Important Websites

www.aetsas.com www.alsg.org www.apola.asn.au/ www.blueflag.org www.cc.uoa.gr/health/socmed/hygien www.cdc.gov/injury www.childsafetyeurope.org/watersafety www.dlrg.de www.dnr.state.ak.us/parks/boating www.drenkeling.nl www.drowning.nl www.drowning-prevention.org www.ehbo.nl www.epsa.org.ar www.hss.state.ak.us/dph/chems/injury-prevention/kids_don’tfloat.htm www.hvrb.org www.ilsf.org www.imo.org www.intensive.org www.intensiv-innsbruck.at/education/ertrinken_hasibeder.htm www.iria.org www.itsasafety.org www.iws.ie www.keepwatch.com.au www.kidsalive.com.au www.kindveilig.nl www.knrm.nl www.marine-medic.com.au www.minvenw.nl www.nationalwatersafety.org.uk www.polmil.sp.gov.br/salvamarpaulista/ www.rcc-net.org www.reddingsbrigade.pagina.nl www.redcross.ca www.redned.nl www.resuscitationcouncil.nl www.rlss.org.au www.rnli.uk www.rospa.com 660 Important Websites www.royallifesaving.com.au www.safewaters.nsw.gov.au www.slsa.asn.au www.sobrasa.org www.socorrismo.com www.sossegovia.com www.sshk.nl www.surflifesaving.com.au www.swimandsurvive.com.au www.szpilman.com www.thelifeguardstore.com www.uscg.mil www.uscg.mil/d17/d17rbs/d17rbs.htm www.usla.org www.vaic.org.au www.watersafe.org.nz www.watersafety.com.au www.watersafety.gr www.watersafety.vic.gov.au www.who/int www.who.int/violence_injury_prevention/ www.who.int/violence_injury_prevention/publications/other_injury/en/ drowning_factsheet.pdf Final Recommendations of the World Congress on Drowning Amsterdam 26 – 28 June 2002

The World Congress on Drowning is an initiative of de Maatschappij tot Redding van Drenkelingen Established in Amsterdam in 1767

As a result of an interactive process that was initiated in 1998 by nine task forces, including some 80 experts, and finalized during plenary sessions, expert meetings and research meetings in 2002 at the World Congress on Drowning, recommendations were made in the field of drowning prevention, rescue and treatment. This was the first time that many of these subjects were addressed in a global forum. The congress was attended by more than 500 persons. Although not every participant was directly involved in the development of each recommendation, these recommendations can be considered to be the most authoritative recommendations on the issue of drowning prevention, rescue and treatment at this moment. Many of the foremost authorities have been involved in the preparations during the four years prior to the congress and have been actively involved during the congress. The draft version of the 13 final recommendations was presented at the plenary closing ceremony of the congress. That preliminary version of the recommendations was distributed by e-mail and adapted as a result of the com- ments received. An additional series of detailed recommendations in the areas of rescue and diving (breath hold, scuba and hose diving) were agreed upon within the nominated task forces. This final version of the recommendations was then agreed upon by the members of the scientific steering group and the chairs of the nine task forces (epidemiology, prevention, rescue, resuscitation, hospital treatment, brain and spinal protection, immersion hypothermia, diving and drowning and water-related disasters).

All recommendations, together with the preparatory documents as consensus papers, reports of expert and research meetings, will be published in 2005 in the Handbook on Drowning.

A list of names of the members of the scientific steering group, task forces and attendees of the World Congress on Drowning is included. 662 Recommendations

1. A new, more appropriate, world-wide uniform definition of drowning must be adopted

A uniform definition of drowning is important for purposes of registration, diagnosis and research. The following definition was accepted: “Drowning is the process of experi- encing respiratory impairment from submersion/immersion in liquid.” All organisations involved in epidemiological research and vital statisti- cal data collection as well as rescue organisations and the medical community should consider and preferably accept this new definition as a basis for useful communication and include it in their glossary. Further consultation of drowning experts is needed to uniformly classify morbidity and mortality due to drowning.

2. There is a great need of adequate and reliable international registrations of drowning incidents

International and national registration procedures of the number of drowning victims, immersion hypothermia victims, rescues, and hospital data are needed to better appreciate the world-wide burden of drowning. Also clinical data, for example on resuscitations and rewarming techniques, are needed to improve treatment. International organisations, such as The World Health Organisation (WHO), the International Red Cross and Red Crescent organisations (IRCRC), the Inter- national Life Saving Federation (ILS), the International Life Boat Institute (ILF) and Diver’s Alert Network (DAN), as well as national organisations, institutions and medical research consortiums are advised to set up and coordinate data- collection.

3. More data must be collected and knowledge gained about drowning in low-income countries and societies

According to repeated WHO reports, over 80% of all drownings occur in low-income countries or in low-income groups in high income countries. Nevertheless only few epidemiological data about these risk groups are available. The WHO, IRCRC, ILS, ILF and the European Consumer Safety Institute (ECOSA) are encouraged to expand the research on drowning risk factors in these low-income groups because this is expected to have a major impact in reducing the risk of drowning.

4. Preventive strategies and collaboration are needed

The vast majority of drownings can be prevented and prevention (rather than rescue or resuscitation) is the most important method by which to reduce the number of drownings. The circumstances and events in drowning differ across many different situations and in different countries world wide. Considerable differences exist in the locations of drowning and among different cultures. Recommendations 663

Therefore, all agencies concerned with drowning prevention – legislative bodies, consumer groups, research institutions, local authorities and designers, manu- facturers and retailers - must collaborate to set up national and local prevention initiatives. These will depend on good intelligence and insightful research, and must include environmental design and equipment designs as a first route, in conjunction with education, training programs and policies which address specific groups at risk, such as children. The programs must be evaluated and the results of the evaluations must be published.

5. All individuals, and particularly police officers and fire fighters, must learn to swim

Knowing how to swim is a major skill to prevent drowning for individuals at risk. International organisations such as WHO, IRCF and ILS, and their national branches must emphasize the importance of swimming lessons and drowning survival skills at all levels for as many persons as possible. The relationships between swimming lessons, swimming ability and drowning in children needs to be studied. In addition, certain public officials who frequently come in close contact with persons at risk for drowning, such as police officers and fire fighters, must be able to swim for their own safety and for the safety of the public.

6. Rescue techniques must be investigated

Most of the current rescue techniques have evolved by trial and error, with little scientific investigation. Rescue organisations such as the ILS, ILF, IRCRC but also the International Maritime Organization (IMO) must be encouraged to evaluate the self-rescue and rescue techniques in their training programs in ac- cordance with current scientific data on the effectiveness and efficiency. Based on the data, the best rescue techniques must be selected for education and training programs.

7. Basic resuscitation skills must be learned by all volunteer and professional rescuers as well as lay persons who frequent aquatic areas or supervise others in water environment

The instant institution of optimal first aid and resuscitation techniques is the most important factor to survive after drowning has occurred. Resuscitation organisations, such as organisations, in particular those related to International Liaison Committee on Resuscitation (ILCOR), as well as professional rescue organisations and other groups who frequent aquatic areas, must promote training programs in first aid and Basic Life Support for anyone who frequently visits or is assigned to work in the aquatic or other water environment. 664 Recommendations

8. Uniform glossary of definitions and a uniform reporting of drowning resuscitation must be developed and used

To increase the understanding of the dying process and the resuscitation potential in drowning, a uniform reporting system must be developed and used for the registration of resuscitation of drowning. International resuscitation organisations, such as ILCOR-related organisations and medical groups, must establish a uniform reporting system, facilitate its use, be involved in the analysis of the data and support of recommendations based on the studies.

9. Hospital treatment of the severe drowning victim must be concentrated

The optimal treatment of drowning victims includes dealing with specific severe complications such as the Acute Respiratory Distress Syndrome, pneumonia, hypoxic brain damage, hypothermia and cervical spine injuries. Due to the limited exposure and experience of most physicians with drowning victims, these victims should ideally be treated in specialised intensive care centres for optimal treatment and promotion of clinical research.

10. Treatment of the patient with brain injury resulting from cardiopulmonary arrest attributable to drowning must be based on scientific evidence. Due to the absence of interventional outcome studies in human drowning victims, current therapeutic strategies must be extrapolated from studies of humans or animals having similar forms of acute brain injury

The following recommendations for care of drowning victims who remain unresponsive due to anoxic encephalopathy are made on the basis of best available scientific evidence. The highest priority is restoration of spontaneous circulation. Subsequent to this, continuous monitoring of core and/or brain (tympanic) temperature is mandatory in the emergency department and intensive care unit (and in the prehospital setting to the extent possible). Drowning victims with restoration of adequate spontaneous circulation who remain comatose should not be actively rewarmed to temperature values >32-34oC. If core temperature exceeds 34 oC, hypothermia (32-34oC) should be achieved as soon as possible and sustained for 12-24 hours. Hyperthermia should be prevented at all times in the acute recovery period. There is insufficient evidence to support the use of any neuro-resuscitative pharmacologic therapy. Seizures should be appropri- ately treated. Blood glucose concentration should be frequently monitored and normoglycemic values maintained. Although there is insufficient evidence to support a specific target PaCO2 or oxygen saturation during and after resuscitation, hypoxemia should be avoided. Hypotension should also be avoided. Re- search is needed to evaluate specific efficacy of neuroresuscitative therapies in drowning victims. Recommendations 665

11. Wearing of appropriate and insulating life jackets must be promoted

Without floating aids, a subject generally drowns within minutes due to swimming failure in cold water. Therefore, the development of insulating and safe garments for aquatic activities is needed. Life jackets should always be worn when immersion can occur to prevent submersion in an early stage. When only non-insulating floating aids can be used, the victim should consider whether swimming ashore is achievable.

12. The balance between safety and profitability of recreational diving must remain critically observed

It was agreed that self-regulation within the world-wide recreational diving industry continues to be the practical route for further improvement but that there is a need to counter the perception that there is a conflict between commercial interest and safety.

13. Safety of diving fishermen needs more attention

Subsistence fishermen, who are predominantly found in the poor countries around the world, use equipment that is minimal and their training, regulations and medical support appear to be zero. To improve diving-fishermen safety and reduce drowning there is a need to collect data on accidents and drowning among representative samples of diving fishermen around the world. This should be followed up with international non-governmental organisations, other charities and appropriate UN development initiatives so that existing academic societies, training organisations and others could deliver suitable medical and diving advice and training for fishermen compatible with the limits of available local resources.

Several more specific recommendations have been proposed and need the full support of related organisations These recommendations refer to the further development of existing research projects such as: • Global uniformity of beach signs and safety flags • Risk assessment of beach hazards • Determination of optimal visual scanning techniques • Construction of the most adequate rescue boats, including alternatives such as jet boats, hovercrafts, with minimum risk of injuries for the drivers

Other recommendations were made to improve practical aspects related to: • Legal aspects of drowning incidents • Evacuation planning of large passenger ships • Uniformity in training programs for lifeguards • Fund raising for aquatic safety activities 666 Recommendations

All recommendations, together with the preparatory documents as consensus papers, reports of expert and research meetings, will be published in the Hand- book on Drowning. The Handbook will be available in 2005.

A large number of additional recommendations were elaborated before and during the World Congress on Drowning by the members of the task forces rescue and diving (breath hold, scuba and hose diving). These detailed recommendations are included in the appendices.

All recommendations need full support from governments, organisations, institutions and individuals to enable reduction of the last remaining field of ne- glected injuries. Each year some 500,000 persons world-wide are still dying from drowning. This is too much. Overview Recommendations Task Force Rescue

During the preparation of the World Congress on Drowning, experts have pre- pared documents on a wide variety of topics. These topics have been further elaborated at the congress by the members of the task force recsue. Because of practical limitations in time, and the wide variety of subjects to be covered, there were no opportunities to include these recommendations in the final procedures.

Recommendations aimed at all national and international governmental bodies, including IMO, Search and Rescue organisations, the International Lifeboat Insti- tution and prevention institutions 1. The existing standard for the evaluation of hazard presented at beaches should be implemented as the world-wide standard to enable the development of appropriate drowning prevention strategies at beaches. 2. Communities throughout the world which can expect to face flooding, must prepare themselves and the emergency workers they designate, to effectively respond to flood rescue. 3. Search and rescue response must be ensured in areas around the world where there is significant maritime traffic, whether it be cruise liners, cargo ships, fishing boats or leisure craft. 4. The International Aeronautical and Maritime Search and Rescue Manual should be reviewed and incorporated by the sea rescue organisations of all of the nations of the world to ensure a coordinated and effective approach to maritime emergencies. 5. The Incident Command System, which has been developed to allow for effective oversight and organisation of emergency responses, should be adopted by all aquatic rescue organisations worldwide.

Recommendations aimed at all national and international bodies in the area of rescue, including the International Red Cross and Red Crescent organisations, the International Lifeboat Institutions and the International Life Saving Federation 1. Scientific study should be undertaken to form a basis for determining the skills and minimum competencies required to rescue another human in an aquatic emergency. 2. Further research is needed in the area of surveillance, scanning and vigilance by lifeguards from a physiological and psychological perspective to de- termine the best methods of instruction and practice. 3. Further research should be undertaken to identify appropriate use and training of the personal watercraft (PWC) in aquatic rescue. 668 Recommendations

4. Rescue communications must provide dependable, robust, integrated, and effective command and control for all involved segments of the response system, not simply point to point communications. 5. Sea rescue providers should ensure that their rescue craft keep pace with available technology, evaluating and embracing effective new types of surface rescue craft and air rescue craft. 6. It is recommended that common terms for spinal injury immobilization techniques be adopted by all lifesaving organisations and that the terms should be vice grip, body hug, and the extended arm grip. Studies should be conducted on each of these methods to establish the best possible methods of extrication. 7. All lifesavers should be taught the standing backboard technique, to allow for immediate stabilization of the spine of a person who walks up to the lifeguard complaining of spinal pain post trauma. 8. An international study of fund-raising activities by aquatic lifesaving organisations should be commenced to identify the most effective methods. Overview Recommendations Task Force Diving (breath hold, scuba and hose diving)

During the World Congress on Drowning, experts of the task force Breath hold, scuba and hose diving have finalised a consensus document on a variety of topics.

