Float and relax: How our drowning prevention research is saving lives
Each day, more than 1,000 lives are lost by drowning – but that number doesn’t include unrecorded drownings in low and middle-income countries. The real figure could be as high as 1.2 million deaths per year, with 25% of those deaths being children.
But now, thanks to research by the University’s Professor of Human and Applied Physiology, Professor Mike Tipton MBE, countless lives could be saved each year.
Since the Titanic sank in 1912, hypothermia had been viewed as the main danger facing anyone who finds themselves in cold water.
But Professor Tipton’s research in our Extreme Environments Laboratory has revealed the main problem is actually cold shock – which peaks in water temperatures between 10-15⁰C. The average temperature of UK and Irish waters is 12⁰C.
His research also revealed a startling method to improve your chances of survival: simply turn on your back, float and relax.
MIKE TIPTON MBE (Professor of Human and Applied Physiology)
Drowning is the second or third most common cause of accidental death around the globe. We lose around about a thousand people a day. In the UK, it's a death about every 20 hours, a child a week. Nearly half of the deaths are people under the age of 15. That loss of a life, of a potential, of a contribution to society. That's the driver to try and help people survive the experience of going into cold water. The background to this project certainly started in '83 with my PhD, which was in human responses to cold water immersion and adaptation to cold. And pretty much everything we've done from there has made some contribution. We work with lots of external organisations. Over the years, the Royal National Lifeboat Institution (RNLI) have supported our research and have used our research a lot. We work with Surf Life Saving GB. We work with the Coast Guard. We work with the Fire and Rescue Service. They cover what we do when we work with all the groups — the fantastic groups we work with — is from lab to lifesaving. So we can produce the science, and we can interpret that science, and then they can take it and turn it into campaigns like Float to Live. You can probably trace everything that's happened subsequently to people just before they go into the water, people as they go into the water and people five minutes after they've been in the water. When they go into water, it's impossible for them to breath-hold. They take a gasp, which is two to three litres. Just with that first, [INHALE], you've crossed the lethal dose for drowning. Now, once the skin gets down to water temperature, which takes about a minute or two, then that response goes away. And so, if you look now five minutes into an immersion, you will see the responses are much lower. And so that led us to conclude that the majority of these deaths that are occurring in the first minutes of immersion are due to cold shock. If you can get through that phase, you've now got a much better chance of surviving. And what you've got to do to get through that phase is float to live. It's a great privilege and an honour to work with these organisations with the common purpose of saving lives at sea.
JAMES INSTANCE (HM Coastguard)
I was at a conference, it was called Coast Safe, which is a collaboration between various maritime organisations in Devon and Cornwall, which actually came about following a tragic incident in North Cornwall. And Mike introduced the concept of float to live. From this, the emergency services that were there, which was ambulance, police, fire, coastguard, took the information and came across a decision that we would impart this data, this information source, into our operations rooms so that when we would get phone calls of people in difficulty in the water if we could get a message that person that was in the water to lie back and float that they would have a better chance of survival.
ROSS MACLEOD (RNLI)
So the research from the University of Portsmouth has been absolutely critical to the success of the RNLI's Float to Live campaign. Drowning numbers in the UK around the coast have been in a gradual decline over the last four to five years. And whilst we can't attribute that fully to the impact of the campaign, we would like to think we are contributing to making a difference there and to the point that we have between 25 and 30 survivors stories who have proactively contacted the RNLI now to say that the float to live advice has helped save their life. And so, we would suggest that's probably the tip of the iceberg of the really proactive people that have actually come forward to us. So we're really proud of the impact that this had and the fact that float to live is now sort of universally accepted in the UK as one of our national safety messages, and it's talked about as part of the Coast Guard script. If someone calls in to say there's someone drowning in the water to talk through what to do. It's been picked up by schools. We know it's a lifesaver now, and hopefully, it'll save many more lives in the future.
ADRIAN MAYHEW (Surf Life Saving GB)
The research at the University and Professor Mike Tipton and his team, because it is a team, has really allowed me to understand what are those things that I need to think about and, more importantly, my 10,000 volunteers. What do they need from me in order for them to learn the knowledge that has been gifted on behalf of Mike Tipton and his colleagues in order that our organisation and organisations around the country and around the world can use it to help keep people safe? And it's critical actually from the science making it into reality. Three words: Float to Live will leave a huge legacy.
STEVE INSTANCE (RNLI)
So the float technique is something that has been developed by the University of Portsmouth and Mike Tipton in cooperation with ourselves, the RNLI. The technique is very simple — it's almost a star shape. Legs out wide, arms out wide and head back. That gives you maximum surface area. The buoyancy that happens to be in your clothes will help you come to the surface of the water. Some people will find they'll have to scale a little bit with their hands in order to stay afloat. Some people are naturally more buoyant. And that position there just helps you acclimatise to that cold water, keeps your airway clear of the water and helps you relax and work out what your next move is, whether that's to call for help or whether it's to swim to a safer place.
