: Given the risks associated with inwater technical rescue, persons without formal water rescue training should only attempt rescues from a safe location by reaching, throwing, or rowing to the drowning patient. ...
Article
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The Wilderness Medical Society convened a panel to review available evidence supporting practices for the prevention and acute management of drowning in out-of-hospital and emergency medical care settings. Literature about definition and terminology, epidemiology, rescue, resuscitation, acute clinical management, disposition, and drowning prevention was reviewed. The panel graded evidence supporting practices according to the American College of Chest Physicians criteria, then made recommendations based on that evidence. Recommendations were based on the panel's collective clinical experience and judgment when published evidence was lacking.
Article
In Biscay beaches, the Biscay Regional Council (BRC) is in charge of looking after the safety of beachgoers. Its aim is to reduce drownings and accidents to zero. Lifeguard services during the summer seasons should be enough to reach this target. But not everything depends on them. There is another key factor to consider: beach users and the extent to which they obey the rules for bathing. Beach users carry out different activities in the surf area, which increases the hazards and the disputes between them. Proactive action such as warning signage and environment education are useful tools to increase beachgoers awareness of the potential risks and how to avoid them. The motivation for this study is to analyze beachgoers’ environmental understanding, their signage perception and their behavior and safety education, from the point of view of the lifeguards. Methodology is based on a main survey for lifeguards and a secondary survey for users. The analysis of the results shows the need for a common safety educational plan and a standardized flag and signage plan supported by the Spanish Authorities.
Article
Beachgoers are not aware of many hazards they may find in the seawater. In 2015 58% of drowning that occurred in Spain took place on the beach. The risk may be reduced by action on the vulnerability and the exposition. Swimming ability may help to decrease vulnerability but it seems not to be enough and, as for exposition, the knowledge of beach hazards is a good aid to reduce bathers' incidents. The aim of this paper is to know which is the knowledge acquired by students who have finished secondary education. Three hundred and sixty four first year students from the University of the Basque Country were surveyed by means of a questionnaire with the purpose of knowing their swimming level, their profile as beach users, their knowledge of rip currents and how to recognize them, and their interpretation of the beach safety information and signals. The research shows that, although more than 95% of respondents go to the beach, the swimming level is low given that 51% can swim between 25 and 100 m. On the other hand, their knowledge of rip currents is also very low. However it is surprising that there are more rescuers than people saved. These results lead us to think that an Aquatic Safety Educational Plan is necessary as soon as possible.
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Rescuers who drown sacrifice their lives so that another might live; these drowning deaths are a particular challenge to prevent. In this research from Australia and the literature, we dissect and discuss the elements of "rescue altruism." This 18-year critical incident population study identified 103 victims who drowned while attempting a rescue. In 74% of cases, the primary "victim" (rescuee) survived; 50% of rescuers were visitors not familiar with the water hazard; 67% of the drowned rescuers were related to the primary victim. None were professionally trained in aquatic rescue. We propose that rescue altruism is composed of (a) an ethos based on the Good Samaritan or Golden Rule ethic; (b) a subjective identity of the rescuer with the victim, intensified by a perceived duty-of-care relationship; (c) perception of risk in which the potential of rescue-resuscitation success is greater than zero; and (d) personal courage that ignores degree of risk. The unmet challenge therefore is to ensure all members of the public are equipped with lifesaving drills and skills to ensure their safety and those in their care.
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Culturally and linguistically diverse populations are generally over-represented in the drowning statistics of high income countries. This paper reports on Asian immigrants’ aquatic recreation and water safety in the aquatically-oriented Auckland region. A survey of new settlers (n=570) was conducted at 7 cultural festivities using a self-complete questionnaire that sought information on immigrant’s current and previous aquatic recreation, and their understanding of water safety. Almost half (43%) had never participated in aquatic recreation prior to coming to New Zealand, and most (72%) now did more aquatic recreation. Most participants (73%) estimated that they could swim less than 50m, one half (47%) had never been taught to swim, and had never received water safety education (63%) or CPR training (65%). Given the continuing influx of new settlers in New Zealand, water safety programmes that are sensitive to the needs of diverse peoples should be persisted with and focus on identified high-risk activities.