It was agreed that 1. Well-constructed national regulations have been effective where enforced and that any significant improvements in health and safety would arise only from a more inclusive definition of working divers and a wider application of existing procedures. 2. Self-regulation within the world-wide recreational diving industry continues to be the practical route for further improvement but that there is a need to counter a perception that there is a conflict between commercial interests and safety. 3. The training agencies comply with international quality assurance and control procedures (QA/QC) such as the International Standard ISO 9000 series and also encourage independent monitoring to assure the effective and safe use of existing and new procedures. 4. Subsistence fishermen who are predominantly found in the poor countries around the world, use equipment that is minimal and that their training, regulations and medical support appear to be zero. To improve diving-fishermen safety and reduce drowning there is a need to collect data on accidents and drowning among representative samples of diving fishermen around the world. This should be followed up with international non-governmental organisations (NGOs), other charities and appropriate UN development initiatives so that existing academic societies, training organisations and others could deliver suitable medical and diving advice and training for fishermen compatible with the limits of available local resources. 5. The collection of diver morbidity and mortality data and the associated con- tributory factors for each incident is a necessary first step in reducing drowning incidents among divers. Also needed are the denominator data that will allow the calculation of risk. 6. Recreational divers are free to dive when, where and how they like but the diver also has an obligation to the public. Any underwater accident to a diver can put buddy divers and rescuers at considerable risk. 7. Greater stringency is needed in the assessment of the physical, mental and medical fitness of all who choose to dive. A single assessment of fitness for diving at the beginning of diver training should not be considered valid throughout the rest of the diver’s life. Re-assessments are recommended at 670 Recommendations

intervals that may diminish with advancing years and re-assessment may also be needed after illness or injury. 8. To give a medical opinion on a diver’s fitness, the doctor should have pri- or knowledge of the unique hazards faced by a diver. Whenever possible, the medical assessment should be conducted by a doctor acknowledged as competent in this special subject. It is recommended the training of diving doctors, both for the medical examination of divers and also for the treatment of medical emergencies in diving, complies with guidance such as that published by the European Diving Technology Committee (ECHM) and the European Committee for Hyperbaric Medicine (EDTC). Periodical revision training is also important. 9. The mental, physical and medical standards of fitness in each category of diving should be harmonised internationally. 10. Greater emphasis should be placed at all levels of training on the causation and prevention of in-water fatalities. 11. After some 3 to 5 years without regular diving, the individual should be subject to a formal re-assessment of competence before re-entering the water. 12. The policy of training children as young as 8 years old to dive should empha- sise the immaturity of mental outlook that many young persons may have when an emergency occurs. 13. Emergency procedures should be consistent with a variety of equipment in a variety of configurations. 14. Programs of refresher training should be established to maximise practical re-learning and updating of basic emergency skills. This is needed particularly after an individual’s equipment has been modified. 15. Self-rescue and buddy-rescue procedures should be compatible with the equipment used and the environmental conditions. 16. Training of rescuers should include the procedures for recovery of the victim from the water into a boat and transfer of the patient from the deck of a boat to a helicopter or some other emergency transport vehicle. 17. Hand signals and basic procedures used in diving emergencies, whether at depth or on the surface, should be standardised and promoted through rescue and diving agencies throughout the world. 18. Rescuers must be made aware that the treatment of drowning in a diver might be complicated by other medical conditions such as carbon monox- ide poisoning, envenomation and omitted decompression arising from that same dive. 19. National and international standards of medical care should be written for all medical emergencies in diving by suitable academic bodies. 20. Drowning is mostly a diagnosis of exclusion and often is a presumptive diagnosis based on purely circumstantial evidence. All diving-related deaths should be thoroughly investigated, including a complete autopsy, evaluation of the equipment and a review of the circumstances surrounding the fatality by knowledgeable investigators with appropriate training and experience. The post-mortem examination of a drowned diver should be conducted by a pathologist who is knowledgeable about diving (or who is advised by a doctor who is knowledgeable about diving). Acknowledgements

Foundation Drowning 2002 Jean Carlet Hans Knape Daniel Danzl Rutger Schimmelpenninck Michel Ducharme Herpert van Foreest Menno van Duin Glen Egstrom National Steering Group Anton Fischer Ed van Beeck Dick Fundter Henk Beerstecher Luciano Gattinoni Joost Bierens Gordon Giesbrecht Jan-Ewout Bourdrez Corsmas Goemans Rob Brons Des Gorman Rob de Bruin Tom Griffiths Hein Daanen Albert de Haas Jan Carel van Dorp Anthony Handley Rob van Hulst Moniek Hoofwijk Hans Knape Adriaan Hopperus Buma Wim Rogmans Jim Howe Rutger Schimmelpennick Paul Husby Lambert Thijs Ahamed Idris Paul Touw Udo Illievich Cor Kalkman Task-force chairpersons Laurence Katz Christine Branche Gabriel Kinney Chris Brewster Olive Kobusingye David Elliott Patrick Kochanek Paul Pepe Ries Kruidenier Jean-Louis Vincent John Langley Beat Walpoth Gerard Laanen David Warner Ian Mackie (†) John Wilson Peter Mair Jordi Mancebo Task-force members Andrej Michalson Peter Barss Peter Morley Elizabeth Bennett Anja Nachtegaal Robert Berg Bengt Nellgård Marileen Biekart Martin Nemiroff Leo Bossaert Beverly Norris Alfred Bove John Pearn Ruth Brenner Eleni Petridou 672 Acknowledgements

Sjaak Poortvliet Michael Tipton Linda Quan Hans van Vught Slim Ray Max Harry Weil Peter Safar (†) Jürg Wendling Takefumi Sakabe Volker Wenzel Ian Scott Peter Wernicki Andrew Short Sip Wiebenga Antony Simcock Jane Wigginton Rob Slomp Klaus Wilkens Gordon Smith Mike Woodroffe David Szpilman Rick Wright Maida Taylor Durk Zandstra Peter Tikuisis Contact Data and Affiliations

Stathis Avramidis, MSc Steve Beerman, MD, BSc, BSR, European Lifeguard Academy Greece, CCFP, FCFP El. Venizelou 12A, Lifesaving Society Canada, 18533 Kastella-Pireas, Greece 287 McArthur Avenue, [email protected]; Ottawa Ontario, K1L 6P3, Canada [email protected] [email protected] www.ela.pre.gr www.lifesavingsociety.com PhD student, Part Time Lecturer Family Physician, Clincial Instructor, of Aquatics, Leeds Metropolitan Department of Family Practice, University (UK) // Director, Faculty of Medicine, European Lifeguard Academy Greece University of British Columbia Chair, Medical Committee, Wolfgang Baumeier, Dipl. Ing, MD International Life Saving Federation // Department of Anaesthesiology, Medical Advisor, Lifesaving Society – University Hospital Schleswig- Canada Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Elizabeth Bennett, MPH, CHES Germany Children’s Hospital and Regional [email protected] Medical Center, Health Eduction, www.sarrrah.de PO Box 50020/S-217, Seattle, Consultant WA 98145-5020, USA Coordinating Physician in Maritime elizabeth.bennett@seattlechildrens. Disaster Management org www.drowning-prevention.org Peter Barss, MD, ScD, MPH, DTMH, Health Education Manager FACPM, FRCPC Clinical Instructor, United Arab Emirates University, University of Washington Faculty of Medicine and Health Sciences PO Box 17666, Al Aïn, United Arab Emirates [email protected] www.fmhs.uaeu.ac.ae Associate Professor 674 Contact Data and Affiliations

Robert A. Berg, Professor, MD Jenny Blitvich, PhD The University of Arizona College of School of Human Movement Medicine, and Sport Sciences, 1501 N Campbell Avenue, Tucson, University of Ballarat, Victoria 3353, AZ 85724-5073, USA Australia [email protected] [email protected] Professor of Pediatrics (Critical Care Senior Lecturer, School of Human Medicine) // Associate Dean for Movement and Sport Sciences, Clinical Affairs, The University of University of Ballarat Arizona College of Medicine // Member, Consultative Committee for Member, Emergency Water Safety Research Cardiovascular Care Committee, Amercian Heart Association // Eke Boesten, LLM, PhD Member, Pediatric Resuscitation Celebesstraat 86, 2585 TP The Hague, Committee, American Heart The Netherlands Association Lawyer

Roger E.Bibbings, MBE, BA, FIOSH, Leo L. Bossaert, Professor, MD, PhD RSP University Hospital Antwerp, Royal Society for the Prevention of Department of Intensive Care, Accidents, RoSPA House, Wilrijkstraat 10, 2610 Antwerp, Edgbaston Park, 353, Bristol Road, Belgium Birmingham B5 7ST, UK [email protected] [email protected] Director, Department of Intensive www.rospa.com Care // Professor of Medicine, Occupational Safety Adviser University of Antwerp, Belgium Executive Director, Joost J. L.M. Bierens, Professor, European Resuscitation Council MD, PhD, MCDM Department of Anesthesiology, Alfred A. Bove, Professor, MD VU University Medical Center, Cardiology Section, De Boelelaan 1117, Temple University Medical School, 1081 HV Amsterdam, 3401 N. Broad Street, Philadelphia, The Netherlands PA 19140, USA [email protected] [email protected] www.vumc.nl www.scubamed.com Professor in Emergency Medicine Member, medical committee, International Life Saving Federation // Advisory board, Maatschappij tot Redding van Drenkelingen // Member, Medical Commission Royal Netherlands Sea Rescue Institution Contact Data and Affiliations 675

Christine M. Branche, PhD Rob K. Brons, LLM National Center for Injury Fire and Rescue The Hague Region, Prevention and Control, PO Box 52158, 2505 CD The Hague, Centers for Disease Control The Netherlands and Prevention, [email protected] 4770 Buford Highway NE, www.denhaag.nl/brandweer; Mailstop K-63, www.usar.nl Atlanta GA 30431-3724, USA Chief Fire Officer [email protected] National Commander, Urban Search Director, Division of Unintentional and Rescue Team, The Netherlands // Injury Prevention Chairman, Examination Committee, Dutch Life Saving Association Helge Brandstrom, MD University Hospital, Department of Christopher J. Brooks, OMM, CD, Anaesthesiology and Intensive Care, MBChB, DAvMed, FFOM Umea, Sweden Research & Development, [email protected] Survival Systems Limited, Senior Consultant Anaesthesiology Dartmouth, Nova Scotia, Canada and Intensive Care [email protected] Scientific Secretary, KAMEDO, www.survivalsystemsgroup.com Swedish National Board of Health Director, Research & Development and Welfare David Calabria Ruth A. Brenner, MD, MPH D&D Technologies (USA), Inc., National Institute of Child Health 7731 Woodwind Drive, and Human Development, Huntington Beach, CA 92647, USA National Institutes of Health, [email protected] Department of Health and Human www.ddtechglobal.com Services, Room 7B03-7510, Chief Executive Officer, 6100 Executive Blvd, Bethesda, D&D Group of Companies MD 20892-7510, USA (Australia) // President, [email protected] D&D Technologies (USA), Inc. Medical Officer Founding board member, National Drowning Prevention Alliance, USA B. Chris Brewster 3850 Sequoia Street, San Diego, CA Ian M. Calder, MD 92109, USA University of Cambridge, Thorpe, [email protected] Huntingdon Road, www.lifesaver1.com Cambridge CB3 0LG, UK Lifeguard Chief (ret.), San Diego [email protected] Lifeguard Service Pathophysiologist President, United States Lifesaving Association // President, Americas Region, International Life Saving Federation 676 Contact Data and Affiliations

Jim Caruso, MD Peter N. Cornall 1413 Research Blvd, Rockville, Water and Leisure Safety, MD 20850, USA Royal Society for the Prevention of [email protected] Accidents, ROSPA house, Commander, US Navy // Chief Deputy Edgbaston Park, 353 Bristol Road, Medical Examiner, Diving Medical Birmingham B5 7ST, UK Officer and Flight Surgeon // Office [email protected] of the Armed Forces Medical www.rospa.com Examiner, Rockville, MD, USA // Head of Water and Leisure Safety Consulting Physician, Divers Alert Secretary, UK National Water Safety Network // Associate Consulting Forum // UK Safety Expert on ISO Professor, Department of Water Safety Information Anesthesiology, Duke University Standardization Committee // Medical Center Chair, UK’s BSI Water Safety Information Standardization Davide Chiumello, MD Committee PH/8/2/1 Istituto di Anestesia e Rianimazione, Universita’ degli Studi di Milano, Günter Cornelissen, Dipl.Pol, Ospedale Maggiore Policlinico- Dipl.Ing IRCCS, Via Francesco Sforza 35, DIN Deutsches Institut für Normung 20122 Milano, Italy eV, Verbraucherrat, [email protected] Postfach 301107, 10772 Berlin, Germany Veronique G.J.M. Colman, [email protected] Professor, PhD www.verbraucherrat.din.de Faculty of Movement and Head of Consumer Council’s offices Rehabilitation Sciences, Safety Standardisation Catholic University Leuven, Tervuursevest 101, 3001 Leuven, Hein A. M. Daanen, Professor, PhD Belgium Department of Performance & [email protected]. Comfort, be TNO Human Factors, PO Box 23, www.faber.kuleuven.be 3769 ZG Soesterberg, The Netherlands Assistant Professor, Faculty of [email protected] Movement and Rehabilitation www.tno.nl Sciences of the Katholieke Head, Department of Performance & Universiteit Leuven // Responsible in Comfort, TNO Human Factors // the Faculty for courses on didactics Professor in Thermal Physiology, of swimming, life saving, didactical Faculty of Human Movement software, multimedia // Educating Sciences, Free University of toplevel coaches and lifesavers Amsterdam Member, Education Commission of the Flemisch Life Saving Federation Contact Data and Affiliations 677

Peter Dawes Mike Espino Surf Life Saving Queensland, American Red Cross National Head- PO Box 3747, quarters, South Brisbane QLD 4101, Australia 8111 Gatehouse Road, 6th floor, [email protected] Falls Church, Virginia 22042, USA www.lifesaving.com.au [email protected] Operations Manager, www.redcross.org Surf Life Saving Queensland Manager Aquatics Technical Development Michel B. Ducharme, PhD Human Protection and Performance Marit Farstad, MD Group, Operational Medicine Section, Department of Anesthesia Defence Research and Development, and Intensive Care, 1133 Sheppard Avenue West, Toronto, Institute for Surgical Sciences, Ontario, M3M 3B9, Canada Haukeland University Hospital, [email protected] 5021 Bergen, Norway Defence Scientist, Head of Human [email protected] Protection and Performance Group at DRDC Toronto Peter J Fenner AM, MD, DRCOG, Adjunct Professor, Faculty of Physical FACTM, FRCGP Education and Health, University of School of Medicine, James Cook Toronto // Adjunct Professor, School University, Townsville, Queensland, of Human Kinetics, University of PO Box 3080, North Mackay, Ottawa Qld 4740, Australia [email protected]. Glen Egstrom, PhD au University of California Los Angeles, Associate Professor Department of Physiological Sciences, 3440 Centinela Avenue, Box 951606, Adam P. Fischer, MD Los Angeles, CA 90095-1606, USA Department of Cardiovascular [email protected] Surgery, Centre Hospitalier Professor (Emeritus) Universitaire Vaudois, President, Glen H. Egstrom Inc. Rue du Bugnon 46, 1011 Lausanne, Switzerland David H. Elliott OBE, Professor, MD, Associated medical doctor in DPhil, FRCP, FFOM Cardiovascular Surgery 40, Petworth Road, Rockdale, Haslemere, Surrey GU27 2HX, UK Andrea Gabrielli, MD [email protected] Division of Critical Care Medicine Specialist in diving physiology University of Florida, 1600 Sw Archer and medicine Road, Gainesville, FL 32610-0254, USA [email protected] Associate Professor of Anesthesiology and Surgery // Medical Director, Hyperbaric Medicine // Medical Director, Cardiopulmonary Services 678 Contact Data and Affiliations

