Survival at sea

Greece, with around 400 drownings per year, ranks 5^th in the European Union between 28 members (Eurostat 2016) and 39^th in 116 countries (World Health Organization 2014) for drownings worldwide. Therefore, drowning is a serious public health issue in Greece.

Instinctive Drowning Reaction
Victims who do not know how to swim usually react as follows: they do not call for help, their body is vertically positioned in the water, they splash their hands in the water sidewards or backwards and they cannot grab a lifesaving aid. A child will sink and drown in about 20 seconds and an adult in about 60 seconds. 

The Drowning Factor RID
A drowning victim cannot be obvious to those around him due to the following 3 factors: Inability to recognize the victim (Recognition) because most people do not know how a drowning victim would look like. Intrusion into other tasks such as reading a newspaper or arranging equipment (Intrusion). Distraction due to a conversation or use of a mobile phone (Distraction).

1-10-1 Rule
From the moment the victim falls into the water, he has the following timeframe: 1 minute to get used to cold water. 10 minutes to swim and get out of the water until his/her limbs get paralyzed from the cold. 1 hour until he/she loses consciousness.

The 4W Drowning Model
According to this model, the factors that determine the outcome of a drowning (death, survival) include the victim, the rescuer, the circumstances and the location of the drowning. The main pair of factors is who (rescuer) saves whom (victim). The main factor is the rescuer. 

Near Death Experiences of Drowning Victims
For every 100 drowning survivors, 20 (1 out of 5) experience a near death experience. This can include 16 symptoms, for example sufferers may see their life as a movie, exit their body and observe their drowning or attempts to bring them back to life, pass through a dark tunnel, meet a glowing being or dead people, be asked “do you want to stay or return?” and understand the impact of their actions on others. They also seem to acknowledge that the most important things in life are love and the ability to learn.

1. RESCUE AND SURVIVAL TECHNIQUES

Castaways in the sea may remain motionless in two positions in order to reduce heat loss:
HELP Position: the person involved wears the individual float device, holds his/her head above the surface of the water and crosses arms and legs in front of their chest.
Huddle Position: persons involved wear their individual float device and with their arms stretched hold the person next to them in such a way that their bodies are side-by-side.

Rescuing drowning victims can be performed as follows (available rescue techniques are listed progressively from the simplest and safest for the rescuer to the most difficult) 

1. Shout and Signal. Shout out to the victim and give him/her a signal encouraging them to come towards you.
2. Rescue by stretching. Lie down and stretch your arm or any object towards the victim (e.g., wood, umbrella, towel).
3. Rescue by throwing object. Throw something that the victim can catch (e.g. rope, board, ball, personal floating device).
4. Rescue by walking. Get into the water and walk on the seabed as far as you can. Stretch your hand or other object towards the victim.
5. Rescue by craft. Approach the victim using any type of a craft (e.g. lifesaving board, sea mattress, rowing boat, jet ski, motor boat).
6. Swimming rescue with aid. Swim to approach the victim and when within 2-meter safe distance extend an object (e.g., towel, blouse, ball, individual floating device or another rescue device).
7. Rescue by dragging. Use this rescue as a last resort. Approach the victim from behind and grab hold of him/her from the chin, arm, clothes, armpits or chest.

2. SAFETY ACTIONS AND APPLICATIONS IN WATER 

• “Sport Lifesaver” magazine is available monthly in 113 countries and its e-version is free.
• The Hellenic National Water Safety Program as well as distance sports lifesaving apprenticeships include free water safety training material.
• The International Drowning Prevention Program “Charlie the Savior” is based on true incidents from the life of Baywatch director. It is approved by international organizations and addressed to children 6-12 years old.
• The Doctor Next 2 Me mobile app locates the nearest doctor on land or at sea. Offers distance medical support and guidance. 

3. LIFESAVING SPORT 

• The Greek Lifesaving Sports Association is the “home” of the life-saving sport. It carries out water safety activities and sports lifeguarding challenges.
• Lifesaving Sport is the epitome of the Olympic ideal and the only humanitarian sport. It takes place since the 1950s in 50+ countries and is hosted at a number of international sporting events.
• It includes sports containing the elements of swimming, rowing, running, rescue and first aid. They prepare ordinary citizens for an emergency in and out of the water and offer operational capacity to professional rescuers and resuscitators.
• The School of Physical Education and Sports Science of the University of Athens conducts competitions for students in Greece and organizes trips to England
• The Greek Lifesaving Sports Association organizes contests in Greece and team expeditions abroad for everyone regardless of status, age or swimming ability.

CONCLUSIONS

• Cold sea water may be lethal.
• Rescue and survival techniques are important for the survival of the victim and the safety of the professional or amateur rescuer.
• Participation lifesaving sports and contests can prepare ordinary citizens and professional rescuers by building their resilience to injuries inside and outside the water.