“Flush Drowning”- You Need to Know About It

On June 30th, 2019 while SUP surfing the “Staircase Wave” in Buena Vista fully kitted out with a pfd/helmet/quick-release-leash/high volume board/paddle, 39 year old Michael Robert James flush drown in the rapids below the wave. Beyond local news reports and very hushed discussions throughout the river surfing community; absolutely nothing has been learned from this fatality nor has it ever been properly discussed publicly as a teaching point.

According to data provided by Charlie Walbridge who manages the American Whitewater Accident Database; flush drowning in 2023 has been the leading cause of drowning deaths while recreating in Colorado rivers. Unfortunately for the river surfing community, the threat of flush drowning is real, but it seems nobody wants to acknowledge it or address it. Why?

READ ON! The following is gleamed partially from a “white paper” on flush downing that was drafted by Charles Duffy, a respected kayak instructor (see pdf link: https://www.teamriverrunner.org/wp-content/uploads/2018/10/Flush-Drowning-1.pdf) and your author’s individual experiences river surfing the past seven years.

WHAT IS FLUSH DROWNING? Flush drowning is when a swimmer isn’t held in place but generally moving downstream through rough water. Repeated dunking and/or being hit by waves causes the swimmer to aspirate water compromising the airway. Eventually, getting enough oxygen in the lungs proves too difficult and they pass out and drown. In simple terms, the person drowns on top of the river with their pfd on from being hit in the face with waves and water in the wave-train of whitewater rapids.

DOES THIS HAPPEN IN RIVER SURFING? Yes. It happens with and without a pfd. In 2019, just prior to when Michael Robert James flush drown, he was conscious and yelling for help. People, with throw ropes tried to get to him but unfortunately he was moving too fast down river into the the rapids and drown on the surface of the river to eventually be recovered on the bank of the river.

CAN YOU SURVIVE FLUSH DROWNING? Yes, but depends on how much water is breathed in. Reality is a significant flush drowning are almost always a fatality once the person is retrieved from the water. Take a look at this table of six (6) grades of drowning (Sourced from Wilderness EMS, Seth Hawkins).

Grade	Signs/Symptoms	Mortality (%)
1	Cough, no foam at mouth/nose	0 (none)
2	Small amount of foam in mouth or nose. Also labored breathing (Rales)	0.6
3	Large amount of foam, normal BP (Blood Pressure)	5.2
4	Large amount of foam, low BP (Blood Pressure)	19.4
5	Respiratory arrest	44
6	Cardiopulmonary arrest	93

HOW TO AVOID A FLUSH DROWNING: This is also adapted partially from Charles Duffy’s white-paper on flush drowning and expanded upon but is by no means authoritative by The Denver Surf Report or author.

• Know Before You Go & When In Doubt Don’t Go Out– Avoid river surfing in conditions you are not sure of such as your local surf spot at high flow or a new river surf spot that you are not fully educated on by self-study (internet searches, books, etc). Ask the locals how the conditions are. Scout downstream to identify the eddys and look for down river hazards (such as no-take outs, rapids, and other hazards such as strainers, rocks, etc.). Surf with others and don’t be afraid to point out any hazards or concerns you have with river surfing that spot.
• Have Your Equipment Dialed In: Know if your board is the right choice for the conditions; does your board drag you down river; know how to release your leash if you have to swim away from your board dragging you down river uncontrollably (ankle leashes are deadly so stop using them anyplace you surf); know how to swim with your pfd on or vest… Bring a throw bag (rope and knife) to the spots you river surf (and learn how to use a throw bag see this link: https://youtu.be/mSjmMB4QFkc).
• Defensive Swimming: If being flushed down river, swim feet downstream on the surface, head lifted a bit to see where you are going) can save energy but eventually (and soon) you need to identify where you need to be and make certain you get there. This is where aggressive swimming techniques come into play (see this link for aggressive swimming: https://youtu.be/jV6_PZzxKus…. Once again, frequently lift your head to watch where you are going and make any necessary corrections….. Be very careful with your feet, keep them on the surface to avoid foot entrapments which are very deadly and exceptionally challenging for rescues. Swim until your hands touch bottom and the water is slowed down by an eddy.
• Time You’re Breathing: In large (and small) wave trains, grab breaths frequently generally on the backside of waves and scout at wave tops where visibility is best. It is generally a good idea to keep the mouth closed while swimming and breath through the nose (less likely to gulp water).
• Stay Calm But Be Ready to Swim With Intent: Even if you breathed in some water, you still can self-rescue yourself by swimming toward an eddy or out of the wave-train or to the shore or behind a large rock to rest and then make a swim for safety when ready.
• Don’t Let the Board Drag You: Remember, if that board is not acting as a life preserver ring and is instead dragging you uncontrollably down river, it is time to get free from the board by deploying your quick release leash.
• Get Swift Water Trained: Often it is said, “take a Swift Water Training course from a certified person“. Yeah, well that is probably an excellent idea; but, truth is there are no “river surfing” specific swift water safety classes and it is unrealistic to think the average river surfer will take a typical kayak based swift water safety course. (This is a call out to the industry and to the experts to create a river surfing safety program that includes a swift water component.)

Here is a vid worth a watch on how flush drowning can potentially occur. Luckily this was not a fatal flush drowning..

River surfing for the most part, is a safe sport but knowing the risks is half the game. Just like other sports (climbing, backcountry snowboarding/skiing/powsurfing, etc), it is up to the individual to set their own “risk tolerances” of how they are going to push the danger factor; however, that risk tolerance needs to set after fully educating oneself before going for it. Flush drowning is one of the things river surfers should be aware of when surfing and setting your own risk taking level of river surfing.

Comments are open for this important topic.. be cool! (note, republished this article due to WordPress glitch…)

Be safe… LBK