Luciano Gattinoni, Professor, MD, Frank St. C. Golden, MB, MD, BCh, PhD PhD Maggiore Hospital, Department of 15 Beech Grove, Gosport, Anesthesia and Intensive Care, Hants PO12 2EJ, UK Via F. Sforza 35, 20122 Milan, Italia [email protected] [email protected] University of Portsmouth, UK, Consultant in Environmental Harry P.M.M. Gelissen, MD Medicine and Applied Human Radboud University Medical Centre, Physiology Department of Intensive Care, PO Box 9101, 6500 HB Nijmegen, Des Gorman, Professor, MD The Netherlands Occupational Medicine Unit, [email protected] University of Auckland, Private Bag 92019, Auckland, Gordon G. Giesbrecht, Professor, New Zealand MD, PhD [email protected] 211 Max Bell Centre, Professor of Medicine University of Manitoba, Winnipeg, MB, R3T 2N2, Canada Ralph S. Goto [email protected] Ocean Safety and Lifeguard Services www.umanitoba.ca/physed/ Division, City and County of giesbrecht Honolulu, 3823 Leahi Avenue, Professor, Department of Anesthesia Honolulu, HI 96815, Hawaii and Faculty of Physical Education [email protected] and Recreation Studies, www.aloha.com/~lifeguards; University of Manitoba www.co.honolulu.hi.us/esd/ Board Member, Wilderness Medical oceansafety/index.htm Society // Revision Committee Administrator, Ocean Safety and Member for State of Alaska Cold Lifeguard Services Division, Injuries Guidelines Honolulu // Emergency Services Department, City and County of Julie Gilchrist, MD Honolulu National Center for Injury Chair, Signage Committee, Prevention and Control, Centers for United States Lifesaving Association // Disease Control and Prevention, Certification Officer, Southwest Re- Division of Unintentional Injury gion, United States Lifesaving Prevention, 4770 Buford Highway NE, Association Mailstop K-63, Atlanta, GA 30341, USA Shirley A. Graves, MD [email protected] University of Florida, www.cdc.gov/injury College of Medicine, PO Box 100254, Medical epidemiologist Gainesville, FL 32610, USA LCDR, US Public Health Service [email protected] Emeritus Professor, Anesthesiology and Pediatrics Contact Data and Affiliations 679

Tom Griffiths, EdD Jack J. Haitsma, MD, PhD Aquatics and Safety Office, Department of Anesthesiology, Penn State University, Department Erasmus University Medical Centre, of Intercollegiate Athletics, PO Box 1738, 3000 DR Rotterdam, University Park, PA 16802, USA The Netherlands [email protected] [email protected] www.aquaticsafetygroup.com Staff Member, Department of Director, Anesthesiology // Secretary, President, Acute Respiratory Failure, Aquatic Safety Research Group, LLC Diagnosis and Treatment of the Respiratory Intensive Care Assembly, Ivar Grøneng European Respiratory Society Norwegian Maritime Directorate, PO Box 8123, 0032 Oslo, Norway Anthony J. Handley, MD, FRCP [email protected] 40 Queens Road, Colchester, www.sjofartdir.no; www.hhsp.no Essex CO3 3PB, UK Project Coordinator // [email protected] Master Mariner Honorary Consultant Physician, Essex Rivers Health Authority, Ton Haasnoot Colchester, UK KNRM, (Royal Netherlands Sea Consultant Physician, Cardiologist Rescue Institution), PO Box 434, Chief Medical Adviser, 1970 AK IJmuiden, The Netherlands Royal Life Saving Society UK // [email protected] Honorary Medical Officer, www.knrm.nl Irish Water Safety // Honorary Head Training Department Medical Adviser, International Life 2nd Coxswain of IJmuiden Lifeboat Saving Federation of Europe // Secretary, Medical Committee, Katrina Haddrill International Life Saving New South Wales Department of Federation // Chairman, AED Tourism, Sport and Recreaction, Subcommittee Resuscitation Council PO Box 1422, Silverwater NWS 2128, (UK) // Chairman, European Australia Resuscitation Council International [email protected] BLS Course Committee // Chairman, www.safewaters.nsw.gov.au BLS Task Force International Liaison Senior Project Officer Committee on Resuscitation Executive Officer, New South Wales Water Safety Taskforce W. Andrew Harrell, Professor, PhD Centre for Experimental Sociology, University of Alberta, 5-21 Tory, Edmonton, Alberta T6G 2H4, Canada [email protected] Director, Population Research Laboratory, University of Alberta 680 Contact Data and Affiliations

Walter Hasibeder, MD James D. Howe Jr Department of Anesthesiology Honolulu Emergency Services and Intensive Care Medicine, Department, Ocean Safety and Krankenhaus der Barmherzigen Lifeguard Services Division, Schwestern, Schlossberg 1, 3823 Leahi Avenue, 4910 Ried im Innkreis, Österreich Honolulu Hawaii 96815 [email protected] [email protected] www.bhs.ried.at www.co.honolulu.hi.us/esd/ Head, Department of Anesthesiology oceansafety/index.htm and Intensive Care Medicine Chief of Lifeguard Operations, Island of Oahu Balt Heldring, LLM Lecturer, University of Hawaii, Maui, PC Hooftstraat 204, Kauai, and Windward Community 1071 CH Amsterdam, Colleges, Ocean Safety Education The Netherlands Course (Personal Water Craft and [email protected] Tow-in Surfing Certification) and www.itlawyers.nl Ocean Safety Management, Principals Lawyer, Member of the Amsterdam and Practices // Expert/Consultant, Bar Association Ocean Safety International, Inc., Hawaii Walter Hendrick PO Box 548, Hurley, NY 12443, Paul Husby, Professor, MD, PhD USA Department of Anesthesia [email protected] and Intensive Care, Institute for www.teamlgs.com; Surgical Sciences, www.rip-tide.org University of Bergen, President, Lifeguard Systems // Haukeland University Hospital, President, RIPTIDE // Ulster County 5021 Bergen, Norway Sheriff’s Office Special Consultant [email protected]

Robyn M. Hoelle, MD Ahamed H. Idris, Professor, MD Emergency Medicine, University of Surgery and Emergency Medicine, Florida, PO Box 14347, Gainesville, University of Texas Southwestern FL 32604, USA Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-8579, USA [email protected] Professor of Surgery and Emergency Medicine, University of Texas, Dallas // Director, Dallas Center for Resuscita- tion Research // Medical Consultant, NASA Contact Data and Affiliations 681

Udo M. Illievich, Professor, MD Cor J. Kalkman, Professor, MD, PhD Neuroanesthesiology and Critical Division of Perioperative Care, Care, Clinic of Anesthesia and Anesthesia, Emergency Medicine General Intensive Care, and Pain Management, Medical University of Vienna, University Medical Center Utrecht, 1090 Vienna, Austria PO Box 85500, 3508 GA Utrecht, [email protected] The Netherlands www.anaesthesiology.at [email protected] Supervising Anaesthesiologist Professor of Anesthesiology Critical Care Physician, Head of the Task Force Neuroanesthesiology Laurence M. Katz, MD and Critical Care University of North Carolina at Chapel Hill, Nicolaas J.G. Jansen, MD, PhD Department of Emergency Medicine, Pediatric Intensive Care Unit, Neurosciences, Wilhelmina Children’s Hospital, 101 Manning Dr, University Medical Center Utrecht, Chapel Hill, NC 27599, USA PO Box 85090, 3508 AB Utrecht, [email protected] The Netherlands Associate Professor, co-Director, [email protected] Carolina Resuscitation Research Senior staff Member, Group Pediatric Intensive Care, Department of Pediatrics Gabriel Kinney Business Development, Bas N. Jonkman, MsC Martime Systems and Sensors, Road and Hydraulic Engineering Lockheed Martin, Syracuse, Institute, Ministry of Transport, New York NY 13221 4840, USA Public Works and Water Management [email protected] and Delft University of Technology, Director, Association for Rescue at Faculty of Civil Engineering, Sea (AFRAS) // Council Member, PO Box 5044, 2628 CS Delft, International Lifeboat Federation The Netherlands Captain, USCG (Ret), Former Chief, [email protected] US Coast Guard Office of Search Engineer working for the Ministry of and Rescue Transport, Public Works and Water Management, Road and Hydraulic Alexandra Klimentopoulou, MD Institute, the Netherlands //Research- 1st Department of Pediatrics, er at Delft University, Faculty of Civil Athens University Medical School, Engineering // involved in the Aghia Sophia Children’s Hospital, research and policy on flood Thivon & Levadias str, protection in the Netherlands 11527 Athens, Greece [email protected] Paediatrician, Senior house Officer 3 Research Assistant, Department of Hygiene and Epidemiology, Athens University Medical School 682 Contact Data and Affiliations

Johannes T.A. Knape, Professor, Amanda Kost, LLD MD, PhD Fire Department of The Hague, Division of Perioperative Care, PO Box 52155, Anesthesiology, Emergency Medicine 2505 CD The Hague, and Pain Management, The Netherlands University Medical Center Utrecht, [email protected] PO Box 85500, 3508 GA Utrecht, Legal Policy Advisor The Netherlands [email protected] Gerard D. Laanen, MSc Chairman, Department of Anaesthe- Ministry of Transport, siology Public Work and Water Management, Honorary Secretary, Section PO Box 20906, 2500 EX Den Haag, and Board of Anaesthesiology, The Netherlands Union Europeènne des Médècins [email protected] Specialistes. www.dccvenw.nl Director, Ministerial Coordination Olive C. Kobusingye, MD, MBChB, Centre for Crisismanagement MMed (Surg), MPH WHO Regional Office for Africa, Burhard Lachmann, MD, PhD PO Box 6, Brazzaville, Department of Anaesthesiology, Republic of Congo Erasmus Medical Center, [email protected] PO Box 1738, 3000 DR Rotterdam, Regional Advisor on Disability / The Netherlands Injury Prevention and Rehabilitation // [email protected] WHO Regional Office for Africa Research Director Accident and Emergency Surgeon John Langley, PhD Patrick M. Kochanek, MD Injury Prevention Research Unit, Safar Center for Resuscitation Department of Preventive and Social Research, Department of Critical Medicine, Dunedin School of Care Medicine, Medicine, University of Otago, University of Pittsburgh School of PO Box 913, Dunedin, New Zealand Medicine, [email protected] 3434 Fifth Ave, Pittsburgh, www.otago.ac.nz/ipru PA 15260, USA Director, Injury Prevention Research [email protected] Unit www.safar.pitt.edu Director, Safar Center for Resuscitation Research // Professor and Vice Chairman Contact Data and Affiliations 683

Laurie J. Lawrence, Dip. Phys Ed, Bo Løfgren, MD Dip. Ed, BA Department of Cardiology, D&D Technologies Inc, PO Box 379, Research Unit, Aarhus University Sydney, Brookvale, NSW 2100, Hospital, Skejby Sygehus, Australia Brendstrupgaardsvej 100, [email protected] 8200 Aarhus N, Denmark www.kidsalive.com.au; [email protected] www.laurielawrence.com.au Company Director // Motivational John B. Long Speaker Safety Institute of Australia Royal Life Saving Society, Fellow // Patron AUSTSWIM Commonwealth Headquarters, Queensland // Founder of Kids Alive River House, High Street, Broom, Water Safety Program Warks, England B50 4HN, UK Master Coach Australian Swimming, [email protected] International Hall of Fame Royal Life Saving Society, Commonwealth Secretary John Leech, Lt Cdr, MNI, MIIMS Secretary, ILS Development Irish Water Safety Association, Committee // Chairman, The Long Walk, Galway, Ireland WHO/ILS Liaison Committee // [email protected] Commonwealth Vice-President, www.iws.ie Royal Life Saving Society Chief Executive, Irish Water Safety Association Marilyn Lyford, BHsc Commander, Irish Navy // Officer The Royal Life Saving Society i/c Naval Diving Section in Ireland // Australia (NSW Branch), PO Box 753, Lecturer, Naval College Gladesville NSW 1675, Australia [email protected] Jennifer M. Lincoln, MS www.nsw.royalifesaving.com.au 4230 University Drive, Suite 310, Health Promotion Manager Anchorage Alaska 99508, USA [email protected] Peter MacGregor, RSP MIFire DMS, www.cdc.gov/niosh/injury/traumaf- FIM MIOSH ish.html Royal Society for the Prevention of PhD canididate, Occupational Safety Accidents, RoSPA House, and Health Specialist, NIOSH Edgbaston Park, 353 Bristol Road, Project Officer for the Injury Birmingham B5 7ST, UK Prevention Project in the Commercial [email protected]; Fishing Industry www.rospa.com Water Leisure Safety Consultant

Ian Mackie, AM, FRACP † 684 Contact Data and Affiliations

Martin H.E. Madern Fernando Neves Rodrigues Fire Department of The Hague, Martinho, PhD PO Box 52155, Casa Patrão de Salva Vidas Ezequiel 2505 CD The Hague, Seabra, Praia de Angeiras 4455, The Netherlands 204, Lavra, Matosinhos, Portugal [email protected] [email protected]¸ www.denhaag.nl/brandweer www.epesajms.coop Bachelor of public administration, Pedagogic Director, Social Economy Senior Safety Consultant (Senior Pol- Professional School, that promotes icy Adviser) // Substitute local coor- the Professional Course in Aquatic dinator emergency planning & crisis Safety and Rescue // President of management, City of The Hague Portuguese Life Saving Association (AsNaSA), delegate to the Interna- Denise M. Mann, BS, EMT-P tional Life Saving Federation 12006 Glenway, Houston, Trainer in Life Saving Techniques – TX 77070, USA First Aid for Water Life Saving // [email protected] Animator for Life Saving Associations Patient Outcome Manager/ in Portuguese Spoken Countries EMS Community Relations & Research, City of Houston EMS, Germ Martini Houston, TX, USA KNRM (Royal Netherlands Sea Harris County Child Fatality Review Rescue Institution), PO Box 434, Board, Save a Life – Prevent a Drown- 1970 AK IJmuiden, The Netherlands ing, Houston CPR Task Force, [email protected] National CPR Task Force, www.knrm.nl Greater Houston EMS Council Operational Lifeboat Inspector Honorary Secretary, Ruy Marra KNRM Lifeboat Station Superfly, Estrada das Canoas, 1476 casa 2 Sao Conrado, John T. McVan, MEd 22610-210 Rio de Janeiro, Brasilia United States Military Academy, [email protected] Aquatic Instruction, www.paralife.com.br 735 Brewerton Road, West Point, Creator and Pilot NY 10966, USA [email protected] Assistant Professor, Director of Aquatic Instruction

Bart-Jan T.J. Meursing, MD Canisius-Wilhelmina Hospital, Weg door Jonkerbos 100, 6532 SZ Nijmegen, The Netherlands [email protected] Cardiologist // Interventional Cardiologist Contact Data and Affiliations 685

Robyn J. Meyer, MD, MS Jaap Molenaar Department of Pediatrics, NIBRA (Netherland Institute for Fire The University of Arizona College Service and Disaster Management), of Medicine, PO Box 7010, 6801 HA Arnhem, 1501 N Campbell Avenue, Tucson, The Netherlands AZ 85724-5073, USA [email protected] [email protected] www.nibra.nl Assistant Professor, Pediatric Critical Project Manager // Senior Trainer // Care, University of Arizona Consultant and Dean Operational Medical Director, Pediatric ECMO, Branch University of Arizona Developer of the courseware for rescue divers and instructors in the Andrej Michalsen, MD, MPH Netherlands Fire Service University Medical Center Utrecht, Division of Perioperative Care, Kevin Moran, MEd Anesthesia, Emergency Medicine Centre for Health and Physical and Pain Management, Education, PO Box 85500, 3508 GA Utrecht, Symonds Street, 74 Epsom Av., The Netherlands Private Bag 92601, Epsom, Auckland, [email protected] New Zealand [email protected] Rebecca Mitchell, MA, MOHS Principal Lecturer in Physical Injury Prevention and Policy Branch, Education New South Wales Health, Chairman, Watersafe Auckland North Sydney, Australia Incorporated (WAI), Auckland, [email protected] New Zealand // Senior Advisor, PhD student Surf Life Saving Northern, Auckland, New Zealand Jerome H. Modell, MD, DSc (Hon) Department of Anesthesiology, Luiz Morizot-Leite, MS University of Florida, Beach and Marine Safety, College of Medicine, Miami Dade County Fire Rescue, PO Box 100254, 10800 Collings Avenue, Gainesville, FL 32610, USA North Miami Beach, FL 33154, USA [email protected] [email protected] Professor Emeritus of Anesthesiology American Red Cross Lifeguard Courtesy Professor of Large Animal Instructor Trainer Clinical Science Ocean Rescue Lifeguard-Paramedic Lieutenant 686 Contact Data and Affiliations

