Dr. Bierens reports receiving payment from the Royal Dutch
Lifeboat Institute for coordinating a training program; and Dr.
Handley, serving as an expert witness in civil litigation cases in
the United Kingdom and receiving publishing royalties from the
Royal Life Saving Society UK. No other potential conf lict of interest relevant to this article was reported.
Disclosure forms provided by the authors are available with
the full text of this article at NEJM.org