Total Life Saving Service Plan

Introduction

There are 4 factors that could lead to a drowning. This is known as the drowning chain and is summarised as follows:

  • Ignorance, disregard or misjudgement of, or, unprepared for the danger,
  • Uninformed, unexpected or unrestricted access to the hazard,
  • Lack of supervision or surveillance,
  • An inability to cope once in difficulty,

A ‘preventable drowning’ is therefore a drowning which could be avoided if the appropriate preventative action was in place to ‘break’ the drowning chain described above.We must look at strategies to address all 4 factors if we want to reduce drowning – not just to provide additional surveillance. A total lifesaving service plan is therefore required.


Introduction

There are 4 factors that could lead to a drowning. This is known as the drowning chain and is summarised as follows:

  • Ignorance, disregard or misjudgement of, or, unprepared for the danger,
  • Uninformed, unexpected or unrestricted access to the hazard,
  • Lack of supervision or surveillance,
  • An inability to cope once in difficulty,

A ‘preventable drowning’ is therefore a drowning which could be avoided if the appropriate preventative action was in place to ‘break’ the drowning chain described above.We must look at strategies to address all 4 factors if we want to reduce drowning – not just to provide additional surveillance. A total lifesaving service plan is therefore required.

This paper highlights options to assist in the prevention of drowning. Options highlighted in the total lifesaving service plan may not suite all locations. However, succesful strategies from various member organisations are highlighted so that alternatives for local conditions and circumstances can be considered.

The work of the ILS Rescue Committee is a work in progress. This paper outlines the work done to date and calls for comment prior to formally presenting this information to the ILS Lifesaving Commission and the ILS Board of Directors in July 2008.

Background

The International Lifesaving Federation (ILS) Rescue Committee has addressed the above issues by developing a Total Life Saving Service Plan.

This helps us identify the gaps, and also enables priorities to be set when addressing the strategies that we need to put in place to address each of the 4 aspects of the drowning chain. The strategies can be grouped as follows:

  • Education and information
  • Denial of access and or provision of warnings
  • Provision of supervision, and
  • Acquisition of survival skills

The ILS Rescue Committee has established a list of the different programs that individual member organisations have developed to address each of these 4 areas.

Discussion

Currently, the World Health Organization (WHO) collates the most comprehensive global data on drowning mortality. Even while acknowledging that drowning deaths are significantly under reported, WHO identifies drowning as the second leading cause of unintentional injury death after motor vehicle collisions. The World Health Organization estimated that 409 272 people died from drowning in 2000World Health Organization, Factsheet on drowning (2003)., and 382 000 in 2002.World Health Organization, The World Health Report 2004, Statistical Annex, available on-line at http://www.who.int/whr/2004/annex/topic/en/annex_2_en.pdf.

  • There are a number of factors that could lead to death by drowning:
  • Ignorance, disregard or misjudgement of, or, unprepared for the danger,
  • Uninformed, unexpected or unrestricted access to the hazard,
  • Lack of supervision or surveillance,
  • An inability to cope once in difficulty.

We therfore need startegies in each of these areas to break this cycle or chain.
These can be grouped as follows:

  • Education and information,
  • Denial of access and or provision of warnings,
  • Provision of supervision, and
  • Acquisition of survival skills.

This sequence is depicted in the following diagram

The various initiatives under each of these four factors can be listed as follows.

The Drowning Chain – Summary of Control Measures

The Sequence

Counter Measure

Control Measures

Applications

Factor One
Ignorance, disregard or misjudgement of the danger

Education and information

Pre-arrival education

  • Electronic & Digital Media
  • Leaflets / Brochures
  • Awareness Programs

Arrival information

  • Information Signage

Safe Beach Access

  • Formal Access Ways

On-site Education

  • Public Address Systems
  • Face-to-face

Factor Two
Uninformed or unrestricted access to the hazard

Denial of access and/or provision of warnings

Barriers

  • Access barriers
  • Booms
  • Buoy lines

Signage

  • Information Signage
  • Warning Signage
  • Prohibition Signage
  • Flags

Byelaw Development

  • Formal Regulatory Arrangements
  • Recognition of Life Saving Services

Factor Three
Lack of Supervision

Provision of supervision

Trained Observers

  • Trained Activity Supervisors
  • Coaches & Instructors

First Aid Facilities

  • Portable First Aid Kits
  • Permanent / Fixed Facilities

Lifeguard Services

  • Intermittent (Roving)
  • Surveillance
  • Full Service (Between the Flags or Open Beach)
  • After Hours Call-out

Activity Management

  • Club / Group Registration
  • Self Regulation Programs
  • Permit Systems

Activity Restrictions

  • Zoning
  • Beach / Water Closure

Factor Four
Inability to cope once in difficulty

Acquisition of survival skills

Community Training

  • Survival Skills
  • Self Rescue Skills
  • Rescue Skills

Emergency Communications

  • Public Telephone
  • Outpost Alarms
  • Dedicated Emergency Telephone
  • Radio

Public Rescue Equipment

  • Lifebuoys
  • Throw Lines
  • Other extraction equipment and fixtures

Table 1 – Summary of control measures to address factors that could lead to a drowning

Conclusion

ILS has identified that there are a number of factors that could lead to death by drowning. ILS has collated a number of control measures that may either by themselves or jointly lead to a reduction in the number of people drowning worldwide. Organizations interested in reducing the number of deaths by drowning should perform both a risk assessment in relation to the nature and causes of drowning in their location and then to prioritise according to the number and nature of resources at their disposal to ensure that the greatest benefit is derived from those resources.

Best practice in relation to the various control measures will be referenced on the ILS web site from July 2008 once the Total Lifesaving Service Plan initiative has been adopted by ILS.

Take Home Messages

  • To understand the factors that could lead to a drowning.
  • To review options that various organisations have adopted to address aspects of the drowning chain.
  • To share learning and to contribute ideas to assist in the prevention of drowning.

Acknowledgments

Surf Life Saving Australia
Surf Life Saving New Zealand
Royal National Lifeboat Institution