Basic Water Life Support (BWLS): Reevaluation after 232 courses

TitleBasic Water Life Support (BWLS): Reevaluation after 232 courses
Publication TypeConference Paper
Year of Publication2007
AuthorsDr Szpilman, MD, D, Guaiano, OP, Barros, M, Cerqueira, SJ, da Bahia, S, Smicelato, CE
Conference NameWorld Conference on Drowning Prevention
Date Published09/2007
PublisherInternational Life Saving Federation
Conference LocationPorto, Portugal
Other NumbersPO-03

A first aid course for the aquatic environment involves principles that are not found in regular first aid classes. Some of these principles are unique and specific to aquatics and essential to all persons living or working near or around the water. These principles can be best assimilated by attending a supplemental first aid course for the aquatic environment named Basic Water Life Support (BWLS). The concept of such a course is not new, but was never studied by such variety of drowning experts and experienced professionals in first aid as in the World Congress on Drowning, Netherlands 2002. This meeting resulted in a BWLS program which was published in the Handbook on Drowning (1). BWLS addresses the information and skills necessary to understand drowning and water related accident management. It includes preventive measures, recognition and priority of an incident, rescue techniques, and in-water life support. Courses may have differing depths of information and education based on the level of skill of the participants, the time spent near an aquatic environment, the possibility to witness a drowning and the need to act.

The objective of this research was to reevaluate the original program BWLS contents to lay person using all events organized by Brazilian Lifesaving Society.

Methods: Considering the proposal of BWLS course (table 1), the Brazilian Lifesaving Society – SOBRASA - started to run courses to lay people, based exactly on program contents proposed. Three different levels of courses were conducted from 2002 to 2006 (Basic and advanced A and B levels). Evaluation was based on informal feedback from students and instructors and considered different aspects: nomenclature, theory and practical contents, written material, classroom and water environments, pre-requisites for lay people, and the final objective to achieve.

Results: From July 2002 to December 2006, Brazilian Lifesaving Society organized directly or gave support to 232 courses; 174 Basic, 32 advanced A, and 26 advanced B. All courses were run on the program contents proposed in table 1. A total of 13,260 people received information on lifesaving by one of our three level courses (table 2). A few advanced courses were paid by attendees and the rest were free of charge. We did not evaluate swimming skills or aquatic familiarity to entrance on courses and did not request any prior skills to any level. The motivation and attendance was a choice of the student. Drowning chain of survival was explained in all classes (figure 1) and a folder with a summary of it was given to attendees of all levels.

Discussion/Implications: A great step forward was achieved in 2002, which resulted in the understanding that drowning has its own “chain of survival”. It shows clearly that “before treatment we need to prevent it”. Furthermore, no one, even with excellent skills on first aid would provide adequate help if the victim is still in the water on arrival. Organizing courses for lay persons shows that lifesaving information for the public is scarce, if any. Many rescuer testimonies were in conflict with their situation; i.e. “I had no idea what to do”, “I was drowning while trying to rescue the victim”, “I couldn’t risk my self to help him”. Students were very impressed with the easy tips to help which they had not heard before. In general, old concepts of lifesaving promoted generation by generation were the only information they have. BWLS nomenclature was adequate for all courses, except Basic which has informative characteristic contents and would be better called “tips to avoid drowning”, or by another name different than the course. Basic theory content seems to be adequate and to be of great value in preventing or helping someone drowning for those who attended their families and friends. It also increases interest in other advanced levels by 5 to 10%. All students from advanced courses (A and B) wanted more practical sessions and preferably in a beach scenario. The implication on this request was the risk of drowning as we did not test their swimming ability. The classroom was a good environment to reduce distraction and increase learning opportunities on basic life support on a mannequin. In summary, instructors had the impression that too much information was given in too short a time, as most of it was new, although many students were more confident to face those incidents after class. Furthermore, all were of the opinion “I will never look water at the same way”. This feeling of being different after the class and not indifferent to water incident will certainly contribute to reducing death by drowning in an increasing way.

Learning Outcomes
  1. Are we teaching the right stuff?
  2. Are we making any difference teaching aquatic safety to general public?
  3. What are the results we are waiting for and we have achieved to now?

Szpilman D, Morizot-Leite L, Vries W, Scarr J, Beerman S, Martinhos F, Smoris L, Lofgren B; First aid courses for the aquatic environment; section 6 (6.7) Resucitation, in Hand Book on Drowning: Prevention, Rescue and Treatment, edited by Joost Bierens, Springer-Verlag, 2005, pg 342-7.