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Successful negotiation of everyday life would seem to require people to possess insight about deficiencies in their intellectual and social skills. However, people tend to be blissfully unaware of their incompetence. This lack of awareness arises because poor performers are doubly cursed: Their lack of skill deprives them not only of the ability to produce correct responses, but also of the expertise necessary to surmise that they are not producing them. People base their perceptions of performance, in part, on their preconceived notions about their skills. Because these notions often do not correlate with objective performance, they can lead people to make judgments about their performance that have little to do with actual accomplishment.
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There is no greater sacrifice than that made by a rescuer who throws it all on the line to rescue a drowning victim. However, in some instances the rescuer tragically drowns in the rescue attempt. This paper examines the circumstances surrounding the drowning deaths of rescuers.Methods All drowning deaths using data from the Australian Bureau of Statistics Deaths Registrar for the period 1 July 1992 to 30 June 2002 and the National [Australian] Coroners Information System for the period 1 July 2002 to 30 June 2009 were examined to identify an unselected complete subset of drowning incidents where a rescuer drowned in attempting to effect a save.ResultsThere were 98 victims who drowned while attempting a rescue. Of these 69% were male. The majority (61%) were aged between 25 and 49 years. Where data concerning the location of the aquatic incident was available (n=37) beaches (35%); rivers (21%); ocean (16%) were common. The summer (42%) was the season of most rescuer fatalities.DiscussionThe urge to leap into action to help someone in trouble is an altruistic impulse and often a source of pride in Australia. Sadly, a percentage (unknown) who attempt such a rescue do not return home. The drills and skills taught by lifesaving and water safety agencies provide a skill set which enables a potential rescuer to ensure both that they place themselves only at minimum risk commensurate with the circumstance; and have appropriate experience to undertake an effective rescue.
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Little is known about the specific water-safety beliefs, swimming skill, and behaviors that might be associated with beachgoers' perception of drowning risk. Summer New Zealand adult beachgoers (N = 3,371) were surveyed to assess beach swimming frequency, swimming skill, swimming behaviors, and perception of the risk of drowning in five prevalidated scenarios. Thirty-two percent of beachgoers estimated that they could currently swim less than 25 m, 55% reported that they had swum outside lifeguard-patrolled areas, and 26% had swum after consuming alcohol. Young adults and men were more likely to self-report strong swimming skill, more frequent at-risk swimming behavior, and lower perception of drowning risk. High swimming frequency, better self-reported swimming skill, and previous at-risk swimming behaviors were all associated with a lower perception of risk of the case scenarios. Addressing tendencies to overestimate swimming skill and underestimate drowning risk should be focal points of drowning-prevention interventions, especially among young male adults.
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Lack of appropriate supervision is a persistent risk factor in most child drowning incidents. The risks to young children associated with swimming at beaches place a premium on close and constant supervision by caregivers. However, little is known about caregiver supervisory practice and perceptions of child water safety at beaches. Adults (N = 769) in charge of children under 10 years of age were surveyed at 18 New Zealand beaches during the summer of 2007 to ascertain caregiver perceptions of their water safety skills, risk of drowning for their child and their supervisory behaviours. Most parents (78%) estimated that they could swim 100 m non-stop in open water, almost one half (48%) had been certified in cardio-pulmonary resuscitation and one quarter (24%) had received some rescue/lifesaving training. More than one quarter (29%) failed to provide appropriate supervision for their under 5-year olds at the beach. Almost half (46%) of caregivers did not provide close supervision for their 5-9 year olds. Although there were no significant differences between males and female self-reported supervision, male caregivers were more likely to rate their 5-9 year olds as good swimmers and less likely to estimate a high risk of drowning for that age group. To address shortcomings in caregiver supervision, it is suggested that water safety education initiatives emphasise how to provide close and constant supervision of young children at beaches. Furthermore, a focus on the necessity for caution when estimating risk and ability to cope with open water conditions is recommended.