Peter Morley, MD Linda Papa, MD, CM, MSc, CCFP, Intensive Care Unit, FRCP(C), FACEP Royal Melbourne Hospital, Department of Emergency Medicine, Parkville, Grattan Street, University of Florida College of Melbourne Victoria 3050, Australia Medicine, PO Box 100186, [email protected] Gainesville FL 32610-0186, USA Senior Specialist Intensive Care, [email protected] Royal Melbourne Hospital Assistant Professor and Director of Chairman, Advanced Life Support Clinical Research, Department of Committee, Australian Resuscitation Emergency Medicine // Council Director of Clinical Studies in Mild Traumatic Brain Injury, McKnight Bengt Nellgård MD, PhD Brain Institute Neuro Intensive Care Unit, Sahlgrenska University Hospital, Luis-Miguel Pascual-Gómez 413 45 Gothenburg, Sweden Buena Vista 4, Esc-3, 2-b, [email protected] 40006 Segovia, Spain Director, Neuro Intensive Care Unit [email protected] Associate Professor, Department of www.sossegovia.com Anesthesiology and Intensive Care Professor, Technical and Educational Medicine, Gothenburg University, Director-E.S.S. (Segovia Lifesaving Sweden School) // Lifesaving Instructor // Co-Founder and former President Martin J. Nemiroff, MD of ESS US Public Health Service/ US Coast Guard, John Pearn, Professor, MD, AM, 20829 Via Colombard, RFD Sonoma California CA 95476 – 8059, Department of Paediatrics and Child USA Health, University of Queensland, [email protected] Royal Children‘s Hospital, Herston, Captain, USCG (ret) Brisbane, Queensland 4029, Australia [email protected] Michael A. Oostman Senior Paediatrician, Royal Children’s 1912 Dimmitt Court, Hospital Brisbane Bloomington, IL 61704, USA Former Surgeon General, Australian [email protected] Defence Force // Leader, Major www.thelifeguardstore.com Research Team in Immersion Studies Vice President, Jeff Ellis & Associates, Inc. Contact Data and Affiliations 687

Margie M. Peden, PhD David E. Persse, MD Department of Injuries and Violence The City of Houston Emergency Prevention, World Health Medical Services, USA Organization, Appia Avenue 20, [email protected] 1211 Geneva 27, Switzerland Director, Emergency Medical [email protected] Services, Public Health Authority, www.who.int/violence_injury_pre- City of Houston // Associate Professor vention/ of Emergency Medicine, University of Coordinator, Unintentional Injury Texas Medical School at Houston // Prevention, Department of Injuries Associate Professor of Surgery, and Violence Prevention, Baylor College of Medicine WHO Geneva Ulrik Persyn, Professor, PhD Tommaso Pellis, MD Faculty of Movement and Cardiac Mechano-Electric Feedback Rehabilitation Sciences, Lab, The University Laboratory of Catholic University Leuven, Physiology, Oxford, OX1 3PT, UK Tervuursevest 101, 3001 Leuven, [email protected] België Senior Research Scientist, [email protected] University Laboratory of Physiology, www.faber.kuleuven.be Cardiac Mechano-Electric Feedback Responsible in the Faculty for courses Lab // Consultant in Anaesthesia on movement and training science of and Intensive Care swimming

Paul E. Pepe, MD, MPH, FACP, Eleni Petridou, MD, MPH FCCM, FACEP, FCCP Department of Hygiene and Emergency Medicine Administration, Epidemiology, Athens University 5323 Harry Hines Blvd, MC 8579, Medical School, Dallas, TX 75390-8579, USA 75 Mikras Asias Street, Goudi, [email protected] 115 27 Athens, Greece Professor of Surgery, Medicine, [email protected] Public Health and Riggs Family Chair www.cc.uoa.gr/socmed/hygien/ in Emergency Medicine, University of cerepri Texas Southwestern Medical Center Associate Professor of Preventive and the Parkland Health and Hospital Medicine and Epidemiology System, Dallas, USA Director, Center for Research and Director, City of Dallas Medical Prevention of Injuries among the Emergency Services (EMS, Fire, Young (CEREPRI) // Director, Police, Health) // Medical Director, Hellenic Society for Social Pediatrics Dallas Metropolitan Medical and Health Promotion Response System (for Anti-Terrorism) // Medical Director for the Dallas Met- ropolitan BioTel (EMS) System 688 Contact Data and Affiliations

Francesco A. Pia, PhD Linda Quan, Professor, MD, MPH Pia Consulting Services, Department of Pediatrics, 3 Boulder Brae Lane, Larchmont, Children’s Hospital and Regional NY 10538-1105, USA Medical Center, [email protected] 4800 Sand Point Way NE cm-09, www.Pia-Enterprises.com Seattle, WA 98105, USA President, Independent Researcher // [email protected] Member, American Red Cross Professor in Pediatrics, Advisory University of Washington School of Council on First Aid and Safety // Medicine, Seattle, Washington, USA National Technical Advisor, Pediatric Emergency Medicine American Red Cross’ Lifeguard Attending, Children’s Hospital and Training Program Regional Medical Center, Seattle, Washington, USA Sjaak Poortvliet Association of Water Boards, Slim Ray, PhD PO Box 80200, 2508 GE The Hague, CFS Press, 68 Finalee Avenue, The Netherlands Asheville NC 28803, USA [email protected] [email protected] www.uvw.nl www.cfspress.com Policyworker, Association of Dutch International Rescue Instructor- Water Boards Trainer

Rolf Popp, Dipl.-Ing Monique Ridder, MSc, PhD Binnenschiffahrts-Berufsgenossen- Christelijke Hogeschool Windesheim, schaft, Präventionsbezirk West D IV-1, PO Box 10090, 8000 GB Zwolle, Frankenweg 2, 56337 Eitelborn, The Netherlands Germany [email protected] [email protected] www.windesheim.nl www.bsbg.de Professor in health science Senior Surveyor // Health and Safety and nutrition Inspector Convenor CEN TC 162 WG 6, ISO TC Rienk Rienks, MD, PhD 188 WG 14, FA PSA SG 13, scope of all: Heart Lung Center Central Military PPE against drowning Hospital, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands [email protected] Cardiologist Chairman of the Task Force on Cardiology and Diving // Chairman, Committee on Cardiology and Sports, Netherlands Society of Cardiology Contact Data and Affiliations 689

Wim H.J. Rogmans, PhD Justin P. Scarr, BEd, MBA (MGSM) Consumer Safety Institute, Royal Life Saving Society Australia, PO Box 75169, 1070 AD Amsterdam, Suite 201, 3 Smail Street, The Netherlands Broadway, NSW 2007, Australia [email protected] [email protected] www.veiligheid.nl www.royallifesaving.com.au Director, Consumer Safety Institute National Operation Manager

Marcia L. Rom, JD Gert-Jan Scheffer, Professor, MD, Alaska Injury Prevention Center, PhD 3701 East Tudor, Suite 105, Radboud University Medical Center, Anchorage, AK 99508, USA Department of Anesthesiology, [email protected] PO Box 9101, 6500 HB Nijmegen, www.alaska-ipc.org The Netherlands Projects Director [email protected] Professor and Chairman Peter Safar, Professor, MD, DSc (Hon) † Rutger J. Schimmelpenninck, LLM Keizersgracht 814, Takefumi Sakabe, professor, MD 1017 EE Amsterdam, The Netherlands Department of Anesthesiology and r.schimmelpenninck@houthoff.nl Resuscitology, Yamaguchi University Lawyer School of Medicine, 1-1-1 Minami-Kogushi, Ube, Adee Schoon, PhD Yamaguchi, 755-8505, Japan Leiden University, [email protected] Institute of Biology, Professor and Chairman, Animal Behaviour Group, Department of Anesthesiology- PO Box 9516, 2300 RA Leiden, Resuscitology, Yamaguchi University The Netherlands School of Medicine // Director, [email protected] Intensive Care Unit, Yamaguchi Researcher University Hospital // Secretary- General, The Japanese Society of Michael Schwindt, Professor, Reanimatology // Secretary-General, Dipl.-Pädagoge Japanese Society of Neurosanesthesia Rolandstraße 35, 31137 Hildesheim, and Critical Care // Deputy Secretary- Germany General, Western Pacific Association www.sarrrah.de of Critical Care Medicine Research and Development of Life-Saving Systems Paloma Sanz Morillo n° 11, 1° D, 40002 Segovia, Ian Scott, PhD Spain PO Box 302, Abbotsford, [email protected] Victoria 3067, Australia Doctor Specialist of Physical [email protected] Education and Sport Department of Injury and Violence President, Cultural Association ESS Prevention, World Health (Segovial Lifesaving School) Organisation, Geneva 690 Contact Data and Affiliations

Jim Segerstrom, MICP Brian V. Sims Special Rescue Services Group, Royal Life Saving Society – United World Rescue Service, PO Box 4686, Kingdom, River House, High Street, Sonora CA 95370, USA Broom, Warwickshire B50 4HN, UK [email protected] [email protected] www.specialrescue.com Member, ILS Rescue and Education President, Special Rescue Services Commission // Secretary, Group ILSE Rescue Commission // Executive Director, International Member, International Standards Rescue Instructors Association // Organisation: Water Safety Signs Technical Specialist to Special and Beach Safety Flags Committee // Operations, Fire and Rescue Branch, Member, British Standards California Office of Emergency Institution Services // Founder, Swiftwater/Flood Rescue Technician Program, US // Paul E. Sirbaugh, DO, FAAP, FACEP International Legal Consultant, Texas Children’s Hospital, Investigater and Expert Witness on 6621 Fannin Ste A210, Life Safety MC 1-1481, Houston, TX 77030, USA [email protected] Andrew D. Short, Professor, PhD Director of EMS, Assistant Professor Coastal Studies Unit, of Pediatrics // Assistant Medical Di- School of Geosciences, rector, Section on Emergency Medi- University of Sydney, cine, TCH // Director of Prehospital Sydney, NSW 2006, Australia Medicine, TCH // Assistant Physician [email protected] Director, City of Houston, EMS www.geosci.usyd.edu.au/about/ people/staff/short.html Robert M. Slomp, Msc Professor of Marine Science, Works and Water Management University of Sydney Department Water Systems, National Coordinator, Australian Safety Against Flooding, Beach Safety and Management Ministry of Transport, Program PO Box 17, 8200 AA Lelystad, The Netherlands Antony Simcock, MD, MB BS, FRCA [email protected] Royal Cornwall Hospital, Truro, www.rijnenmaas.nl Cornwall TR1 3LJ, UK Team Leader, RIZA (Disaster [email protected] management flood risk Rhine and Honorary Consultant Anaesthesist Meuse) // Advisor Risk Analysis Contact Data and Affiliations 691

Gordon S. Smith, MD, MPH John A. Stoop, PhD Liberty Mutual Research Institute Faculteit TBM, Technical University for Safety, 71 Frankland Road, Delft, PO Box 5015, 2600 GA Delft, Hopkinton, Massachusetts 01748, The Netherlands USA [email protected] [email protected] www.kindunos.nl www.libertymutual.com/research/ Associate Professor, Safety Science, Epidemiologist // Associate Professor, Delft University of Technology // Center for Injury Research and Policy, Managing Director, Kindunos Safety Johns Hopkins Bloomberg School of Consultancy Ltd Hygiene and Public Health, Baltimore Accredited Aviation Accident Investigator // Board Member, Luiz Smoris Dutch Road Victim Organisation [email protected] Martin Stotz, MD Robert K. Stallman, PhD Bloomsburry Institute of Intensive Sandvollvn. 80, 1400 Ski, Norway Care, The Middlesex Hospital, [email protected] Mortimer Street, London, W1T 3AA, Associate Professor, Norwegian UK University of Sport & Physical [email protected] Education Anaesthesiologist Member, Board of Directors, Norwegian Life Saving Association David Szpilman, MD Socieda Brasiliera de Salvamento Alan M. Steinman, MD, MPH Aquatico, Av. das Américas 3555, 1135 Harrington Place, bloco 2, sala 302, Barra da Tijuca, DuPont, WA 98327, USA Rio de Janeiro, Brasil 22631-004 [email protected] [email protected]; Rear Admiral, US Public Health [email protected] Service / US Coast Guard (Retired) // www.szpilman.com; Advisor to the US Coast Guard in www.sobrasa.org the areas of drowning, sea-survival, Medical & Rescue Helicopter hypothermia, flotation devices and Service – GSE – CBMERJ // Head, protective clothing // Professional Adult Intensive Care Unit, Affiliate, Health Leisure and Human Hospital Municipal Miguel Couto Performance Research Institute, Founder, Ex-President and Former Univ. of Manitoba, Winnipeg, Medical Director of SOBROSA Manitoba, Canada (Brazilian Life Saving Society) Medical Commission and Board Carla St-Germain, BA, BEd Member of International Life Lifesaving Society, Saving Federation // Member 287 McArthur Avenue, of CLAR (Comitê Latino-Americano Ottawa, Ontario K1L 6P3, Canada de Ressuscitação) [email protected] www.lifesaving.ca Project Manager Education 692 Contact Data and Affiliations

Richard Ming Kirk Tan Lambert Thijs, Professor, MD, PhD 73 Farrer Drive, Department of Intensive Care, #02-01 Sommerville Park, VU University Medical Centre, Singapore 259280, Singapore PO Box 7057, 1007 MB Amsterdam, [email protected] The Netherlands www.slss.org.sg [email protected] Consultant, Shook Lin & Bok // Emeritus Professor of Intensive Care Adjunct Associate Professor, National University of Singapore Peter Tikuisis, PhD Honorary Secretary-General, Human Modelling Group, Singapore Life Saving Society Simulation, Modelling, Acquisition, Rehersal, Greg Tate and Training Section, Defence Royal Life Saving Society Australia, Research and Development Canada, Floreat Forum, Perth WA 6014, 1133 Sheppard Avenue West, Toronto, Australia Ontario, M3M 3B9, Canada [email protected] [email protected] www.lifesavingwa.com.au Defence Scientist Manager Community Health Adjunct Professor, Faculty of Physical Education and Health, University of Maida Taylor, MD Toronto 785 Foerster Street, San Francisco, CA 94127, USA Michael Tipton, Professor, MD [email protected] Institute of Biomedical & Clinical Professor, University of Biomolecular Sciences, California San Francisco, Department of Sport & Exercise Department of Obstetrics Gyneology Science, University of Portsmouth, and Reproductive Sciences // Clinical Portsmouth PO1 2DT, UK Director for Women’s Health, Medical [email protected] Affairs, Novo Nordisk Pharmaceutical, Princeton, NJ, USA Nigel M. Turner, MB ChB, FRCA, EDICM Andreas Theodorou, MD Pediatric Intensive Care Unit , Pediatric Critical Care Medicine, Wilhelmina Children’s Hospital, Department of Pediatrics, University Medical Center Utrecht, The University of Arizona Health PO Box 85090, 3508 AB Utrecht, Sciences Center, PO Box 245073, The Netherlands Tucson, AZ 85724-5073, USA [email protected] [email protected] Paediatric Anaesthesiologist Professor of Clinical Pediatrics // Director, Dutch Advanced Paediatric Associate Head, Department of Life Support (APLS) Course // Pediatrics Secretary, Dutch Foundation for the Emergency Care of Children Contact Data and Affiliations 693

