WATER EMERGENCIES: DROWNING RESPONSE, COLD WATER AND IMPACT INJURY

The Technique

1. Learn what real trouble looks like, because it does not look like the films. A person who is drowning usually cannot shout, cannot wave and cannot call your name, because the body uses the mouth for breathing before it uses it for speech. What you see instead is quiet: a head low in the water with the mouth at or under the surface, the body upright and going nowhere, arms pressing down on the water as if trying to climb a ladder, hair over the face, eyes blank or closed. It is silent and it does not last long. Compare that with the rider who is splashing, swearing, laughing and holding the ski. Loud is usually fine. Quiet and vertical is the emergency. Also watch for the rider who surfaces after a hard crash and does not move, or who is face down and drifting, and treat that as an emergency the instant you see it rather than waiting to be sure.
2. Get to them without adding yourself to the problem. Work the standard order: reach, throw, row, and only then go. From a ski or boat that means bringing a flotation aid to them rather than swimming empty handed to a panicking person, because a person in real trouble will climb whoever arrives. Approach from downwind and downcurrent so you drift onto them rather than past them, keep your approach slow, and never approach with the engine driving. On a jet ski, kill the engine or at minimum come off the throttle and keep the intake well away from the person in the water before you get close, because the jet intake will pull a body, a rope or long hair into it. Bring the casualty to the side away from the intake. If you must enter the water, take flotation with you, keep it between you and them, and talk constantly so they know help has arrived. Nobody enters the water without a second person watching from the surface.
3. If they are unresponsive, get them out of the water and put the airway first. Drowning kills by starving the body of oxygen, so the airway and breathing are the priority in a way they are not in most other collapses. While the person is in the water, keep the face clear of the surface and get them to a stable surface quickly, because you cannot do useful chest compressions in water. Lift them out with enough hands, keeping the head supported and the body as straight as you reasonably can, but do not spend extra minutes on careful handling if that delays getting air into them. Once they are on a boat deck, a pontoon or the beach, roll them on their side long enough to let water and vomit run out of the mouth, clear anything visible, then get them on their back on a firm flat surface. Do not press on the belly, do not do abdominal thrusts, and do not try to drain water out of the lungs. That does not work and it wastes the minutes that matter.
4. Run resuscitation the drowning way. Follow DRSABCD as trained. If they are unresponsive and not breathing normally, start CPR at thirty compressions to two breaths and keep going. The key difference is this: for drowning, the breaths matter. Compression only CPR is a reasonable option for a bystander at a cardiac collapse on land, but a drowning casualty is short of oxygen and needs air moving in, so give the breaths if you are trained and willing. Send someone for emergency help and for a defibrillator at the same time as you start, never before. On a wet casualty, dry the chest before the pads go on and get them off any metal deck or standing water. Expect vomiting, and expect it repeatedly: roll, clear, and get straight back to compressions. Every person who was pulled out unresponsive, or who needed rescue breaths, or who came out coughing hard and short of breath, goes to hospital even if they seem to recover, because breathing can deteriorate hours later.
5. Understand what cold water does to a body in the first moments. Sudden immersion in cold water triggers an involuntary gasp and then fast, uncontrollable breathing that a person cannot override by willpower. If their face is under during that gasp, they inhale water, and it makes no difference how strong a swimmer they are. Shortly after that comes the loss that catches riders out: hands and forearms stop working. Grip fails, they cannot hold a tow rope, cannot climb the boarding step, cannot operate a zip or a whistle. This happens well before serious hypothermia. Practically, this means three things. Wear a lifejacket or buoyancy vest so survival does not depend on grip or strength. If you go in, get your face clear and let the breathing settle before you try to do anything. And if you are the rescuer, do not assume a rider in cold water can help themselves in any way, even if they are talking to you. Hypothermia comes next and is covered in the hypothermia and cold injuries lesson.
6. Take spinal injury seriously after a high speed water impact, without letting it stall the airway. Water at speed is not soft. Consider a possible neck or back injury when someone hits the water hard at speed, is thrown into a hull, ramp or shallow bottom, or comes up with a headache and no memory of the impact. Warning signs are neck or back pain, numbness, pins and needles, weakness in arms or legs, or a casualty who cannot tell you what happened. If they are awake and breathing, keep them still in the water with support under the head and shoulders, keep the head in line with the body, and use enough people to move them as one piece onto a rigid surface. If they are unresponsive or not breathing normally, the airway wins every time. Support the head as best you can while you move them, but never delay breathing and CPR to protect a spine.
7. Respect the machine itself. A ski is a hard object with a jet intake, and the injuries reflect that. Impacts with the hull, the handlebars and another ski cause head injury, broken ribs, broken forearms and deep cuts, and cuts bleed heavily in water while looking worse than they are, so get the casualty out and apply firm direct pressure on dry land, as covered in the trauma bleeds and breaks lesson. The intake grate will draw in rope, clothing, hair and limbs, so nothing goes near the back of a ski with the engine running, ever, and the engine cut off lanyard stays attached to the rider so a fall stops the machine. The jet thrust itself causes severe internal injuries if it hits a body opening at close range, which is exactly why manufacturers tell riders and passengers to wear a wetsuit or neoprene shorts and why nobody should be in the water immediately behind a running ski. Treat any suspected internal injury of that kind as a hospital problem, not a beach problem, no matter how embarrassed the rider is.
8. Build the spotter system that stops most of this happening. Freestyle riding means deliberate crashes, so the group protocol is the safety system. Nobody rides alone. Every session has a nominated spotter on shore or on a boat who is not riding, who knows how many riders are on the water and where, and whose only job is to watch. The spotter counts heads after every crash and does not go back to filming until every rider has waved a clear signal. Agree one simple signal for I am fine and one for I need help before you launch, and agree that a rider who does not signal is treated as in trouble. The spotter holds the phone or radio, knows the exact launch point name and the nearest road access, and has the number for the local marine rescue or emergency service already saved. Rotate the spotter so nobody sits out all day, and change the plan when conditions change.

Common Mistakes

Waiting to be certain someone is in trouble because they are not shouting. Fix: treat a quiet, upright, low in the water rider as a drowning until proven otherwise and go now.

• Swimming out empty handed to a panicking rider. Fix: take flotation every time, keep it between you and them, and never enter without someone watching you.
• Approaching a person in the water with the engine running. Fix: kill the engine before you get close and always bring them to the side away from the intake.
• Trying to get water out of the lungs before starting CPR. Fix: clear the mouth, then compressions and breaths, thirty to two, without delay.
• Skipping the breaths because compression only CPR is what you remember. Fix: for drowning, give the breaths, because oxygen is what is missing.
• Letting a rider who was pulled out coughing and breathless go home because they perked up. Fix: hospital assessment for anyone who needed rescue, every time.

The Drill

In waist deep water at a known safe beach, run a full sequence with a willing volunteer as casualty. One rider spots the quiet casualty and calls it, a second brings flotation and retrieves without touching the intake side, and the group extracts to the sand, rolls to clear, and runs two minutes of CPR on a manikin placed alongside. Standard: from the moment the casualty goes quiet to the first breath delivered on dry sand, under three minutes, with emergency services called by a named person within the first minute and the head count completed out loud.

← Full freestyle jet ski curriculum