Around four hundred observations of adult swimmers during ten summer seasons were analyzed and then sorted according to their skills and behaviour. Underwater observation proved essential to understand how bathers manage to remain afloat and how they react to potential water incidents. Results: Our analysis showed that bathers could be classified according to the following criteria: - Aquatic abilities, motor skills and performance. - Body and head positions in water. - Swimming movement tracks. - Response to “incidents”. - Signs indicating failure to control buoyancy. - Signs indicating a drowning process. Thus, we described and defined five categories of swimmers’ ability levels including risks factors involved, as well as surveillance criteria focused on detecting when a swimmer starts to lose control. A six-hour teaching module was specifically developed and incorporated into our lifesaving courses including strategies to improve drowning prevention and surveillance: guides to advise bathers on safe behaviours, swimming movement patterns and early drowning recognition tips. Additionally, psychological training on social skills was included in order to improve the relationship between professional Lifeguards and pool users. This module has been implemented in ESS lifesaving training courses since 2003, reaching over 345 lifeguards in our new or refresher courses. Follow-up questionnaires completed around a year after the above-mentioned training activities resulted in over 90% effectiveness of professional performance regarding swimmers’ surveillance and early drowning detection. Discussion: Our results show a direct relationship between aquatic expertise and the possibility that bathers’ reaction is not being effective enough to overcome a drowning episode and also suggest a clear relationship between real or perceived performance and the actual behaviours of swimmers at a pool. Certain factors have a considerable bearing on the development of potential drowning situations: - Not knowing how to move and control the face, the eyes or the head underwater. - Not knowing how to do the apnoea technique or hold breath underwater. - Beginner or very basic swimming skills or lack of self-confidence. - Increase of water treading movements to keep afloat. - Not being able to react to incidents properly. Our classification has proved highly useful to improve lifeguards’ professional response to potential drowning situations as it significantly reduces the necessary time to detect, assist, or perform the rescue of swimmers in trouble. It is easily understandable with an appropriate but simple audiovisual support and adaptable to all kinds of bathers and pool conditions. Moreover, our study clearly shows that most people at risk do not wave their arms or shout for help; on the contrary, they move their arms underwater trying to remain afloat, gasp for breath or present reflex apnoea.

1. Luis M. Pascual-Gomez Primary School Teacher, Certified Swimming and advanced Life Saving Instructor Instructing Team Director of Escuela Segoviana de Socorrismo. Segovia (Spain) www.sossegovia.com Early Detection of a person at risk of Drowning Implications on training and performance of professional Lifeguards.

2. Escuela Segoviana de Socorrismo Segovia Lifesaving School Luis M. Pascual-Gomez Primary school teacher. Certified swimming and Lifesaving Instructor. Instructing Team Director of Escuela Segoviana de Socorrismo (Segovia Lifesaving School), Segovia (Spain)

8. Luis M. Pascual-Gomez Primary School Teacher, Certified Swimming and advanced Life Saving Instructor Instructing Team Director of Escuela Segoviana de Socorrismo. Segovia (Spain) www.sossegovia.com Early Detection of a person at risk of Drowning Implications on training and performance of professional Lifeguards.

11. The Hot Spots Research Area Ap plication Area

13. Bathers’ Observation

29. Thank you. I would be very happy to expand on this concepts later on. www.sossegovia.com