RUTH OSBORNE (Survivor)
I would actually consider myself to be quite safety conscious. The only problem was it was dependent on me being attached to my surfboard. I think it was probably the first wave of the next set I came off my board. I realised quite quickly that the leash had broken. Wave after wave after wave was just smashing on top of me, and I just thought, This is it. About three or four days prior to going out surfing on my own, I had asked an RNLI lifeguard, what's the best thing to do if my leash breaks? The advice that they'd given about float on your back relax, that all came flooding back to me immediately. I mean, in my mind, that was the only way I was going to survive. The way I feel about the sea has completely changed. The key message is you do have it within your power to relax and have some control over that situation with that float to live information.
Education is a really critical component feeding into preventative medicine. So if people know what's going to happen to them when they go in the water, they tend to deal with it better — we've done studies that prove that. If they know how to behave and you teach them how to behave, then survivability just goes up off the scale.
So we're running a session this afternoon with St Agnes Surf Lifesaving Club, a group of their nippers, their younger members are going to be down here, and we're going to be showing them the float to live technique and how they do it. Eventually, these young children, seven or eight years old as they are now, will be the 16, 17, 18-year-olds that we at the RNLI will be recruiting to be lifeguards that will, in turn, will be keeping us safe when we visit the beaches.
So my hopes for the future around the campaign and the work in general for water safety is that we carry on having an impact, and it's really brought it home to me the last couple of years that we have made a difference in real people's lives.
The crucial thing is having the University of Portsmouth as part of that research that is the flagstone of everything we're all doing here in doing drowning prevention. We all need to work together, and it's that interoperability, which is really key. Many lives that we save, not just in the UK, but around the world.
So the legacy for this research in my eyes is that it has, we know, helped to save lives, and I don't think from an academic point of view, you can really ask for anything more than that. And the key really for us is that this research, which is a lifetime's worth of work for Mike and the team, has now been applied in a way and at a scale that is genuinely making a difference. And so if we can keep doing that, I think that will be the legacy and hopefully for many years to come floating to live will be in the same kind of safety message bracket as wearing a seatbelt or something like that that just becomes normal life and that, for me, will be success and legacy.
Cold water shock
Mike says: “When you fall into cold water, it quickly cools your skin. This reduces skin blood flow, and increases your heart rate, blood pressure and the strain placed on your heart.
“Cold water tends to make you thrash around and try to swim hard, panicking and fighting the water. That's the ‘fight or flight’ response – which works on land but not in water.
“Your first instinct is to get out – to swim to safety. But you need to fight this instinct until the cold shock passes, usually within 60–90 seconds. Then float on your back until you’re able to catch your breath."
Even though it’s the right thing to do, staying still in cold water can understandably feel counterintuitive.
If you take a big breath in, that’s around three litres and the lethal dose of salt water for drowning is about a litre and half. Being under the water or having a big wave splash into your face can be enough to start the drowning process.
Anyone can float
During his research, Mike also found that many people incorrectly believe they're unable to float, despite our bodies being naturally buoyant.
Mike and his team conducted trials with 85 people of different ages, shapes, sizes, genders and swimming abilities. These revealed that everyone truly can float, either on their own or with gentle sculling.
That knowledge is especially important if you can't swim but instinctively try to anyway. Doing so can worsen your position by allowing air – which could help you float – to escape from your clothing.
Mike’s research also found that the act of lying back is particularly important. If you’re upright in the water, you get hydrostatic squeeze, which returns blood upwards to your heart and creates even more strain. .
Mike says: "Clothing can restrict you if you're trying to swim and it’s one of the reasons for not swimming, but if you stay still in clothing, it traps air and helps you stay above the surface.
“As for being horizontal: it’s a much less stressful position to be in. You’ve simply got to have the confidence to do nothing and to fight that instinct to thrash about and swim.”
You’ve simply got to have the confidence to do nothing and to fight that instinct to thrash about and swim.
Saving lives with the RNLI
One of the tangible results of Mike’s work is Float to Live, a campaign by the Royal National Lifeboat Institution (RNLI) that’s been influenced and informed by Mike’s research.
With a focus on educating people about what to do once they're in the water, Float to Live aims to get you over that period where you’ve lost control of your breathing. If you can float until you get your breathing under control, you're in a much stronger position to survive.
It’s already working, too: coastal drownings fell by 30 per cent in 2017 and many other organisations are now spreading similar messages about water safety.
And while Mike is motivated by both his physical proximity to the sea in Portsmouth and “the possibility of reducing the global burden of drowning”, he’s keen to emphasise that safety starts on dry land.
He says: “If you’re planning to go into the water, choose a lifeguarded beach and swim between the red and yellow flags – the area most closely monitored by the lifeguards.
“And if you see someone else in danger in the water, don’t try to rescue them: call 999 or 112 and ask for the Coastguard.”
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