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Emergency! - Drowning

Drowning is a silent killer. How can you tell if someone is in trouble? And what are hidden drowning hazards to watch out for so you, or someone around you, don't become a statistic?

My close friend is looking lethargic and is insomniac. Is she suffering from depression?

Text by Lyn Chan

Your son and his friends are splashing in the pool. Suddenly, his friend stops splashing and someone shouts, "Help! He is drowning!" What should you do?

Get the attention of lifeguards on duty


Jump in and save the child


Reach out with an object or with your hand


Alert other people to call 995


Throw a life-saving device or anything that floats, and is lightweight

*Read on to see answers

With the year-round tropical heat, swimming pools are irresistible weekend draws for families with children, especially young energetic ones with extra energy to spare from being indoors all week.

These same watery playgrounds are drowning magnets however, especially for children. In Singapore, drowning incidents involving children, both fatal and non-fatal, have been on the rise, and most of the incidents occur in pools.

Between 2011 and 2015, the KK Women's and Children's Hospital treated 104 — or a yearly average of 20 cases of submersion injuries. Of the 104 cases, 10 children died; two are living with irreversible brain damage. A total of 69 drowning emergencies took place in private pools.

Could these mishaps have been avoided? It seems so, if the victims and their parents had a greater respect for water and taken appropriate precautions.

"Drowning risks for Singaporeans include not supervising children, not knowing the pool depth before swimming, swimmers pushing themselves to the limit when swimming, and swimming despite having a known medical condition," said Ms Delphine Fong, Safety Management Director at Sport Singapore.

Find out how to recognise drowning dangers

To help you avert drowning tragedies, here is a checklist of water safety essentials, common misconceptions about drowning, and first-aider responses.

Active drowning, passive drowning, dry drowning, wet drowning, secondary drowning, delayed drowning, near-drowning. So many types! How would I know what is taking place and how do I respond?

Scratch all that. Drowning is drowning, there is only one "type". The rest are misnomers that only distract you from what is really important: enforce water safety practices and prevent drowning accidents from happening to those you love.

Drowning occurs when you cannot get oxygen into your lungs when you are immersed in, or submersed below water.

When drowning, reflexes of panic, agitation and air hunger will take place. And when you really must take a breath under water, fluid will gush into the lungs. This is seen in about half of drowning emergencies.

Some drowning victims try to hold their breath for as long as possible, to the point where they black out from laryngospasm — a protective reflex action whereby the larynx closes up when water is detected in the airway. But while laryngospasm prevents water from entering the lungs, it also keeps out oxygen. Falling oxygen level in your blood causes you to lose consciousness. As your heart struggles to pump blood around your body, it eventually fails and goes into a cardiac arrest.

Laryngospasm sometimes occurs even after the victim has been rescued, resulting in brain injury, respiratory problems or death. To play safe, anyone who has fallen into water or experienced a non-fatal drowning ought to be sent to the emergency room right away. Recovery is possible with swift intervention.

Small children most often drown in pools. For children under four years old, it is essential to maintain supervision within arm's length.

At the pool, while my toddler plays in the water, I usually relax nearby, toying with my phone and watching videos. I am sure I can hear him call out — I have a parent's sharp ears! Anyway, he is wearing his trusty floaties and lifeguards are always around.

Small children most often drown in pools. For children under four years old, it is essential to maintain supervision within arm's length. Better yet, stay in the water with them. It is great bonding time!

Sport Singapore advises that at swim classes, parents should accompany their children even when there is an instructor present. "Parents should not be distracted by other activities," said Ms Fong. "They should stay vigilant to help keep watch over the class and alert the instructor, or render help when necessary."

Parents always think they will hear their kids' cries for help. This is a huge, possibly heartbreaking mistake. If your son gets into a fix, he will not be screaming for you because he will be too focused on keeping his airway above water. In 20 to 60 seconds, he will sink and oxygen deprivation will quickly set in.

Floaties and water wings keep young children upright in the pool and help strengthen their core. But make no mistake, they are not life vests and should never replace the parent, especially if they are four years or younger. Do not float where you cannot swim!

Lifeguards are not glorified babysitters. Their job is to make sure swimmers follow safety guidelines and to help anyone in danger. But at a packed pool, things can slip through the cracks for even the most hawk-eyed lifeguards. In Singapore, lifeguards* were not present at seven out of 10 fatal and non-fatal drowning incidents from 2012 to 2014.

Your child's best safeguards against drowning are swimming lessons that focus on water safety instead of just strokes and form, and a cardiopulmonary resuscitation (CPR) course for you and other caregivers.

