The Instinctive Drowning Response, so named by Francesco A. Pia, Ph.D., is what people do to avoid actual or perceived suffocation in the water. And it does not look like most people expect it to. When someone is drowning there is very little splashing, and no waving or yelling or calling for help of any kind. To get an idea of just how quiet and undramatic drowning can be, consider this: It is the number two cause of accidental death in children age 15 and under (just behind vehicle accidents). Of the approximately 750 children who will drown next year, about 375 of them will do so within 25 yards of a parent or other adult. In 10 percent of those drownings, the adult will actually watch them do it, having no idea it is happening.

Drowning does not look like drowning. Dr. Pia, in an article he wrote for the Coast Guard’s On Scene magazine, described the instinctive drowning response like this:

Drowning is almost always a deceptively quiet event. The waving, splashing and yelling that dramatic conditioning (television) prepares us to look for is rarely seen in real life.

• Except in rare circumstances, drowning people are physiologically unable to call out for help. The respiratory system was designed for breathing. Speech is a secondary or overlaid function. Breathing must be fulfilled before speech occurs.
• Drowning people’s mouths alternately sink below and reappear above the surface of the water. The mouths of drowning people are not above the surface of the water long enough for them to exhale, inhale and call out for help. When the drowning people’s mouths are above the surface, they exhale and inhale quickly as their mouths start to sink below the surface of the water.
• Drowning people cannot wave for help. Nature instinctively forces them to extend their arms laterally and press down on the water’s surface. Pressing down on the surface of the water permits drowning people to leverage their bodies so they can lift their mouths out of the water to breathe.
• Throughout the Instinctive Drowning Response, drowning people cannot voluntarily control their arm movements. Physiologically, drowning people who are struggling on the surface of the water cannot stop drowning and perform voluntary movements such as waving for help, moving toward a rescuer or reaching out for a piece of rescue equipment.
• From beginning to end of the Instinctive Drowning Response, people’s bodies remain upright in the water, with no evidence of a supporting kick. Unless rescued by a trained lifeguard, these drowning people can only struggle on the surface of the water from 20 to 60 seconds before submersion occurs. (Source: On Scene magazine: Fall 2006 page 14)

This doesn’t mean that a person who is yelling for help and thrashing isn’t in real trouble — they are experiencing aquatic distress. Not always present before the instinctive drowning response, aquatic distress doesn’t last long, but unlike true drowning, these victims can still assist in their own rescue. They can grab lifelines, reach for throw rings, etc.

Look for these other signs of drowning when persons are in the water:

• Head low in the water, mouth at water level
• Head tilted back with mouth open
• Eyes glassy and empty, unable to focus
• Eyes closed
• Hair over forehead or eyes
• Not using legs
• Hyperventilating or gasping
• Trying to swim in a particular direction but not making headway
• Trying to roll over onto the back
• Appears to be climbing an invisible ladder

Children drown everyday surrounded by adults and other children. Sometimes the most common indication that someone is drowning is that they don’t look as if they’re drowning. They may just look as if they are treading water and looking up at the sky. One way to be sure? Ask them, “Are you alright?” If they can answer at all, they probably are. If they return a blank stare, you may have less than 30 seconds to get to them. And parents — children playing in the water make noise. When they get quiet, you need to get to them and find out why. Keep a vigilant eye on your children, the text can wait.