Fancy a dip in the wild?

The weather is finally warming up and the water levels are going down again. There will be a hose pipe ban before you can say "open water swim" just you wait.
On the subject of open water swimming, it's getting to that time of year when people take the plunge, I've even been known to get out the old budgie smugglers myself, but the less said about those the better.
We here at Beyond First Aid have already been asked to cover several swimming events across the South and my good friend Ripley is even planning on swimming around Ireland. Yeah, he's nuts but that's why we get on so well.
Ripley somewhere around the Irish Coast
The first event to get the Beyond touch is a mere three-point-something kilometres swim around Dinton Pastures with a hint of running between lakes added for variety. With a few dozen men and women thrashing around in the lakes, there are bound to be the odd nudge every now and then, but hopefully nothing serious. Remember, if my team and I are busy, someone is having a bad day. So, accidents aside, what other hazards might you expect to come across while wild swimming? Here are some of the things that the Dinton Gang and Ripley need to be aware of.
Chris Buggy - Dinton's Countryside Coordinator

I'll start with the larger things people need to worry about while in the water.

Sharks
Don't be crazy, there are not any sharks around us... I think.
Actually, around the UK there are over 30 species of shark found in the waters off our coasts, from the Toothless Shark to the massive Basking Shark. Not forgetting the Blue Shark, the Tope, and the Lesser spotted dogfish. Don't panic though Rip, swimming around the coast of Ireland you should not be bothered by any of these, as even the largest (The Basking Shark) is more interested in plankton than you. Most of the 'toothed' kind are either too small, too rare, or too timid to cause you any concern, and more people in Ireland and the UK suffer bee stings than shark bites. However, that said, I am sending you some large dressings... just in case. I'll also be sending some of the wax strips ladies use to remove hair from their legs. No, not so you're silky smooth, but should you come across some of our next creatures on the list.

Jellyfish
Unfortunately we are blessed with these around our coast. They're not jelly nor are they fish, but some of them do sting and some really hurt, trust me, they hurt. Urinating on them, pouring vinegar on them, even using hot water on them are all bad ideas. Hot water may neutralise some of the toxins but to be effective it has to be so hot, you'd be better off with the sting. The best temporary treatment is to keep any remaining tentacles from the jelly in sea water until it can safely be removed. Not always possible due to the fact that drowning may be an issue, so use common sense here. Once out of the water use tweezers or a stick to remove any jellyfish or tentacles. Then any remaining nematocysts, or little poison sacks similar to bee stings, can be removed with the back of a knife or a credit card. The best way to remove very small stings that are still attached is with gaffer tape or ladies leg wax strips. I kid you not, this actually works and is also good for when any large amount of small stings or irritating hairs from plants or insects may be sticking out of your flesh. Then the best thing for pain relief is the good old Ice Pack. Be aware of, and make sure your team know the signs of anaphylaxis and get emergency care as soon as possible should you experience any symptoms. See my post on this here.

Poop
Most of the sea around Britain and Ireland is reasonably clean, or so I'm told. However there are some areas where you may find yourself, not necessarily face to face with a 'floater' but swimming in less than sanitary conditions.
The Good Beach Guide is an excellent resource to help you stick to 'cleaner waters'
Some of the risks you face while swimming in water that may be contaminated with sewage include gastrointestinal and respiratory infections, should you swallow or even inhale any water, along with ear, nose and throat complaints. Other than "see your GP" there is not much I can offer here in the way of first aid advice.
It's a good idea however to keep any cuts and grazes covered while swimming by using a waterproof bandage or plaster. This could also help protect against Leptospirosis or Weil’s disease, a bacterial infection spread by animal urine, especially that of rats. While it gets into your bloodstream through wounds, you can also get leptospirosis by swallowing infected water.
There was a case where several people drank from bottles of lager or had ice in their drinks. The pub, it turns out, had rats. The rats urinated on the bottles, which were then put in the ice maker to get them especially chilled for their 'special' customers. The special customers then all ended up with Leptospirosis, lucky them.
See it's not just human poop that causes problems, as swimming in water contaminated with animal waste (liquids and solids we're talking here) also has it's own little treasures waiting to ruin your day.
E.coli and Cryptosporidium immediately spring to mind as the culprits when vomiting, diarrhoea show their ugly faces. Not to mention the huge amount of parasites that lurk in the shadows.
Some of which cause swimmers itch... also called cercarial dermatitis, swimmers itch is a skin rash caused by an allergic reaction to parasites. These microscopic parasites are released from infected snails found in fresh and salt water. Not to be confused with Swimmers Ear, an inflammation of the outer ear and ear canal usually cause by bacteria. Bacteria or Parasite, it doesn't matter where in the world you go for a swim, this stuff is everywhere, but mostly occurs during warmer times of year. Not a time when you think about our next swimmers problem.


