Summary of 58 cases of loss of consciousness during underwater swimming and diving

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Abstract
Hyperventilation before breath hold swimming and diving makes it possible for a person to extend the time under water, but this maneuver can cause loss of consciousness due to hypoxia. This accident happens almost exclusively to males (56 of 58 cases). The most common age group was 16-20 yr (range 12-33 yr). All were known to be good swimmers or divers. Approximately 80% of the cases occurred in guarded pools. Thirty-five subjects survived the accident and of the 23 fatalities, there was only 1 good autopsy report. In this instance the findings were those associated with classical drowning preceded by hypoxia and hypercapnia. Breath holding experiments indicated that the times between loss of consciousness and death may be no longer than 2.5 min. Those who are responsible for aquatic safety as supervisors or guards of pools could prevent most accidents by watching for young male swimmers who are practicing hyperventilation and underwater swimming in competition with themselves or with others.

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