Coroner warns against practicing Wim Hof ​​breathing method underwater after drowning man

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SINGAPORE: Man who drowned while practicing underwater breathing method likely suffered a blackout in shallow water while holding his breath underwater after hyperventilating, coroner has found .

In findings made available Friday, January 14, State Coroner Adam Nakhoda warned against practicing prolonged underwater apnea after hyperventilation, advising those practitioners to have a buddy in the pool who is concentrating. on them at all times.

He ruled on the death of Mr. Danzel Goh Choon Meng, who leaves behind a wife and a son, a mishap. Mr. Goh, a business owner, was 29 years old.

Mr. Goh had gone to a swimming pool in Mimosa Park in Yio Chu Kang area with his wife on the evening of March 27 last year.

At around 7:10 p.m., a resident entered the pool to swim a few lengths. He noted that Mr. Goh appeared to be doing breathing exercises in the pool and not doing laps.

Mr. Goh’s wife left the pool at around 7.20 p.m. because she had some household chores to do, but Mr. Goh remained in the water. About 15 minutes later, the resident finished his rounds and left as well.

At approximately 7:50 p.m., Mr. Goh’s neighbor walked past the pool and saw a cell phone by the pool. He recognized it as Mr. Goh’s and thought he must have forgotten to bring it home.

He didn’t see anyone in the pool, but walked over to take a look as he heard sounds coming from the phone.

When he reached the locked pool door and looked, the neighbor saw Mr. Goh lying at the bottom of the pool. He immediately alerted the security guard at the main entrance to Mimosa Park.

Paramedics were called in as neighbors helped lift Mr. Goh out of the water. He was placed in the recovery position, but did not wake up despite cardiopulmonary resuscitation.

He was taken to hospital but did not regain consciousness and was pronounced dead around 9:30 p.m. that night. CCTV footage showed he was submerged underwater for nearly 38 minutes before being rescued.

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A medical examiner certified that the cause of Mr. Goh’s death was drowning.

Mr. Goh’s wife said that her husband was a very physically fit person who exercised daily, ran, lifted weights, and did static training. She described him as someone who would try to push his limits.

She said her husband downloaded the Wim Hof ​​app and used it for about a week before his death.

THE WIM HOF METHOD

An expert on the Wim Hof ​​method, Mr. Tan Chun Yih, testified that it has three components. The first is the component of respiration, which involves air intake involving controlled hyperventilation, respiratory retention, or breathing retention; and respiratory recovery.

Participants would take up to 30 breaths before holding their breath for a while. This has been described as a form of meditation, where participants will gradually feel the urge to breathe build up.

The second element of the method is cold immersion, where participants immerse themselves in cold water between 3 degrees Celsius and 6 degrees Celsius for no more than two minutes.

The third element is a state of mind element. Mr. Tan explained that he would focus on the safety aspects of the two physical components to his students.

He said it is essential that the breathing component is never practiced in or near water. Mr Tan said this was because the act of expelling carbon dioxide during hyperventilation would reduce the feeling of shortness of breath, allowing the practitioner to hold their breath for longer.

The consequence of holding their breath for longer without the corresponding urge to breathe – which would usually be present if the carbon dioxide was not expelled by hyperventilation – was that the practitioner may faint from the lack of oxygen.

Once he passed out he would no longer be able to consciously hold his breath and would inhale again automatically.

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If the person were in the water when this happened, they could potentially drown in what is called a shallow water blackout, Tan said.

He said the risks of blackout in shallow water are “non-existent” if the respiratory component of the Wim Hof ​​Method is performed in the presence of qualified instructors, as they would not allow students to perform it. near or in the water.

He also pointed out that the breathing component should not be performed simultaneously during the cold immersion part of the Wim Hof ​​method.

Mr Tan said the Wim Hof ​​app came with safety instructions and warnings. Before a person can begin the breathing component, a warning screen is displayed, emphasizing that the practitioner should not be in or near water.

Checks on Mr Goh’s phone showed that he had recorded basic breath recordings in the Wim Hof ​​app from March 21 to 26 last year, in the days leading up to his death.

SHALLOW WATER OPPORTUNITY AND RELATED EDUCATION

According to the US National Center for Biotechnology Information, the shallow water blackout has the potential to affect anyone in the water, even fit and experienced swimmers.

SportSG Sports Safety Division Chief Ms. Delphine Fong said shallow water blackout is most common among physically fit swimmers, spear fishermen and free divers.

The most dangerous risk of blackout in shallow water comes from prolonged repetitive and competitive apnea laps with little rest in between, especially if intentional or unintentional hyperventilation has occurred.

In shallow water blackouts, it takes about two and a half minutes before brain damage and death, she said. In comparison, it takes six to eight minutes for a drowning person who has not suffered a blackout in shallow water to sustain brain damage and death.

Mdm Fong said SportSG carried out research, discussion and statistical analysis on the blackout in shallow water after an incident in 2008 where a boy drowned during a swimming lesson in an outdoor swimming pool. ‘one meter deep.

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SportSG published the Water Watch Guide, which has been distributed to all public swimming pools and at school conferences and has a section on blackout in shallow water.

SportSG plans to include this as a topic to be included in a technical benchmark code of practice for water safety to be disseminated to all swimming operators, including private pool operators.

CORONER WARNINGS AGAINST WATER BREATHING EXERCISES AFTER HYPERVENTILATION

State coroner Adam Nakhoda said it appeared Mr. Goh had performed the breathing component of the Wim Hof ​​Method on dry land for six days before his death.

However, he decided to execute it while submerged in the pool on March 27, 2021.

“It was not clear why Mr Goh had ignored the warnings from the Wim Hof ​​app and practiced breathing in the pool,” the coroner said. “In other words, it was an activity full of dangers.”

“I discovered that Mr. Goh had, on his own, engaged in very risky behavior by choosing to do the breathing component of the Wim Hof ​​Method underwater,” he said. . “As a result, Mr. Goh most likely suffered a blackout in the shallow water and drowned.”

He said that a person should not hyperventilate and then practice prolonged underwater apnea on their own.

If a person intends to practice prolonged underwater apnea, they should have a buddy in the pool who is focused on them at all times.

This is to ensure that the person does not encounter difficulties, or so that the buddy can safely remove the person from the water in case of difficulty and provide first aid.

The coroner urged SportSG to continue its outreach activities by educating pool operators, lifeguards, swim coaches and the public about the dangers of freediving with hyperventilation.

He offered his condolences to Mr. Goh’s family for their loss.

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