Wolfgang Ummenhofer, MD, PhD Robert A. van Hulst, MD, PhD Department of Anesthesia, Diving Medical Center, University Hospital, Basel, Royal Netherlands Navy, Switzerland PO Box 10.000, 1780 CA Den Helder, [email protected] The Netherlands Associate Professor [email protected] http://www.marine.nl/schepen/ Ed van Beeck, MD, PhD mijnendienst/duiken/ Institute Public Health Care, duikmedischcentrum/ Erasmus University Rotterdam, Senior Medical Officer, PO Box 1738, 3000 DR Rotterdam, Diving and Submarine Medicine The Netherlands Director, Diving Medical Center, [email protected] Royal Netherlands Navy www.erasmusmc.nl/mgz Consultant, National Sportdiving Associate Professor of Public Health Association // National Representa- tive, European Diving Technology Giel van Berkel, MD Committee (EDTC) Beatrixziekenhuis, PO Box 90, 4200 AB Gorinchem, The Netherlands Joost van Nueten [email protected] Belgium Medical Crash Team Internist-Intensivist Sea Eagles vzw, Vloeiende 26, 2950 Kapellen, Belgium Pieter van der Torn, MD, DEnv [email protected] Foundation for Cooperation of www.powerboat-rescue.com Technique & Care, Chief Nurse, Emergency Care Blankenburgerpark 154, Department, Jan Palfijn Hospital 3042 HA Rotterdam, The Netherlands Antwerpen, Belgium [email protected] Rescue diver and helicopter Consultant for risks assessment jumper // Chairman BMCT – Sea and disaster response Eagles Rescue Team

Josephus P.J. van Gestel, MD, PhD Adrianus J. van Vught, Professor, Pediatric Intensive Care Unit, MD, PhD Wilhelmina Children’s Hospital, Pediatric Intensive Care Unit, University Medical Center Utrecht, Wilhelmina Children’s Hospital, PO Box 85090, 3508 AB Utrecht, University Medical Center Utrecht, The Netherlands PO Box 85090, 3508 AB Utrecht, [email protected] The Netherlands Staff Member, [email protected] Pediatric Intensive Care Unit Director, Pediatric Intensive Care Unit 694 Contact Data and Affiliations

Hans Vandersmissen Michael Vlasto, FRIN, FNI KNRM (Royal Netherlands Sea The Royal National Lifeboat Rescue Institution), PO Box 434, Institution (RNLI), West Quay Road, 1970 AK IJmuiden, The Netherlands Poole, Dorset BH15 1HZ, UK [email protected] [email protected] www.knrm.nl Operations Director, RNLI Free-lance maritime journalist Chairman, National Water Safety Forum // Chairman, UKSAR Karel R.R. Vandevelde, MD Organisation Maritime and Aviation Emergency Department, Consultative Committee AZ Sint-Jan, Ruddershove 10, 8000 Brugge, Wiebe de Vries, MSc Belgium Royal Foundation of National [email protected] Organisation Providing Accident Consultant Anaesthesiologist, Rescue Services and First Aid Critical Care Medicine “The Orange Cross”, Scheveningseweg 44, Harald Vervaecke, PhD 2517 KV Den Haag, The Netherlands International Life Saving Federation, [email protected]; [email protected] Gemeenteplein 26, 3010 Leuven, Head, Research and Development Belgium Professional Secretary, [email protected]; Dutch Resuscitation Council [email protected] http://www.ilsf.org Beat H. Walpoth, MD, FAHA Senior Advisor, Qatar National Cardiovascular Research, Olympic Committee // Senior Service for Cardiovascular Surgery, Advisor, Doha 2006 Asian Games Department of Surgery, HUG, Secretary General, International Life University Hospital, 1211 Geneva 14, Saving Federation // President, Switzerland Belgian Life Saving Federation // [email protected] President, Flemish Life Saving Director of Cardiovascular Research // Federation President-Elect, European Society of Artificial Organs Jean-Louis Vincent, Professor, MD, PhD David S. Warner, Professor, MD Department of Intensive Care, Department of Anesthesiology, Erasme University Hospital, Box 3094, Duke University Medical Route de Lennik 808, 1070 Brussels, Center, Durham, NC 27710, USA Belgium [email protected] [email protected] Professor, Departments of www.intensive.org Anesthesiology, Neurobiology, Head, Department of Intensive Care and Surgery, Duke University President, International Sepsis Forum // Medical Center Past President, European Society of Intensive Care Medicine // Past President, European Shock Society Contact Data and Affiliations 695

Max Harry Weil, MD, PhD, ScD Andrew G. Whittaker, BHMS (Hon), Distinguished University Victorian Aquatic Industry Professor Council, 44–46 Birdwood Street, 35100 Bob Hope Drive, Box Hill South, Victoria 3128, Rancho Mirage, CA 92270, USA // Australia The Keck School of Medicine, [email protected] University of Southern California, www.vaic.org.au Los Angeles, CA, USA Chief Executive Officer [email protected] www.911research.org Sip E. Wiebenga President, The Institute of KNRM (Royal Netherlands Sea Critical Care Medicine Rescue Institution), PO Box 434, 1970 AK IJmuiden, The Netherlands Jürg Wendling, MD [email protected] Fbg du Lac 67, 2505 Biel-Bienne, www.knrm.nl Switzerland Director, Royal Netherlands Sea [email protected] Rescue Organisation EDTC, Vice Chairman, Surgery, Hand Surgery, Jane Wigginton, Professor, MD Diving Medicine SUHMS University of Texas Southwestern National Director, Divers Alert Medical Center, Network Hotline in Switzerland 5323 Harry Hines Blvd, Dallas, TX 75390-8579, USA Volker Wenzel, Professor, MD, PhD Jane.Wigginton@UTSouthwestern. Department of Anesthesiology and edu Critical Care Medicine, Innsbruck Assistant Professor, Emergency Medical University, Anichstrasse 35, medicine // Assistant Medical 6020 Innsbruck, Austria Director, EMS // Resuscitation [email protected] Research Coordinator www.anaesthesie.uibk.ac.at Associate Professor of Anesthesiology Klaus Wilkens, PhD and Critical Care Medicine//Respon- Holunderweg 5, 21365 Adendorf, sible Coordinator, Experimental Germany Anesthesiology [email protected] www.ilseurope.org Peter G. Wernicki, MD Lecturer for Management, Pro sports, 1355 37th Street, University of Hamburg Vero Beach, FL 32960, USA President DLRG, (German Life [email protected] Saving Society) // President, Vice Chair Medical Commission, International Life Saving Federation International Lifesaving Federation of Europe (ILSE) Medical Advisor, United States Lifesaving Association – Board of Directors // Past Chief of Orthopaedics, Indian River Memorial Hospital 696 Contact Data and Affiliations

Ann M. Williamson Rick Wright NSW Injury Risk Management Rescue and Education Commission, Research Centre, International Life Saving Federation, University of New South Wales, PO Box 451, Swansea NSW 2281, Sydney NSW 2052, Australia Australia [email protected] rickwright50@hotmailcom www.irmrc.edu.au Past Chairman, ILSF Rescue and Associate Professor, Deputy Director Education Commission

Robert L. Williamson, BS, MS Andrea Zaferes Marine Sonic Technology, Ltd., Lifeguard Systems/RIPTIDE, 5508 George Washington Memorial PO Box 548, Hurley, NY 12443, USA Highway, PO Box 730, [email protected] White Marsh, VA 23183-0730, USA www.teamlgs.com, www.rip-tide.org [email protected] Vice President // Dive Team Trainer // www.marinesonic.com Death Investigator // Marketing Director Side Scan Sonar Medicolegal Death Investigator Trainer Water and ice rescue Instructor

John R. Wilson, Professor, MSc, PhD Durk F. Zandstra, MD, PhD Institute for Occupational Intensive Care, Ergonomics, University of Onze Lieve Vrouwe Gasthuis, Nottingham, PO Box 95500, 1090 HM Amsterdam, Nottingham NG7 2RD, UK The Netherlands [email protected] [email protected] Professor of Human Factors www.olvg.ziekenhuis.nl Medical Director ICU // Director, Michael Woodroffe Postgraduate Intensive Care Training International Lifeboat Federation c/o Program The Royal National Lifeboat Institution, West Quay Road, Edward Zwitser Poole, Dorset, BH15 1HZ, UK KNRM (Royal Netherlands Sea [email protected] Rescue Institution), PO Box 434, Commander// Overseas Training and 1970 AK IJmuiden, The Netherlands Development Advisor // Deputy Chief [email protected] of Operations, RNLI // Master www.knrm.nl Mariner // Commander RNR Director, Seahorse Marine Consultancy Subject Index

A aerobic gram-negative micro- AMPA, see α-amino-3-hy- organism 418 droxy-5-methyl-4-isoxa- ABC, see Airway Breathing Aeromonas spp. 417, 418 zole proprionic acid Circulation Africa 61, 185, 187 amyotrophic lateral sclerosis abdominal thrust 327, 337 afterdrop 403, 425, 495 458 aboriginal 123 AHA, see American Heart As- anaesthetics, local 459 ABSMP, see Australian Beach sociation antibiotic 399, 405, 409, 419 Safety and Management air anticoagulation 460 Program – embolism 607, 610 anti-fencing group 107 absolute pressure 592 – trapping 415 antioxidant 459, 464 academic study 178, 180, 182 airbag 239, 240 anti-terrorism unit 140 accident airspace consolidation 411 anxiety 305 – powerboat airway APLS, see Advanced Paediat- – prevention in pools 180 – clearing 327 ric Life Support – rate 279 – management 525 apneic acidosis 373, 445, 601 – pressure 414 – diving 595 – metabolic 392 – unprotected 316, 328 – patient 325 active compression–decom- Airway Breathing Circulation apolipoprotein E (apoE) 454 pression pump 316, 330 (ABC) 296 approach system 261 Acute Respiratory Distress AIS, see Automated Identifica- ARDS, see Acute Respiratory Syndrome (ARDS) 349, 360, tion System Distress Syndrome 399, 405, 410–417, 419, 444 Alaska 73, 74, 129, 254 ARF, see Acute Respiratory – incidence 410–411 albumin 516 Failure Acute Respiratory Failure alcohol 62, 67, 85, 215, 228, Arie Visser 269 (ARF) 419 307 ARPA, see Automatic Radar Ad Hoc Panel on Manual alertness 217 Plotting Aid Methods of Artificial Respi- alfa-stat strategy 519, 520 arrhythmia 352, 423, 464 ration 20 ALS, see Advanced Life Sup- arteriovenous anastomosal adrenaline 303 port (AVA) rewarming 509 – endogenous 260 alveolar epithelium 419 Asia Pacific 187 Advanced Life Support (ALS) alveolocapillary permeability Aspergillus species 418 318, 323, 324, 332, 348–350, 422 asphyxia 47, 370, 513, 612 375, 547, 645 American Academy of Pediat- – encephalopathy 438 – children 359 rics (ACP) 312 – insult 435 – intervention 325, 348, American College of Emer- – perinatal 447–449 364 gency Physicians (ACEP) aspiration 47, 337, 370, – technique 349 312 407–410, 414–417, 419, 426, – – indications 349 American Heart Association 428, 601 Advanced Paediatric Life Sup- (AHA) 310, 312, 317, 318, assault 51 port (APLS) 404 320, 323, 325, 379 assessment AED, see Automated External American National Red Cross – hazards 152 Defibrillator 20, 146, 215 – initial medical 392 AER, see active external re- α-amino-3-hydroxy-5-meth- – risk of beaches 152 warming yl-4-isoxazole proprionic atelectasis 419 Active external rewarning acid (AMPA) 457 – compressive 411 (AER) 506 amiodarone 348 attention span 216 698 Subject Index attitude 115 – – sequence 327 bladder lavage 404 Australia 54, 70, 74, 101, 106, – rescue technique 343 Blair, James 16 120, 121, 123, 131, 143, 156, – water life support blood 159, 207, 210, 211, 272, 276, (BWLS) 342, 344 – alcohol concentration 370 – – course 342, 347 67 Australian Beach Safety and – – training 346 – potassium level 512 Management Program bathtub 66 – pressure 498 (ABSMP) 156 – family 104 – viscosity 242 Australian Consumer Associa- battery 174 – volume 514 tion (ACA) 109 battle drill training 270 blue flag beach 125 Australian Resuscitation beach 151, 341 boat, inflatable 162 Council (ARC) 312, 323, 379 – dissipative 154 boating fatality 129 Australian Standard on Fenc- – energy reflective 154 boat-related drowning 58 es and Gates for private – flag event 299 boatsafe 124 swimming pool 103, 106 – hazard rating 153–155 Bolivia 186 Automated External Defi- – high-energy dissipative bottle of Leiden 18 brillator (AED) 317, 327, 153 bottom scouring 623 333–335, 348, 355 – intermediate 155 Boyle’s law 606 – reliability 332 – intertidal zone 154 brain – training 332 – low energy reflective – asphyxia 453 Automated Identification 155 – cooling 448, 465 System (AIS) 224 – low gradient intertidal – damage 364 Automatic Radar PlottingAid zones 154 – function 431 (ARPA) 270 – morphodynamics 154 – oedema 483 autopsy 382, 409 – patrol 110 – perfusion 364 – observation 639 – safety 212 – tissue pO2 450 – technique 638 – – flag 204, 211 Branhamella spp. 418 avalanching 599 – sediment 153 Brazil 157, 287, 428 AVPU (alert-verbal-painful- – shape 154 breath-hold diving 589, 595 unresponsive) scale 382 – sloping 340, 341 breathing 237, 416 awareness 85, 101, 290 – surf zones 154 – pattern 234 – training 584 – systems 152 bridge resource management – – tide dominated 152, 270 154 Brisbane Drowning Study B – – tide modified 152, 154 102, 103 – – wave dominated 152– British standard for water backboard 293, 296 154 safety sign 207 bacteriology 418 – type 153 BRM, see Bridge resource Bacteroides spp. 418 – usage 152, 156 management bag-valve-mask Beck, Claude 20 broad spectrum beta-lactam – device 316 behaviour 92 penicillin 419 – ventilation 328 Belgium 180, 182 Brodie, Benjamin 18 Bangladesh 56 beta-blocker 354 bronchospasm 415 barbiturate 456, 463 bias medallion, bronze 275 baroceptor 242 – availability 96 brush specimen 417 barometric pressure 591 – compression 96 bucket 66, 104 barotrauma 415 – publicity 96 buddy system 306 barriers on road 72 bible 14 Bulgaria 187 basic bi-level positive airway pres- buoyancy 7, 232, 252 – life support (BLS) 151, sure (BiPAP) 440 – acid 581 316, 327, 331, 359, 364, BiPAP, see bi-level positive – result 231 370, 645 airway pressure Burkholderia pseudomallei – – children 359 biochemical marker 454 417, 418 – – course 346 biofeedback 219 burns 260 – – provider 348 biomechanical model 274 Subject Index 699