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To explore 5 years of drowning deaths in Australia compared with a previous Australian study a decade earlier, and to assess the feasibility of achieving a 50% reduction in unintentional drowning deaths by 2020. An audit of all unintentional drowning deaths in Australia using data from the National Coroners Information System for 1 July 2002 to 30 June 2007. Number and rate of drowning deaths, by age, sex, location, activity, place of birth, visitor status, and involvement of alcohol or drugs. There were 1452 drowning deaths during the study period (76.4% male). The age-adjusted rate per 100 000 people ranged from 1.61 in 2002-03 to 1.23 in 2006-07. Children aged 0-4 years had the highest rate (2.63 per 100 000 people), and 29% of deaths were of people aged 55 years or older. Over half of all deaths occurred in rivers (20.3%), at beaches (18.3%), or in swimming pools (13.3%). Alcohol was involved in 21.6% of all drowning deaths, although this varied by age. This audit suggests that a 50% reduction in drowning fatalities by 2020 may be achievable using current knowledge and preventive systems in certain types of immersions. However, further research and new initiatives will be required, particularly to prevent drowning deaths in rivers and of older people.
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Men have higher drowning rates than women for most age groups. Data from a 1991 national household survey (n = 3042) on aquatic activities were used to examine hypotheses about differential drowning rates by sex. Men and women were compared by (1) exposure to aquatic environments; (2) frequency of aquatic activities involving or potentially involving, submersion; (3) swimming training and ability; (4) aquatic risk-taking behaviors; and (5) alcohol use on or near the water. Men had elevated risks for exposure, risk taking, and alcohol use. It was concluded that several factors contribute to their relatively high drowning rates, including a possible interaction between overestimation of abilities and heavy alcohol use.
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Drowning is the second leading cause of unintentional injury death among adolescents. The authors describe the epidemiology of adolescent drowning and near-drowning; review the literature with emphasis on what is known about risk factors, treatment, and prevention; and identify the gaps in our knowledge on the circumstances surrounding submersion injuries in this age group.
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To measure the validity of self reported safety practices from a questionnaire, completed by families participating in a home safety randomised controlled trial. The postal questionnaire was used to measure secondary outcomes in a randomised controlled trial. The answers to 26 questions that could be assessed by observation were checked by a home visit. Families were invited to take part in a "home safety check"; they were not told that the visit was part of a validation study. At the time of the visit the researcher was blind to the self reports in the questionnaires. Sixty four questionnaires were validated by visits to 64 households. Percentage agreement ranged from 58% to 100%. Sensitivity was high (68% or above) for most safety practices. The positive predictive value was also high for most safety practices (78% or above for 15 of the 16 practices). This study found a fairly high degree of consistency between self reported data and actual observations. The findings from this relatively small study need confirmation from larger studies.
Article
People tend to hold overly favorable views of their abilities in many social and intellectual domains. The authors suggest that this overestimation occurs, in part, because people who are unskilled in these domains suffer a dual burden: Not only do these people reach erroneous conclusions and make unfortunate choices, but their incompetence robs them of the metacognitive ability to realize it. Across 4 studies, the authors found that participants scoring in the bottom quartile on tests of humor, grammar, and logic grossly overestimated their test performance and ability. Although their test scores put them in the 12th percentile, they estimated themselves to be in the 62nd. Several analyses linked this miscalibration to deficits in metacognitive skill, or the capacity to distinguish accuracy from error. Paradoxically, improving the skills of the participants, and thus increasing their metacognitive competence, helped them recognize the limitations of their abilities. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
To estimate the frequency of episodes of serious risk of drowning, three related studies were conducted in South Carolina. Death certificates revealed 909 drownings for the period 1968 to 1972. Thirteen percent of 100 consecutive near-drowning victims admitted to 11 major hospitals died. Questionnaires answered by 9,420 primary school children reported that 15% had experienced at least one episode constituting a serious threat of drowning during the preceding year. Drowning rates per 100,000 population were calculated for different age groups based on the 1970 census. Based on the relationship of a drowning rate of 7.4 per 100,000 to a reported incidence of high risk of 15% in the surveyed age group, it was calculated that at least a half million incidents with a serious threat of drowning occurred annually in the state for all age groups. Previously undocumented facts indicate a strong parental and racial factor in a child's swimming ability. Black males aged 15 to 19 had the highest drowning rate, almost three times the rate for white males of comparable age. White females had greater ability than black males and shared a very low rate of drowning with black females. Males of both races were 8.3 times more likely to drown than females.