Sometimes, you think that everyone is watching but actually, no one is. That lapsed moment is ripe for drowning to occur. And please, put that mobile phone away!

*From a joint study by the Singapore General Hospital and the Singapore Civil Defence Force

People say that drowning is a silent killer. How would I know my child is drowning if there is no sound? And what do I do after that?

The first tell-tale signs of a person in danger of drowning are looks of distress. The victim is still capable of moving their legs and inching forward. This is known as aquatic distress, the pre-drowning stage, said Dr Chong Shu-Ling of KKH's Department of Emergency Medicine. Victims know they are in trouble and are still able to wave or call for help. But Dr Chong added that not all drowning victims manifest aquatic distress, especially children.

    Next, look out for any of the following signs of the Instinctive Drowning Response, according to Sport Singapore.
  • Head is low in the water, mouth is at water level
  • Head is tilted back with mouth open
  • Eyes look glassy and empty, unable to focus or eyes are closed
  • Hair over forehead or eyes
  • Legs are vertical
  • Hyperventilating or gasping
  • Attempts to swim in a particular direction but no headway
  • Trying to roll over on the back
  • Appears to be climbing an invisible ladder

If you identify it as a drowning emergency, do the following immediately, according to Dr Chong:

  • Get the victim out of the water without delay
  • Check to see if he is breathing on his own. If not, promptly begin CPR
  • If someone else is present, have him call for emergency medical help
  • Concentrate on rescue breathing and CPR until they are breathing without assistance
  • Expect water in the lungs to be expelled during CPR

When saving a drowning victim, reach or throw, don't go!


Get the attention of lifeguards on duty
Lifeguards are specially trained to manage drowning situations.


Jump in and save the child
A drowning person is usually panicking and the primary instinct is to grab onto whatever he can. This may result in his pulling you down. Only trained and qualified personnel like life guards should jump in and save the victim.


Reach out with an object or with your hand
Brace yourself against sturdy support. Hold out to the drowning victim something that extends your reach. Wait for him to grab it tightly before slowly and carefully towing him to safety. If the drowning victim is close enough to where you are and no suitable objects are near, lie down flat close to the edge of the water, spread your legs out wide for stability, grip the ground with one hand and extend your other hand to the victim. Latch onto his wrist or forearm for better traction. Pull him in with care.


Alert other people to call 995
Inform others that someone is drowning and to call 995. Let them know you are assisting.


Throw a life-saving device or anything that floats, and is lightweight


Drowning dangers

Popular Belief: Drowning only occurs at swimming pools or the beaches
Unexpected Fact: Drowning can take place in your home, and children can drown in as little as a few centimetres of water

Many people have the misconception that drowning takes place only outdoors where there is a large catchment of water. In fact, one in five drownings happen at home, with young children being especially at risk.

Indoor drowning hazards

Young children can drown in 2.5cm of water, in where you least expect it. Poor supervision is to blame for their drowning. But we can all prevent drowning accidents by being more mindful of the hidden hazards lurking around.

Pails, toilet bowls, fish tanks, water features, wading pools, any water-carrying vessels.

Even if there are closed lids, any curious toddler could pass by, lift up the cover, and fall right in.


Slipping and sliding in soapy water is slick danger. Your child could plunge into the water headfirst to look for a toy. Adults, too, could be at risk when intoxicated or experiencing a seizure; senior citizens could also lose consciousness after soaking in hot baths for too long.

Hot tubs, spas and whirlpools

An accidental fall may become a drowning emergency, especially if hair or a body part gets caught in drains or jets.

Baby bath seats/ rings

Your child may climb out of the seat or slide downwards into the water. There is also a chance the entire seat or ring could tip over.

Outdoor drowning hazards
Safety tips: Remember your ABCs
Adult supervision and Alcohol

There must be adult supervision at all times when young children are near or in any type of water.

In the bathtub, always keep your child within an arm's length. Do not leave them alone, even for a second, and never put another child in charge of your child!

Barriers and Buddies

Fences should be built around all outdoor home pools. Make sure the pool is locked and toy-free when not in use.

When swimming, use the buddy system; never swim alone. Take a friend or a family member with you. If you get into a fix, they can help you immediately.


CPR classes are crucial for parents, caregivers and pool owners. Swimming classes are believed to lower the drowning risk in young children, although it does not eliminate it completely. Knowing how to swim improves the chances of survival.

Download as PDF
Indoor drowning hazards
Safety tips: Remember your ABCs

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