Who is at risk for swimmer's itch?
Anyone who swims or wades in infested water may be at risk. Larvae are more likely to be swimming along shallow water by the shoreline. Children are most often affected because they swim, wade, and play in the shallow water more than adults. Also, they do not towel dry themselves when leaving the water. 

Once an outbreak of swimmer's itch has occurred in water, will the water always be unsafe?
No. Many factors must be present for swimmer's itch to become a problem in water. Since these factors change (sometimes within a swim season), swimmer's itch will not always be a problem. However, there is no way to know how long water may be unsafe. Larvae are generally infective for 24 hours once they are released from the snail. However, an infected snail will continue to produce cercariae throughout the remainder of its life. For future snails to become infected, migratory birds or mammals in the area must also be infected so the lifecycle can continue.

What can be done to reduce the risk of swimmer's itch?
  • Avoid swimming in areas where swimmer's itch is a known problem or where signs have been posted warning of unsafe water.
  • Avoid swimming near or wading in marshy areas where snails are commonly found.
  • Towel dry or shower immediately after leaving the water.
  • Encourage health officials to post signs on shorelines where swimmer's itch is a current problem.
  • Do not attract birds by feeding them in areas where people are swimming.
Is my swimming pool safe to swim in?
Yes. As long as your swimming pool is well-maintained and chlorinated, there is no risk of swimmer's itch.
Portions of the above information have been provided with the kind permission of the Center for Disease Control and Prevention.

Hypothermia
We humans are quite good at regulating our body temperature, and keeping it around the normal
37°C (98.6°F) is not usually a problem. If however you decide to take a dip in water that is around 10°C  for a while then stop exercising, or become ill or injured, then your body is going to struggle to maintain this 'normal' temperature. A drop of just 2°C is enough to start experiencing problems. Cold water will suck the heat from your extremities at quite a rate. You may not actually be aware of how much you are suffering until you actually try and get out of the water.
The Outdoor Swimming Society actually recommends that wet suits are worn if you are going to be in the water for more than a few minutes. Other useful advice includes:
  • Swim close to the shore
  • Take boat support for crossings
  • Increase your time in open water gradually
 At first the signs and symptoms of hypothermia are:
  • constant shivering
  • tiredness
  • low energy
  • cold or pale skin
  • fast breathing (hyperventilation) 
as the situation worsens you may experience:
  • being unable to think or pay attention
  • confusion
  • loss of judgement and reasoning (someone with hypothermia may decide to remove clothing despite being very cold)
  • difficulty moving around 
  • loss of co-ordination
  • drowsiness
  • slurred speech
  • slow, shallow breathing (hypoventilation) 
People may stop shivering at this point, this is serious and a sign that emergency help is needed immediately. Severe hypothermia can lead to shallow or undetectable breathing, a weak, irregular or undetectable pulse, dilated pupils and unconsciousness. Note I say undetectable rather than no breathing or pulse. The appearance of death is not uncommon, but we in the trade say you're not dead until you're warm and dead. Someone suffering from severe hypothermia must still be taken to hospital as a matter of urgency as medical intervention may still be able to resuscitate them.

Here is part of a slide from one of our First Aid Courses
First Aid for Hypothermia
The priority is to stop any further heat loss, then to slowly warm the casualty. If possible carefully move the person somewhere warm. Remove any wet clothing and get them dry. If necessary use your own body heat to get them warm. Getting into a sleeping bag with them, wrapping a blanket around you both maybe. A gentle hug never did anyone any harm and can literally save someone's life.
Wrap blankets, dry clothing or other peoples clothing around them.If they are capable of shivering, let them, this is after all the bodies way of warming up.
Warm drinks and energy bars are a good idea if the casualty is totally conscious. Make sure they can swallow before stuffing that Snickers in.

DO NOT...
  • Give them alcohol
  • Rub their arms and legs
  • Apply direct heat
  • Put them in hot water
Cyanobacteria
Also known as Blue-Green Algae, Cyanobacteria is actually one of the good guys, and given the right conditions, it can create blooms that can be seen from space. It produces oxygen as a by product of photosynthesis. Swimming through it however is not recommended. It appears as a scum on the surface of still or slow flowing waters. Among other things it can cause skin rashes, eye infections and stomach upsets caused by cyanotoxins, or poisons to you and me. Worst case scenario, you could end up with Lou Gehrig's disease or Amyotrophic lateral sclerosis also know as motor neurone disease. Yep, too much of a good thing can be bad for you. So if Blue-Green Algae is covering the surface, find somewhere else to swim.
Blue/Green Algae on the surface of the water

Still fancy a swim?

Good, see you there :o)


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