Article
Drowning is a leading cause of injury related death in many countries, including Turkey, where this study originates. The aim of the study is to define and examine "rescuer" drowning and Multiple Drowning Incidents (MDIs), and suggest preventative measures against MDIs. The event of a person drowning can be complicated if an untrained person attempts to rescue the Primary Drowning Victim (PDV). This can result in the death of the "rescuer" as well as the PDV, which then becomes an MDI. This study categorizes these MDI incidents by examining online news media accounts in Turkey from 2005 through 2008. In this 4-year period, 88 "rescuer" drowning incidents occurred in which 114 "rescuers" and 60 PDVs died from drowning in MDIs; 114 drowned "rescuers" rescued 47 PDVs before they died from drowning. Most of the "rescuers" were male and 42.1% of them were under the age of 18. Most of the drowning incidents (68.5%) occurred in fresh water (lakes/dams/water holes and rivers/creeks/streams). In this study, risk factors for drowning deaths include gender and entering in unguarded open water. An increased awareness of such risks as well as promotion of both swimming and rescue skills in water could help reduce MDIs. Parents who live close to fresh water sources with boys under the age of 18years should be more aware of drowning risk because of their higher rates of deaths from drowning. The results of this study give the chance to policy makers and all other related people or organizations to see the whole picture of deaths by drowning and the results can be used to build up preventative strategies as swimming teaching and life guard education.
Non-intentional drowning incidents remain a leading cause of mortality in Turkey as well as all over the world. A following related secondary syndrome is composed of those who drown during altruistic attempts to rescue a drowning person. Such 'rescuers' who attempt to rescue a drowning person, may themselves drown, resulting in a tragic multiple death. This study covers the year 2009, and necessary data was found by using internet search engines to identify cases in which a potential rescue attempt resulted with the rescuer's fatal drowning. Thirty-one 'rescuers' and 20 primary drowning victims (PDV) drowned in 28 incidents in which 80% of drowned primary victims (DPV) were children, and 48.4% of the 'rescuers' were children. In 48.4% of the 'rescuers' succeeded in rescuing the PDV's life. Out of them, 38.7% of the 'rescuers' and PDVs were friends/colleagues. The aim of this study is to define and examine multiple drowning syndromes (MDSs) and to suggest preventative measures. An increased awareness of such risks as promotion of swimming and rescue skills could help reducing the MDSs.
Non-intentional child drowning remains a leading cause of child mortality. A related and secondary syndrome is composed of those who drown in impulsive, altruistic attempts to go to the aid of a drowning child. Such 'rescuers' who attempt to save a drowning child may themselves drown, a tragic event we term the AVIR syndrome or aquatic victim-instead-of-rescuer. This study is composed of a five-year (1 July 2002 to 30 June 2007) total population Australian survey, using the National Coroners Information System to identify cases and an analysis of every immersion rescuer-victim dyad where the primary 'victim' was a child and where the 'rescuer' drowned. In Australia (2002-2007), 17 rescuers drowned in 15 incidents in which the primary victim was a drowning child. In 93% of the incidents, the primary 'child-victim' survived, 82% of the victims were unfamiliar with the aquatic location (i.e. were a visitor) and 76% of the victims were a male parent, partner of first-degree relative. Alcohol was not generally involved. We define the AVIR syndrome as one that typically involves the following: a male, parent, partner or relative; an unfamiliar water hazard; a 'rescuer' who is a tourist; alcohol is not usually involved; and the primary victim usually survives. We posit that an increased awareness of such risks, the promotion of rudimentary rescue skills (e.g. being able to throw a lifeline) and increased advocacy for parents to learn the simple and basic life-saving skills of non-contact rescue will help reduce these drowning tragedies.