BWLS, see basic water life Canadian Red Cross 117 catecholamines 406, 494 support Canadian Search and Rescue causes bystander 314, 323, 331 Planning (CANSARP) 222 – drowning 88 – CPR 325, 365 Candida spp. 418 – – homicide 99 – rescue 250 CANSARP, see Canadian – unintentional injury 84 Search and Rescue Plan- CDC, see Centers for Disease ning Control and Prevention C capillary CEN standard 227 – leakage 419 Centers for Disease Control CAA, see Civil Aviation Au- – refill time (CRT) 542 and Prevention (CDC) 41, thority capnometry 441 146, 161, 278, 312, 379 caisson disease 606 capsizing 72, 267 central calcium car – nervous system injury – entry blockers 457 – falling into water 238 446 – homeostasis 454 – technology 239 – venous catheter 414 Calcoen, Abraham 3 carbon dioxide effect 593 – venous pressure 424 California 104, 276 carboxyhaemoglobin 608 cephalosporin 419 caloric deficit 502 cardiac cerebral calpain 460 – arrest 323, 328, 331, 332, – anoxia 612 campaign to prevent drown- 404, 445, 601 – hypothermia 445 ing 119, 120, 124 – – hypothermic 396 – oedema 406, 444, 518 – Canada 118 – output 360, 413, 414, – oximetry 450 – UK 119, 130 424, 428 Cerebral Performance Cat- – Safewaters 120–121 – sudden death 323 egories (CPC) 383 – Ireland 122–123 cardiopulmonary certification 302 – Swim and survive 124– – bypass (CPB) 366, 399, cervical 125 404, 440, 483 – spine injury 259, 359, – Safesummer 124–125 – cerebral resuscitation 369 – Riversafe 124–125 (CPCR) 436, 461–467 – stabilisation collar 294 – New Zealand 124–125 – – phases 461 – trauma 259 – Spain 125–126 – resuscitation (CPR) 302, chain of survival 331, 335 – Blue ribbon pool 125– 323, 325, 435, 365 – in drowning 347 126 – – bystander 326 checks and balance 149 – The reasons people – – emergency response chest drown 126–127 model 304 – compression 316, 324, – The Netherlands 128– – – lay persons 326 329, 330, 359 129 – – one rescuer 329 – rise 328 – Float Coats 129–130 – – provider 317 – röntgenogram 325 – Alaska 129–130 – – research 302 – wall elastance 413 – Australia 120–124, – – skill acquisition 302 – X-ray 398, 405, 430 131–132 – – two rescuer 329 child abuse 51, 102 – Be Water Wise 128 cardio-respiratory system children 99, 105, 114, 121, 324, – Enjoy Your Swim, Sure! 234 356–362, 404 125 cardiovascular – body size 320 – Keep Watch 130 – change 423–427 – outcome 360 – Kids Don’t Float 129–130 – disease 607 – safety week 119 – Play It Safe by the Water – fitness 300 – susceptibility to tem- 131 cardioverter defibrillator perature extremes 320 – Stay on Top 127 – implanted 319 Chilean Lifeboat Service 224 – The Kids Alive - Do the – internal 354 chin lift 328 Five program 121 Carlot-class 12 Chinese community 121 Canada 72, 73, 207, 212, 222 Carribean 186 chloroform 20 Canadian Coast Guard 117 CASP, see Computer Assisted Chromobacterium violaceum Canadian Lifesaving Society Search Planning 417, 418 117, 207 casualty 283, 284 circadian rhythm 217, 219 700 Subject Index circle of Willis 610 complication CPR, see cardiopulmonary circulating – circulation 400 resuscitation – blood volume 409 – infectious 405 craft design 273 – warm water mattress – neurological 406, 428 C-reactive protein 453 508 – pulmonary 394, 395, crew training 286 circulatory centralisation 242 399, 405, 416 cricothyroid membrane pres- circum rescue collapse 242, compressed-air diving 595 sure 346 542 compression 329 crisis management 553 CISD, see Critical Incident – barotrauma 592 critical Stress Debriefing compression-ventilation ratio – closing pressure 413 City of Houston 324 329 – incident stress debrief- Civil Aviation Authority (CAA) computed tomography (CT) ing (CISD) 307 227 411 crotch strap 228 classification Computer Assisted Search cruise ship 221 – of drowning incident Planning (CASP) 222 crystalloid 517 394 computer simulation 163–165 CT, see Computed Tomo- – of the severity of drown- computer-based program graphy ing 391 167 Cullen, William 17 – system 51, 427–432 computerised model 273 current 153, 621 climatic condition 66 conceptualisation 302 cytokine 460 clostridium spp. 418 conscious 338, 489 coagulopathy 357, 403, 464 consensus process 45, coast guard 222, 280 315–323 D Coastal Safety Auditing Pro- consumer gram 156 – group 117 Daan Goedkoop’s Amsterdam coding practice 60 – safety institute 128 Kromhout shipyard 10 cold, exposure to 250 contaminated water 403, 636 Dalton’s law 592 cold shock 228, 233, 234, 250 continuing education effort DALY, see disability adjusted – response 486 109 life years cold water immersion 232 continuous positive airway DAN, see Divers Alert Net- collection system 171 pressure (CPAP) 349, 393, work collision 550 412, 416, 424, 440 dangerous activity 110 colloid solution 519 controlled environment 113 data colour blindness 213 convective warm air device – collection 170, 171, 324, coma 398 373 325 combitube 525 cooling 242 – – purpose 169 Comitê Latino-America de – brain 448, 465 – registration 169, 171, 172 Ressuscitacao 379 – deep tissue 488 DCS, see Decision Support commercial – foetal head 448 System or Dutch Continen- – diving 73, 605 – limb 489 tal Shelf – fishing 73 – lung 486 de Booy, H. 10 communication 225 – muscle 234, 487 de Clerq, Jacob 3 community – nerve 487 de Fabrica Humana Corporis – aboriginal 123 – skin 486 16 – campaign 121, 123 cooperation 186 de Vreede 6 – Chinese 121 coping strategy 304 dead bodies 620 – European 176 corticosteroid 399, 409, 419, Dead Sea 368 – indigenous 42 456 death 395, 511 – latino 128 counselling service 307 – rate 50 community campaign 121, CPAP, see Continuous Positive – mechanisme 50 123 Airway Pressure deceleration competency 158, 166 CPB, see cardiopulmonary – injury 273 competitive swimmer 289 bypass – trauma 258 compliance check 109 CPC, see Cerebral Perfor- Decision Support System mance Categories (DCS) 548 Subject Index 701 decision-making 361, 364 – underwater emergen- – silent 380 deckchair position 248 cies 600 – site 100 decompression illness 604, – velocity 289 – wet 47, 380 606, 610 DLRG, see German Life Saving – with aspiration 47 deep tissue cooling 488 Society – without aspiration 47 defibrillation 323, 332, 396 dobutamine 360 drownproofing 115, 116 definition 26, 45, 379 dog 625 dry suit 230 – drowning 87 Donateur 271 Duke of Northumberland – swimming ability 112 Dorus Rijkers 8, 9 Award 7 – sea rescue 220 drainage 337 Dutch Coastguard 554 Deltaworks 553 draining water 336 Dutch Continental Shelf (DCS) demographic information drift 222 554 321 driver Dutch Deltaworks 572 Denmark 60, 227 – inexperience 273 Dutch Transportation Safety design 104 – license 326 Board 239 – change 85 drowning dying process 315 – difference 208 – accidental 51 – factor 208 – active 380 development model 187 – causes E dextran 40 460 – detection 218 DiaboloVR 167 – dry 47, 380 EAA, see Excitatory Amino diatom analysis 613 – epilepsy 101 Acid dike 566 – estimation of time of EAN, see Enriched Air Nitrox diphenylhydantoin 458 death 637 early disability adjusted life years – investigations 642 – access 331 (DALY) 42 – flood 562, 568 – Advanced Life Support disaster – homocide 51, 62, 102, (ALS) 332 – at sea 540 633 – Basic Life Support (BLS) – management 555 – location 331 – plans 573 – – bathtub 100–102 – defibrillation 331 discharge 261 – – bucket 102 ebb 203 – criteria 394 – – garden pond 119 ECMO, see Extra Corporal distraction 215 – – home 100, 101 Membrane Oxygenation distress, signs of 147 – – pail 102 E-Code 51 diuresis 495 – – swimming pool, 101, ECOSA, see European Con- Divers Alert Network (DAN) 102 sumer Safety Association 25, 30 – – washing machine 100 eco-system 623 diving 589 – occupational 73 ECSA, see European Child – breath-hold 589–595 – paediatrics 47, 320 Safety Alliance – drowning accidents 598, – passive 380 education 104, 178, 208, 227, 600 – prevention 104, 112 228 – equipment 600 – – bathtub 99 – continuing effort 109 – fatality – – buckets 99 – level 65, 88 – – long QT syndrome 354 – – campaign 117 – minimum duration 177 – mechanical trauma 606 – – fish ponds 99 – post-graduate 179 – mental fitness 597 – – garden pond 119 – program 126, 204 – military 589, 605 – – home 99 EEG, see electroencephalo- – mixed-gas 596 – – ornamental pools 99 gram – partner (buddy) 597 – – pails 99 EEZ, see Exclusive Economical – physical fitness 597 – – swimming pools 99, Zone – physiology 591 101 effectiveness 106 – reflex 403, 425, 486 – process 214, 215, 407 Egypt 61 – risk-benefit analysis 600 – prospective, population- Elam, J.O. 20 – skills 290 based study 320 elastance of the respiratory – secondary 380 system 414 702 Subject Index electrical power 239 European Network of Sport Faculty of Physical Education electroencephalogram (EEG) Science, Education and and Physiotherapy of the 450, 451 Employment (ENSSEE) 176 University of Leuven 180 electrolyte 427 European Resuscitation fall velocity 153 electronic Council (ERC) 31, 312, 315, fatality rate 97 – chart 224 316, 379 Federal Aviation Administra- – safety system 240 European Union 205 tion (FAA) 227 – system failure 239 evacuation 231, 278, 541 fencing 102, 106, 108 emergency evaluation 106, 117 FER, see fluid extravasation – department 367, 382 EVLW, see extravascular lung rate – – management 441 water ferryboat 67 – mass 575 evoked potential 450 FESSGA, see Lifesaving Fed- – medical system (EMS) exam 300 eration in Galicia 327, 440 excitatory amino acid (EAA) Feyenoord shipyard 9 – – response 325 457 fiberoptic – position indicating radio Exclusive Economical Zone – bronchoscopy 415 beacon (EPIRB) 224 (EEZ) 554 – catheter 451 – room 392 exercise 217 film emotional response 302, 303 expanding square search 222 – footage of drowning 126 EMS, see emergency medical experience 177, 306 – industry project 278 system experiment fire service 149 Enriched Air Nitrox (EAN) 595 – dogs 423 firefighter 116, 148 ENSSEE, see European Net- – surfactant 421, 423 first aid 103, 315 work of Sport Science, Edu- expert meeting 305 – course 342–347 cation and Employment – first aid course 342 First World War 227 environment 284, 369 – lifesaver effectiveness fishermen 74 – controlled 113 146 fishing trip 62 – local 300 – lifesaving in developing fitness level 301 – measure 117 countries 185 flag 204 – risk factor 65 – physical and psychologi- – beach safety 210 epidemiological data 54 cal acute stress reaction – black-white (quartered) epidemiology 357 304 209 epilepsy 102, 447, 451 – psychological care after – green 209 EPIRB, see Emergency Posi- CPR and rescue 305 – red 209 tion Indicating Radio – rescue organisation 143 – red-yellow 209 Beacon – Utstein-style consensus – yellow 209 ERC, see European Resuscita- conference 379 flamingo pond 417 tion Council – water safety sign and flash flood 559 ergonomics 102–104, 231, 232 flag 208 fleet plan 549, 551 escape 240, 258 exposure 64, 94 flip-over 277 Escherichia coli 418 – to cold 250 float coat project 129, 130 ESS, see Segovian Lifesaving extended arm grip 296 flood 558, 562 School extra corporal membrane – average mortality 560 Europe 224 oxygenation (ECMO) 400, – Bangladesh 160 European Child Safety Alli- 441, 512 – Central America 160 ance (ECSA) 129 extraction 291 – debris 278 European Community 176 extravascular lung water – defences 567, 568 European Consumer Safety (EVLW) 517 – drowning 562, 568 Association (ECOSA) 25 – fatality 161 European Lifeguard Academy – flash 559 of Greece 178 F – forecast 565 European Master’s Degree in – guidelines 579 Swimming 180 FAA, see Federal Aviation – hazards 559 Administration – hurricane-induced 160 – North Carolina 161 Subject Index 703

– India 160 – pressure 592 Haemophilus influenzae 417, – preparation 538 – solubility 592 418 – rescue training 581 – volume 592 Hall technique 19 – safety chain 570 gastric handbook on drowning pre- – statistics 560 – distension 443 vention, rescue and treat- – worldwide 161 – inflation 328 ment 24 Florida 262, 417 – lavage 404 Harder 269 flotation 227 – overdistension 404 Hawaii 157, 277 – device 67, 228, 251 GCS, see Glasgow Coma Score hazard 91, 94, 114, 301 fluid gender 63 – beach 152 – amount 368 geographic planning 150 – identification 84 – balance 492 German Life Saving Society – situation 89 – extravasation rate 516, (DLRG) 184 – toxic 263 517 Germany 143, 227 head-up position 339 – infusion 507 Gesellschaft zur Rettung health – replacement 425, 426 Ertrunkener 4 – behaviour 97 – repletion 426 Glasgow Coma Score (GCS) – status 416 – resuscitation 518 361, 366, 382, 383, 398 healthcare provider 361 – shift 425 Glasgow-Pittsburgh Cerebral Heart and Stroke Foundation – type 368 Performance Category of Canada 379 – warm 510 (CPC) 383 heat escape lessening pos- focus group 128 Global Burden of Disease ture (HELP) 237 foetal head cooling 448 Study 45 heat loss 234 Foley catheter 441 Global Maritime Distress and heated aerosol 509 foot Safety System (GMDSS) heat-shock protein 455 – entrapment 161 200, 224 Heimlich manoeuvre 316, – injury 300 Global Positioning System 327, 337, 359, 440, 601 forced air surface rewarming (GPS) 624, 629 helicopter 162 399, 508 glucose 436 helium 596, 606 forebrain ischaemia 463 glutamate receptor antago- HELP, see heat escape lessen- foreign-body airway obstruc- nist 457 ing posture tion 330 GMDSS, see Global Maritime Henry’s law 592 forensic 102 Distress and Safety System heparinisation 460, 512 Fothergrill 18 golden hour 364 hepatitis A/B 300 Foundation Drowning 2002 GPS, see Global Positioning Herald of Free Enterprise 546 24 System high-income country 84, 185 fracture 273 graphical symbol 205, 212 Hillary, William 5, 14 France 227 Great Britain 157 histidine 520 Francisella philoniragia 418 Greece 64, 178 history Frederik, Johannes 269 Groenlandse sloepen 6 – lifeboat development free radical scavenger 459 Gross Domestic product 64 266 freshwater 403, 408, 416, 419, guard auxiliary 224 – rescue 223 424, 428 guideline 329 – resuscitation 14 – flood 562 – for Safe Pool Operation 290 home drowning 101 froth 639 guilt 302, 305 – prevention 104 fund-raising 141, 143, 184, 186 homeotherm 481 fungi 418 homicide 61, 62, 102, 633 H hospital 430 – admission 402 G H+ ions 519 – course 382 haematocrit 515 – discharge 325 garden 104, 119 haemoconcentration 515 – rewarming 502 gas haemodilution 460 – treatment 389 – inert 606, 610 haemoglobin, free 369 hospitalisation 430 – law 592 Houston 324 704 Subject Index hovercraft 162, 280–285 ICAO, see International Civil – injuries 273 – cleaning 283 Aviation Organisation – mathematical model – environmental impact ICD, see International Classifi- 275 283 cation of Diseases – rescue 274 – injuries 283 ice rescue information processing 303 – operational require- – approach 251 infrared ments 280 – bystander 250 – camera 632 – terrain limitations 282 – equipment 251 – – hand-held 632 human – guidelines 249 – – mounted 632 – factor 88 – international standardi- – detection system 630, – judgement 93 sation 254 631 – scent-tracking dog 625 – preparation 249 inhalation 393, 428 Humane Society for the – professional 251 injury 273, 301 Recovery of Persons – rescue technique 252 – acceleration 256 Apparently Dead by – self-rescue 250 – central nervous system Drowning 4 – standard 253 446 hydrodynamic 153 – techniques 249 – competition-related 299 hydrostatic – training 251 – exposure 298 – assistance 242 – transport device 252 – foot 298 – pressure 339 ice water submersion 357, – hovercraft 283 hydroxyethyl 516 370 – infectious disease 298 hypercapnia 360, 594 ICP, see intracranial pressure – IRB-related 273, 274, 299 – permissive 405, 415, 438, ICS, see Incident Command – joint 298 450 System – lifeguard calf 298 hyperglycaemia 437, 444 ILCOR, see International Liai- – penetrating 259 hypertension 466 son Committee on Resus- – prevention 300 hyperthermia 404, 437 citation – rate 50 hyperventilation 360, 594 ILF, see International Lifeboat – rowing 298 hypervolaemia 443 Federation – running 298 hypoglycaemia 445 ILS, see International Life Sav- – swimmer’s shoulder 298 hypotension 339 ing Federation inotropic support 360 hypothermia 233, 234, 242, imidazole 520 inspection 103 260, 268, 320, 349, 364, immersion 233, 242, 481 inspiratory 367, 370, 399, 403, 426, 436, – suit 74, 230 – pressure 422 445, 465 immobilisation 258, 291, 295 – resistance 328 – ice rescue 250 IMO, see International Mari- – threshold device 316, – immersion 484 time Organisation 330 – induced 447 incapacitation phase 233 – time 328 – mild 318, 442 Incident Command System insulation 230, 499, 504 – prevention 484 (ICS) 162, 220, 226 insulin 442 – therapeutic 319, 348, Independent Victim Positive insurance 175, 273 360 Buoyancy (IVPB) 252 intensive care management hypovolaemic shock 443 indigenous community 42 446 hypoxaemia 319, 327, 360, infanticide 100, 102 interference 89 392, 399, 423, 443, 525, infectious interleukins 453 601, 612 – agent 300 International Aeronautical hypoxia 319, 424, 445, 593, – complication 399 and Maritime Search and 596 inflammatory mediator 416, Rescue Manual (IAMSAR) hypoxic-ischemic injury 357 417 199, 220, 221, 226 inflatable rescue boat (IRB) – search 224 299, 272–276 International Civil Aviation I – biomechanical study Organisation (ICAO) 220 273 IAMSAR, see International – competition 273 Aeronatical – gemini 275 Subject Index 705

