You're at the pool or the beach and you scan the water. You'd be able to tell if someone was drowning, right? You’ve seen it on TV and in the movies -- the person flails their arms, thrashes about wildly, and cries for help.
Here’s the problem: That's not what it always looks like.
Internal bleeding is one of the most serious consequences of trauma. Usually, the bleeding results from obvious injuries that require rapid medical attention. Internal bleeding may also occur after a less severe trauma or be delayed by hours or days. Some internal bleeding due to trauma stops on its own. If the bleeding continues or is severe, surgery is required to correct it.
"In the public's mind, someone who is drowning is waving frantically and calling for help, and that's just not the way it is," says Alan Steinman, MD, an expert on drowning and sea survival. Steinman is a former director of health and safety for the U.S. Coast Guard.
The call for help may come first, but when someone is actually beginning to drown, he is desperate for air. “They're silent and struggling just to keep their nose and mouth above the water," says Steinman. "Their arms are outstretched, trying to keep themselves up out of the water. It's a very quiet, desperate posture."
This silent, almost calm behavior is called the instinctive drowning response. It was detailed by lifeguard and water rescue expert Francesco Pia, PhD.
Learn to Spot Drowning
What does a drowning person look like? According to Pia, he’s likely to be:
Silent: There’s no spare breath to call for help.
Bobbing up and down: His mouth sinks below the water’s surface, pops up just enough to breathe and sinks back down.
Stiff-armed: Instead of waving for help, his arms are out to the side, hands pressed down on the water to keep him afloat. He can't even reach out to grab a life preserver.
Still: He won’t be kicking. His body will be straight up and down, almost like he’s standing in the water.
A drowning person will only be able to stay like this for 20-60 seconds before going underwater.
If you don’t get to him soon enough, Steinman says, he will start to submerge. People often miss the chance to help because they don’t know what’s really going on.
"When a person is actually drowning, in many cases they seem to be playing," says Gerry Dworkin, a professional aquatics safety and water rescue consultant for Lifesaving Resources LLC. "That's one of the problems for moms, dads, and even lifeguards. They see somebody floating on the surface, but because of the movement of waves, they appear to be moving or playing even though they may be unconscious."
Knowing how to swim is important. But even good swimmers can drown, and it can happen fast, Steinman says. "Never take your eye off children in the water. You have to watch them all the time. You can't look away."