Article
In Australia, 86 "rescuers" have drowned over 15 years (1992-2007). Many victims have needlessly drowned simply because of bystander unfamiliarity with the simple skill of throwing a lifeline or lifebuoy. The basic paradigm of aquatic lifesaving is to affect a rescue, without placing oneself at risk. Twenty-five fit, untrained adults were recruited to assess their lifeline throwing abilities. Results from 190 competitors as participants in the Line Throw events at the National Australian Pool Lifesaving Competition 2009 were analyzed for speed, efficacy, and accuracy. It takes a medium time of 35 s for an untrained bystander to throw a lifeline. Only 20% can throw a line within 2 m of the target at a first attempt. In the heat of the moment, 20% do not secure the end of the flung rope. Trained children can affect a 10 m accurate throw and pull a potential victim to safety with a medium elapsed time of 23 s. The Australian national record for trained lifesavers (adult, 12 meter), is 10.08 s-world record 9.06 s. This simple lifesaving technique, with training in improvisation (e.g., garden hoses), will undoubtedly save lives.
Article
Bystanders make a critical difference in the survival of drowning victims. Little information on their role before arrival of the Emergency Medical Services (EMS) is available in the scientific literature. In a descriptive study, this role is investigated. We studied 289 rescue reports (1999-2004) available from the Dutch Maatschappij tot Redding van Drenkelingen (Society to Rescue People from Drowning), an organisation that, since 1767, acknowledges awards to bystanders who have contributed to the survival of a drowning victim. There were 138 variables retrieved from these reports. The Utstein Style for Drowning (USFD) was used as a guideline. Of the 26 USFD parameters on victim and scene information, 21 were available for analysis. Eight non-USFD parameters, defined by the authors of this research, were available in >60% of the cases. There were 343 victims, rescued by 503 rescuers. 109 victims were resuscitated by bystanders. Of the 18 victims who first received resuscitation from bystanders and then consequently from pre-hospital professionals, 14 survived. Rescues often occurred in dangerous circumstances: multiple victims (n=90/343), cold or ice-cold water (n=295/341), deep water (n=316/334), swimming to the victims (n=262/376), young age of rescuers (the youngest rescuer was 5 years of age). Bystander rescue and resuscitation of drowning victims seems to contribute to a positive outcome. Bystanders are prepared to take responsibility to rescue a drowning victim in spite of significant dangers. The USFD is helpful in understanding the role of bystanders in drowning situations, but may need modification to become more instrumental.
Article
Data from state telephone surveys of self-reported seatbelt use, driving while intoxicated, and drinking five or more alcoholic drinks at one sitting were compared with objectively observed belt use in traffic and evidence of blood alcohol in fatally injured drivers. Self-reported belt use overstates actual use by more than 20 percentage points on average. Self-reported alcohol use is not predictive of the percentage of fatally injured drivers with evidence of blood alcohol among the states.
Article
To describe usual water-related behaviour and 'near-drowning' incidents in a cohort of young New Zealand adults. This was a cross-sectional study based on data collected as part of the Dunedin Multidisciplinary Health and Development Study, which is the study of a cohort (n = 1,037) born between 1 April 1972 and 31 March 1973 in Dunedin, New Zealand. The data analysed were collected at age 21 (1993/94). Each study member was given a face-to-face interview using a structured questionnaire. Males reported a higher level of water confidence, exposure to risk behaviours, and exposure to unsafe locations, and more 'near-drowning' incidents, than the females, but protective behaviour did not differ. Males and females who were 'confident' in the water were more likely to be exposed to unsafe water locations, and water-confident males were more likely to drink alcohol before water activities, but not boating. A total of 169 'near-drowning' incidents were reported by 141 study members (63% males). 'Near-drowning' incidents were associated with unsafe swimming environments for males (p < 0.001) and boating within two hours of consuming alcohol for females (p = 0.002). This study described usual water-related behaviour and has provided preliminary evidence of the factors associated with 'near-drowning' incidents among a high-risk age group. Larger case-control studies are required to further investigate risk factors for 'near-drowning'. IMPLICATIONS FOR PRACTITIONERS: Further investigation is required to determine the effectiveness of providing water skills acquisition in both safe and unsafe environments on 'near-drowning' experience.
Review of the economic and social costs of drowning and water-related injuries compared to prevention
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