International Classification of intratracheal administration Kite, Charles 18 Diseases 43, 50, 51 of surfactant 417 Klebsiella spp. 418 – 10th Revision (ICD) 50, intravascular KNRM, see Koninklijke 51 – bubbles 611 Nederlandse Redding – codes for drowning 51 – gas 611 Maatschappij – Supplementary Classifi- – volume 423 Koninklijke Nederlandse Red- cation of External Causes intravenous medication 348 ding Maatschappij 5–14, of Injury and Poisoning intrusion 215 224, 265–267, 269, 270 (E-Code) 51 intubation 19, 348, 398 KSC, see Kennedy Space International Collaborative invasive (advanced) life sup- Center Effort (ICE) on Injury Sta- port 318 tistic 59 investigation post mortem International Federation of 102 L Red Cross and Red Crescent in-water Society 25 – communication 624 laboratory finding 366 International Liaison Com- – life support 342 lack of oxygen 593 mittee on Resuscitation – technique 294 laminated glass 239 (ILCOR) 312, 315–318, 320, IRB, see inflatable rescue boat lamotrigine 458 322, 323, 340, 379 IRCRC, see International Red laryngospasm 327, 403, 404, International Life Saving Cross and Red Crescent 407 Federation (ILS) 25, 31, 56, Ireland 74, 122 lateral position 318, 341 86, 158, 160, 176, 186, 194, Irish Water Safety (IWS) 122 latino community 128 199, 208, 210, 312, 334 iron lung 19 lavage 416 – development commis- ISO, see International Standar- law sion 186 disation Organisation – criminal 173 – education commission iso-electric ST segment 353 – rescue instructors 173 176, 210 Israel 59 lay – medical commission 333 IVPB, see Independent Victim – person 315, 345 – rescue commission 210 Positive Buoyancy – – role of 323–326 International Lifeboat Federa- IWS, see Irish Water Safety – public 330 tion (ILF) 25, 86 – rescuer 329 international lifejacket stan- learning dard 227 J – computer simulations International Maritime Or- 163 ganisation (IMO) 25, 31, J wave 425 – mastery 164 86, 200, 220, 224, 225, 227, Japan 65 legal 230, 550 Jason’s cradle 244, 245 – advice 175 International Red Cross and Javazee 12 – liability 173 Red Crescent (IRCRC) 86 jaw thrust 293, 328, 439 Legionella species 418 International Standardisation Jean Jacques Leroy d’Etioles legislation 102, 104, 556 Organisation (ISO) 205, 19 level of education 65 211, 230 jet boat 285–287 lidocaine 459 – standard for testing jugular bulb oximeter 450, lidoflazine 457 safety signs 212 451 life interstitial perivascular space jurisdictional zone 554 – hammer 241 413 – vest 128 intervention program 106, – lifebuoy 248 290 K lifeboat 5, 6 intracranial hypertension 466 – boattype 266 intracranial pressure (ICP) Kennedy Space Center (KSC) – history 266 328, 414, 415, 518 262 – open 246 – monitoring 450 Kenya 61 – self-righting 8, 266 intrapulmonary shunt 408, kerosene 368 lifeguard 110, 111, 145 424 ketamine 457 – effectiveness 146 kinetic energy 259 706 Subject Index

– fatigue 110 location microvascular fluid exchange – scanning 214 – domestic swimming 514 – self-report 110 pools 105 middle-income country 185 – vigilance 111 – home pools 105 Ministry – working as team 111 lock – of Health, Welfare and lifejacket 226–235, 541 – hands 290 Sport 30 – inflatable 227 – head 290 – of Interior and Kingdom – international standard long QT syndrome (LQTS) Relation 30 227 319, 352–355, 359, 443 – of Transport 30 – legislation 227 – diving fatalities 354 Mitropoulos 225 – price 228 – swimming 353 MOB, see man-overboard – requirements 228 Lord Shaftesbury 104 monitoring 424 – self-righting 227 low-income country 42, 55, morphodynamic 154 lifesaver 70, 136 86, 185 mortality 430 – competence 151, 159 lubeluzole 458 motor skills 113, 114, 279 – curriculum 188 lung 487 mouth-to-mouth technique – effectiveness report 146 – cooling 486 18 – injuries 297 – dependent regions 413 muscle cooling 234, 487 – minimum competencies – injury 601 myocardial 158 – lavage model 411 – irritability 425 – minimum requirements – oedema fluid 640 – ischaemia 607 159, 174 – overdistension 414 – paid 144 – protective strategy 400 – professional 147 – recruitment 411–414 N – protection 147 – skills 151, 159 NASA, see National Aeronau- – surveillance 214 M tics and Space Administra- – training 215 tion – vocational standards Maatschappij tot Redding van – ocean rescue plan 261– 159 Drenkelingen 3, 18, 22, 379 265 – volunteers 133, 144, 154 Madrid 179 nasogastric tube 441 lifesaving magnesium 457 National Aeronautics and – academic career 176 man-overboard (MOB) 72 Space Administration – appliance 230, 231 mannequin 302 (NASA) 261 – competition 299 marine organism 623 National Association of EMS – developing countries maritime Physicians 312 185 – accident investigation National Institutes of Health – fund-raising 183 653 312 – mental health 307 – safety 573 National Safety Council 126 – organisation 307 marketing 183 national surveillance data- – psychological aspects Markus Lifenet 244, 245 base 118 306, 308 Mary of Burgundy 3 near death experience 307 – quality assessment 148 mechanical ventilation 405, near infrared spectroscopy – risk monitoring 148 410, 411, 419 (NIRS) 450, 451 – service 149 medallion, bronze 275 near-drowning – station 150 media – with aspiration 47 Lifesaving Federation in – campaign 103 – without aspiration 47 Galicia (FESSGA) 178 – management 574 near-shore water 622 lifevest 127 mental neck stabilisation 294 limb – skills 297 negligence 173 – cooling 489 – stress 307 neonaticide 100, 102 – muscle 498 metabolic acidosis 392 Netherlands 128, 239, 402 liquid aspiration 47 methylprednisolone 456 neurologic local anaesthetics 459 Mexico 58 – evaluation 412 local environment 300 micro-organism 417, 418 – prognosis 403 Subject Index 707 neuromonitoring 450, 466 OPC, see Overall Performance penetrating injury 259 neuron-specific enolase 454 Category pentobarbital 456 neuroprotection 360 open water Peptostreptococcus 418 – therapy 350 – drowning 113 PER, see passive external neuroresuscitation 436 – search technique 199 rewarming neurotoxicity 593 oral airway device 328 percutaneous cannulation neurotrauma 259 organisation 512 New South Wales (NSW) 108, – paid 143 performance 282 120 – volunteers 143 – in-water 231 – Water Safety Taskforce Osborne wave 425 perinatal asphyxia 448 120 OSC, see on-scene coordina- peritoneal New Zealand 59, 70, 72, 101, tor – dialysis 404 124, 157, 207, 210, 277 outcome 89, 358, 372, 382, – irrigation 510 nicaraven 459 383 permissive hypercapnia 415 Nielson, Holger 19 – children 360 personal night vision 224 – predictor 360 – flotation device (PFD) nimodipine 457 – scale 383 71, 74, 129, 161, 227, 228, nitric oxide 400 – variables 363 234, 236 – synthase (NOS) inhibitor Overall Performance Category – lifeboat 230 460 (OPC) 383 – lifesaving appliance 229 nitrogen 606 oxygen 316, 327, 333, 392, – locator beacon (PLB) – narcosis 593, 594 413, 449, 601 224 nitro-glycerine 508 – neurotoxicity 595 – protective equipment nitrox 595 – reserve 357 161 N-methyl-D-aspartate – therapy 346 – watercraft (PWC) 199, (NMDA) 457 – toxicity 593, 607 200, 276–279 non-expert 95 – – designs 277 non-invasive positive pres- – – injuries 278 sure ventilation (NPPV) 412 P – – rescue sled (RC) 277 non-profit organisation 183 PFD, see personal flotation non-shockable rhythm 332 paediatric 372 divice noradrenaline 494 – consideration 320, phrenic nerve stimulator 316 normoglycaemia 445 356–362 pH-stat 519 Northern Ireland 280 – drowning 320, 447 – strategy 520 Norway 229 – mortality score 442 pH-value 373 Norwegian Maritime Director- – population 324 physical ate 30 paid lifesaver 144 – environment 88 NPPV, see non-invasive posi- pail 104 – separation 85 tive pressure ventilation panic 113 – skill 114, 297 NSW, see New South Wales Papua New Guinea 58 PICCO system 400, 518 paraglider 287–288 plane crash 254 parental supervision 68 plasma O parents 110 – catecholamine level 486 passenger ship module 549 – protein 506 observation passive external rewarming – volume 514 – of lifeguard 110 499, 504 PLB, see personal locator – platform 300 pathophysiology 319, 411 beacon occupational drowning 73 – children 357 pneumonia 636 ocean rescue plan 264 peak inspiratory pressure 422 – denominator 417 oesophageal thermal probe Peake, James 7 – nosocomial 417 (OTP) 510 Pediatric Cerebral Perfor- – risk factors 416–419 offshore powerboat 256–261 mance Category Scale 383 pneumopericardium 610 on-scene coordinator (OSC) PEEP, see Positive End-Expira- pneumothorax 19, 638 222 tory Pressure polder model 553 Pellew-Plenty, James 7 poliomyelitis 19 708 Subject Index polypropylene line 629 prelaunch landing contin- – response during admin- pond 104, 119 gency 263 istration of CPR 302–305 – safer 119 preparedness 148, 150 psychomotor practice 302 pool 358 pre-rescue collapse 494 psychosocial aspect 361, 371 – blue ribbon 125 preschool kit 128 PTSD, see Post-Traumatic – drowning 108 pressure 606 Stress Disorder – – rate 107 – partial 592 PTSS, see Post-Traumatic – fencing 97, 109 – peak inspiratory 442 Stress Syndrome – owner 68, 106, 121 – transpulmonary 413, 414 public – swimming prevention 77, 82, 136, 148, – area 332 – – fencing 66 150, 185, 186, 194, 198, 214, – awareness 106 – – regulation 106 358, 378, 402, 573 – education 104, 320 population 50 – education level – health 315 – at risk 325 – – basic 343 – information 204 – during resuscitation 337 – – advanced 343 – – symbol 208, 212 – near-horizontal 337 – home drowning 104 – safety 147, 581 – parallel to the shore 340 – program 84, 117, 118 Public Work and Water Man- – vertical 242 – – see, campaign agement 30 position – routes 89–91 pulling boat 266 – during recovery 337 – secondary 103, 104 pulmonary – head down 337 preventive action 170 – artery pressure 424 – head-up 337 priming solution 516 – barotrauma 594, 607 – horizontal 242 Prins Hendrik Fond 30 – oedema 444, 601, 639 – in-water 338 prioritisation system 545 – surfactant 408, 411 – on-land 338 pro-action 148, 150, 571 pulse check 329 – recovery to on-land 338 procaine 459 pulse oximetry 441, 601 – drowning victim 318, process management 35 pulseless 325 335–341 profession 217 PWC, see personal watercraft Positive End-Expiratory Pres- prognosis 363, 406 pyramid-shaped wave 204 sure (PEEP) 349, 398, 399, program 414, 424, 440 – for collaboration 86 – right level 413 – intervention 106, 290 Q Post-Traumatic Stress prohibition sign 212 – disorder (PTSD) 306 project QALYS, see quality-adjusted – syndrome (PTSS) 151, – coordinator 27 life years 306 – management 35 QIMR, see Queensland Insti- post-anoxic brain injury 502 prone position 414, 444 tute of Medical Research post-incident management Propionibacterium spp. 418 QRS complex 425 547 propofol 456 QT prolongation (long QT post-ischaemic-anoxic en- prostacyclin 400 syndrome) 50, 352 cephalopathy 462 protective gear 161, 230 quadriplegia 292 post-rescue collapse 496 protocol 397, 398 quality-adjusted life years post-resuscitation phase 360 Pseudoallescheria boydii 417, (QALYS) 52 potassium 373, 424 418 Queensland 106, 108, 121 practical Pseudomonas spp. 418 – drowning figure 109 – advice 241 psychological – Institute of Medical – skills 151 – care Research (QIMR) 273 practice 109 – – after CPR and rescue pre-arrest phase 358 305–308 pre-assignment physical – – needs 306 R exam 300 – – risks 306 precipitation forecast 565 – – team approach 306 radiant heating 508 predictor 52 – distance 306 radio direction finding (RDF) prehospital management – interpretation 304 222 430, 439, 499 Subject Index 709 ratio – ice 249–253 – termination 320, 363– – child-to-adult 64 – information 171 368 – male-to-female 369 – instructor 174, 175 re-telling 324 RCC, see rescue co-ordination – lifting system (RLS) 245, retention 163, 167 centre 246 retrieval 163, 167 RDF, see radio direction find- – – type B 247 return of spontaneous circula- ing – – type H 247 tion (ROSC) 502 Reaumor 17 – – type L 248 rewarming 465, 497 rebreathers 596 – offshore powerboat 256 – cardiocirculatory arrest recommendation 23, 86, 116, – organisation 143, 223 399 138–142, 157, 186, 197–201, – procedure 252 – collapse 498 214, 218, 226, 229, 314, 330, – self 232–239, 346 – prehospital 497 349, 350, 361, 367, 391 – – capacity 233 – rate 373, 426 recovery 148, 151 – – technique 114 – shock 506 – horizontal 268 – – training 540 – strategy 504 – net 268 – simulation 164 – techniques 426 – position 318, 340 – skill training 279 – warm water bath 509 recreational – submerged vehicles rigid inflatable boat (RIB) 12, – boating 66, 221 239–241 265–272 – swimmer 289 – task force 138, 198 – Arie Visser class 267 recruitment 151, 415 – technique 142, 242–249, – bridge resource man- – manoeuvre 413, 417 342, 343 agement (BRM) 270 rectal fumigator 21 – – in-water 157 – casualties 268, 269 Red Cross 186 – tip 343 – endurance 269 Reddingsbrigades Nederland – unusual circumstances – exploitation 267 30 321 – Johannes Frederik class reflex apnoea 403 rescuer 136, 253 267 regulation 74 – inexperienced 304 – navigation 270 – data 169 research 109, 177, 303, 315, – personnel 270 regulatory requirement 108 316, 318, 362, 378 – recovery of drowned regurgitation 408, 409 respiration 392 persons 268 relative tide range (RTR) 153 respiratory – Valentijn class 267 reliability 171 – arrest 324 rigour mortis 361 reporting system 315, 377 – complication 405 riluzole 458 rescue 89, 226 response 148, 151 Ringer solution 510, 516 – assisted 600 – instinctive 214 Rio de Janeiro Drowning – breathing 295, 324, 327, responsibility 302 Resuscitation Centre 376 328, 337, 339 resuscitation (see also CPR) rip current 154, 237 – capacity 551 71, 103, 268, 370, 396, 399, risk – collapse 242, 493, 494, 449 – assessment 84, 93 511, 542 – Council of the United – – beaches 156 – co-ordination centre Kingdom 174 – – by non-expert 96 (RCC) 222 – Councils of Southern – – by expert 96 – death 485, 511 Africa 379 – beaches 139 – definition 170 – first responder 302 – conceptualisation 98 – details 171 – fluid 518 – controllability 96 – diver 240, 257, 258 – in the water 337 – definition 94 – document 525 – length of 361 – drowning 94 – equipment 252, 333 – low-flow phase 358 – factor 63, 297 – – basic 162 – no-flow phase 358 – – behavioral 67 – flood 140 – on-land 340 – management 223 – – training 581 – post-resuscitation phase – – monitoring 148 – historical data 223 358 – – program 174, 175 – horizontal technique – pre-arrest phase 358 – perception 93, 95 242, 243 – – by parents 97 710 Subject Index

