A Prospective Analysis of Lifeguard Medical Team Interventions in Ecuador During 2011 Carnaval

Abstract

Drowning remains a leading cause of death globally. The true burden is unknown because of underreporting. Carnaval, a large-scale event in Ecuador, draws large sections of the population to the coast and historically is associated with numerous drowning deaths. The purpose of this study was to prospectively quantify preventative, rescue, and first aid interventions by lifeguards protecting the beaches in Ecuador during Carnaval. This was an Institutional Review Board approved, prospective observational study. Inclusion criteria were any rescue, prevention, or first aid encounters by lifeguards. Lifeguards were trained on the 18-item data collection form and dictionary, and completed the form after every intervention. Elements collected included age, gender, time of day, injuries, contributing factors, disposition, and mortality. The primary measure was the proportion of the 3 types of interventions. We secondarily characterize the lifeguard rescues. Data were entered into a database by trained and monitored research assistants. We report descriptive statistics as appropriate. During the 4-day event, lifeguards performed 246 unique interventions: 153 preventative maneuvers on 2141 swimmers, 94 water rescues, and 29 first aid interventions. The mean age was 22.7 years (range 3–60 years). The rescued swimmers were predominantly male, 36 of 52 (69% [95% confidence interval (confidence interval): 55% to 80%]). The time of day analysis revealed a bimodal pattern with peaks during the 11:00 am to 12:00 noon and the 1:00 pm to 2:00 pm periods. Rip current was a factor in 52 of 94 cases (55% [95% CI: 45% to 65%]), and alcohol was a factor in 4 of 47 rescues (9% [95% CI: 3% to 21%]). None of the 94 rescues (0% [95% CI: 0% to 5%]) required resuscitation, and only 2 of 94 (2% [95% CI: 1% to 7%]) required transfer to a hospital. There were no drowning deaths. Study limitations were that beach crowd estimates and number of persons impacted by preventative interventions were not adjudicated. The majority of lifeguard interventions were preventative in nature, and there were no drowning deaths. Most rescues occurred in the late morning or early afternoon, and involved male, nonintoxicated swimmers. Our data may provide insight for others planning large water events in the future.