The study reveals that Rapid Onset Pulmonary Edema (ROPE) is the cause of some, if not most, snorkel-related fatal and near-fatal drownings. ROPE has not been associated with snorkeling in the past, but it has significant implications for the safety of divers. Factors increasing the risk of ROPE include snorkel resistance, health concerns, and wearing a flotation device at all times. There are four mechanisms of drowning that may befall snorkelers: trauma, intervening acute medical adverse event, and inadvertent or accidental aspiration.
The study suggests that ROPE diagnosis accounts for the lack of distress signals in many snorkel drownings, as it causes muscle fatigue and loss of consciousness, and can also be triggered by a heart. It does not need either submersion or inhalation of liquid, but rather respiratory impairment that can be triggered by snorkeling. Over hydration can also increase the risk.
To prevent ROPE, snorkelers should avoid snorkels with constricted airways, familiarize themselves with their equipment in shallow water, and be confident before moving into deeper water. Some people should wait two or three days after extended air travel before snorkeling, avoid snorkels with constricted airways, and familiarize themselves with their equipment in the shallows.
The concept of ROPE being caused by snorkeling caught a small amount of media attention with the study’s preliminary release due to its novelty. However, it could not confirm a correlation between all fatal cases of snorkeling ROPE and recent prolonged air travel. Expert advice for safer snorkeling includes avoiding tubes with constrictions in bore size or mouthpiece calibre, as these may increase the likelihood of resistance to inhalation. Snorkeling in water where the water is warm and the water is cold can also increase the risk of ROPE.
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