– severity of 96 safety 104, 114, 256 sea – sociodemographic – certification 241 – rescue 224 factor 63 – chain 148, 149, 152, 575 – – definition 220 river – – for lifesavers 149 – scan 199 – flood 559 – colour 212 – state 245 – rescue program 583 – cover 106 search 226 riversafe 124 – definition 99 – at sea 214–219 RLS, see rescue lifting system – equipment 67 – dog 625 245, 246 – legislation 103 – expanding square 222 RLSS, see Royal Life Saving – measure 106 – open water 199 Society – policy 67 – pattern 222 RNLI, Royal National Lifeboat – sign 204 – plan 222 Institution – – national 206 – technique 199, 220, 625 roadmap 195 Safety of Life at Sea Commit- Search and Rescue (SAR) RoSPA, see Royal Society tee (SOLAS) 224, 227 – organisation 220, 548 Prevention of Accident Safe Waters 120, 121 – information module 549 Rotgans 8 saltwater 403 – equipment 243 Rotterdamsch Welvaren San Diego Lifeguard Service – fleet plan 549 Shipyard 8 298 – manual 220 rower 7 SAR, see Search and Rescue – operation 280 Royal Dutch Lifesaving As- SARIS, see Search and Rescue – SARPC 222 sociation, see Reddingsbri- Information System Search and Rescue Informa- gades Nederland SARRRAH project, see Search tion System (SARIS) 222 Royal Humane Society 18 and Rescue, Resuscitation Search and Rescue, Resusci- Royal Life Saving Society and Rewarming in Acciden- tation and Rewarming in (RLSS) tal Hypothermia Accidental Hypothermia – Australia 123, 130, 290 SART, see Search and Rescue (SARRRAH) 524 – Canada 111 Transponder Search and Rescue Transpon- – UK 119, 186, 312 scanning 214–219 der (SART) 224 Royal National Lifeboat Insti- – deficiencies 110 sea-to-shore communication tution (RNLI) 5, 157, 265, – length of time 110, 623 280 215–217 seawater 408, 416, 419, 423, – Operational Require- – patron 10/20 215 424, 428 ment 280 – patron 30/120 216 security 221 Royal Netherlands Navy 27 – physical positioning 111 sediment 152 Royal Netherlands Sea Rescue – process 217 Segovia Lifesaving School Institute, see Koninklijke – scientific basis 219 (ESS) 125, 178 Nederlandse Redding – station 216 seismic activity 203 Maatschappij – strategy, five minutes seizure 447 Royal Society for Rescue and 216 self-contained underwater First Aid in Accidents (the – sweeping 217 breathing apparatus Orange Cross) 21 – swimming area 110 (SCUBA) 590, 595 Royal Society Prevention of – technique 218 – diving 319, 354 Accident (RoSPA) 119 – towfish altitude 629 – regulator 439 RTR, see relative tide range – visual 216 self-reliance 240 rubber duck 272–276 scene information 381 self-rescue 232–239, 346 rural setting 360 scientific – capacity 233 Russia 56, 58 – basis 323 – ice 250 Ruys, Willem 9 – evidence 106 – technique 114 scoop-and-run 373 – training 540 scoring system 406 self-righting lifeboat 8, 266 S SCUBA, see self-contained Sellick manoeuvre (cricothy- underwater breathing roid membrane pressure) S-100B 454 apparatus 346 safe diving skills 289 Subject Index 711

Sengstaken-Blackmore tube Society to Rescue People – international training 510 from Drowning, see 160 severity Maatschappij tot Redding – lifejacket 227 – of injury 52 van Drenkelingen – nomenclature 378 – scale 346 sociodemographic 63 Staphylococcus aureus 418 sheltering death 511 socioeconomic 64, 65 statistic 169 shipping data 549 sodium stay-and-play 373 shipping density 552 – bicarbonate 441 stopperblock 247 shipwreck 540, 542 – channel blocker 458 storm 565 shipyard SOLAS, see Safety of Life at strap design 275 – Daan Goedkoop’s Sea Committee strategic planning 177 Amsterdam Kromhout somatosensory evoked stratification 321 10 potential (SSEP) 452 Streptococcus pneumoniae – Feyenoord 9 South Africa 62, 101 417, 418 – Rotterdamsch Welvaren space Streptococcus spp. 418 8 – shuttle 261–265 stress 302, 361 shoreline 318 – transportation system – inoculation 302 side scan sonar 627, 629 (STS) 262 – management 302 sign Spain 125, 178, 180 – negative consequences – circulation 327 speed 392 304 – fire safety 205, 207 spinal stretcher 258, 268 – mandatory 205, 207 – injury 126, 338 struggle 366 – prohibition 205, 212 – – awareness 289 STS, see space transportation – safe condition 205, 207 – – body hug 295 system – warning 205 – – circumstances 292 student 174 signage 111, 290 – – epidemiology 292 submerged vehicle 239–241 simulation – – extended arm grip 295 submersion 327, 487 – cockpit 257 – – extrication 201, 289 – icy water 370 – computer 164 – – immobilisation 289, – time 502 – program 293 subsidy 5 – – diaboloVR 165 – – incidence 289 sudden cardiac death 323 – – learn first aid fast 165 – – presentation 294, 296 suffocation 47 – – wet’n wise 165 – – prevention 289 suicide 51, 55, 366 Singapore 173 – – recognition 293 sunburn 300 sinking loop 248 – – standing backboard superoxide dismutase (SOD) SIRS, see Systemic Inflamma- technique 294 459 tory Response – – treatment 292, 293 supervision 92, 177, 358, 370 skeletal maturity 275 – – vice-grip 294 – adult 84 skill 167, 326 – precaution 318 – parental 68 – acquisition 302 – stabilisation equipment surf 277 – motor 114 296 – pattern 202 – cognitive 114 splash 129 – zone process 153 – diving 290 splashdown 264 Surf Life Saving Association – safe diving 289 splenectomy 515 (SLSA) 207 skin spontaneous circulation 437 – Australia 139, 273 – cancer 300 – restoration 439 – Great Britain 157 – cooling 486 sport 179, 180, 204 – Queensland 285 SLSA, see Surf Life Saving SSEP, see somatosensory surface Association evoked potential – search 222 Smit, Fop 9 stakeholder 32 – tension 419, 420, 424 Smit International 9 standard surfactant 328, 400, 416, 419 snorkel 439 – care 144 – aerosolised artificial 421 Society for the Preservation of – definition 314 – bolus administration Life from Shipwreck 5 – evaluating 160 420 712 Subject Index

– bronchoscopic temperature 217 – university 176 application 421 – core 373, 445, 446 – vocational 176 – dosage 420, 421 – central 404 transcranial Doppler ultraso- – exogenous 420, 421 tetanus 300 nography (TCD) 450 – inhibitors 420 tetracaine 459 transesophageal echocar- – intratracheal the Hague diography 414 administration 417 – fire service 148 transforming growth factor – natural 421, 422 – lifesaving stations 150 beta (TGF-β) 453 – replacement 415 thermal transport – therapy 419–422 – imaging system 630 – device 253 – time elapsed 420 – protection 229, 230 – safety board 654 surveillance 118, 214–219, 221 Thermax 509 transpulmonary pressure – report 118 thermogenesis 503 413, 414 – technique 198 thermophysical 425 trauma 365, 523 survival 231, 235, 365 Thornycroft, John 9 – cervical spine 397 – factor 255 tidal – co-existing 397 – measure 233 – movement 153 traumatic brain injury 435, – program 123 – volume 316, 328, 349, 448 – technique 236 350 treatment 382, 424, 430, 431 survivor 349 – water 237 – cardiovascular 397 – rate 50 – wave 58 – emergency room 392 swath lines 628 tide 153, 203 – intensive care 397 sweeping 217 – range 153 – paediatric 402 swimmer 113, 114 – – relative (RTR) 152 – protocol 393 swimming 234, 484 time 240 – respiratory 397 – ability 55, 112, 115, 116, – dimension 88 triage 542, 543, 263 236 – interval 321 tumour necrosis factor – distance 234 tirilazad mesylate 459 (TNF-α) 453 – failure 233, 234 tissue turtle 257 – instruction 112, 115 – gas equilibrium 592 two-rescuer CPR 329 – lesson 116 – oedema 514, 516 – pool 66, 70, 104, 121 tobacco smoke insufflation – – fencing 66 18 U – – regulation 106 toddler 55, 99 – program 123 toilet 100 ubiquitin 455 – training 71 torsade de pointe 352 Uganda 62 Systemic Inflammatory tort 173 UK 56, 59, 259, 210, 211, 222, Response (SIRS) 404 Tossach, William 16 224, 280, 428 tourism 204 – National Immersion towfish scanning 629 Incident Survey 521 T toxic hazard 263 – Road Traffic Act 280 training 118, 293, 300, 301, ultrafiltration 399 target care system 148 322, 584 under-reporting 62 task force 27, 81, 135, 138, – flood rescue 140, 160, underwater 237 193, 197, 198, 311, 312, 318, 163 – self-rescue 600 320, 323 – in-water rescue 140 – survival time 486 teaching 163, 177 – minimum duration 177 United Nations (UN) 220 technical complexity 270 – non-university 176 United States Lifesaving As- technician 584 – program 279 sociation (USLA) 146, 159, technique – risk management 173 170, 207 – scanning 214 – standard 157, 160 University of Athens 178 – surveillance 214 – swift water 162 urbanisation 84 technology 224 – swimming 142 US Coast Guard 224, 227 television 131 – technician 584 US Congress 276 Subject Index 713

US National Transportation Victoria 131 water-safety program 118 Safety Board 278 Vietnam 417 water-tight compartment 267 USA 60, 64, 127, 143, 159, 210, vigilance 110, 215, 217, 218 wave 203–205, 237 211, 222, 227 violence 51 – bottom 203 USLA, see United States Life- viscocity 242 – cross 203 saving Association vital sign 485 – energy 204 Utstein vocational training 176 – green 203 – drowning data form 384 volume 606 – heights 152, 203 – style 26, 377–385 volunteer 143, 270 – pattern 202 vomiting 337, 417 – period 152 Vossnack, Ernst 12 – pressure 203 V Vrije Universiteit medical – ripple 202 centre of Amsterdam 30 – type 202 Valentijn 269, 270 VT, see ventricular tachycardia – wind 202 van Engelen, Cornelis 4 wave-dominated beach sys- van Houten, Willem Jr. 6 tem 153, 154 van Spreekens, Barend 6 W Western Pacific region 185 vasopressin 348 wet suit 230 vasopressor drug 431 warm water bath 509 wheelhouse 267 vehicle, submerged 239–241 warm-up 300 WHO, see World Health Orga- Venezuela 160 water nization venomous 610 – aspiration 601 witness 324 venous return 329 – board 565 working divers 589 ventilation – competence 114–116 World Congress on Drown- – CPAP 412 – contaminated 403, 636 ing 3, 27, 84, 100, 135, 137, – device 327 – current 222 146, 166, 195, 197, 210, 211, – high-frequency 415 – draining 336 214, 217–219, 228, 293, 305, – invasive mechanical 412 – fresh 403, 408, 416, 419, 312, 315–317, 319–321, 323, – non-invasive positive 424, 428 342, 389 pressure (NPPV) 412 – – flood 562 – steering groop 197 – pressure support 412 – Hazard Mapping Project World Health Organization – rates 349 124 (WHO) 25, 31, 32, 86 – volume-cycled 412 – near shore 622 – Global Burden of Disease ventilation-perfusion – quality 300 study 185 – mismatch 392, 440, 444 – recreation 68 – ratio 424 – safety 115, 120, 122 ventilatory – – attitude 115 X – strategy 405 – – education 112 – support 424 – – knowledge 115 X-ray 417 – technique 318 – – sign 204, 211 ventricular – – standard 118 – fibrillation (VF) 260, 317, – – week 132 Y 331, 348, 352, 359, 370, – salt 403 425 – sea 408, 416, 419, 423, years of potential life lost – tachycardia (VT) 332, 424, 428 (YPLL) 52 353, 359 – still 621 Vereniging Parkherstellings- – temperature 66, 321, oorden 30 365, 372 Z Vesalius, Andreas 16 – transportation 73 VF, see ventricular fibrillation waterpark 215 zero arrest time 463 vice-grip 296 water-related victim 369 – disaster 535 – information 380 – injury 118 – needs 576 – unconscious 338