Anita Alvarez's coach has revealed the American artistic swimming wasn't breathing for two minutes after she fainted in the pool and had to be rescued from drowning at the world championships on Thursday.
Andrea Fuentes, a four-time Olympic artistic swimming medallist, dived into the pool while fully-clothed and dragged Alvarez out after the athlete fainted and sank to the bottom of the pool in Budapest.
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Fuentes and another bystander dragged Alvarez out of the pool, where she received first aid and regained consciousness.
But speaking later on Thursday, Fuentes revealed that Alvarez went a full two minutes without breathing in the touch-and-go situation.
"I think she was at least two minutes without breathing because her lungs were full of water," the coach said.
"She vomited the water, coughed and that was it, but it was a big scare."
Local organisers and the sport's governing body have come under fire after lifeguards were accused of not reacting quick enough to the incident.
It later emerged that Alvarez had fainted while previously competing at an Olympic qualifying event in Barcelona last year.
Fuentes said she could see the warning signs that Alvarez was in trouble, but dived in when lifeguards balked.
"I saw her feet were a little more white than normal so I though her blood was not going as normal," Fuentes told the BBC.
"Normally when you finish what you really want to do is breathe but instead of going up, she was going down.
"It was a big scare. I had to jump in because the lifeguards weren't doing it.
"When I saw her sinking, I looked at the rescuers, but I saw that they were stunned. They didn't react.
"I thought, 'Will you jump in now?' My reflexes kicked in."
FINA rules prevented lifeguards from jumping in
Bela Merkely, the head of the Hungarian medical service, told local media that staff had followed "extremely strict FINA rules" that "determine when lifeguards can intervene."
"Under the rules, members of the judges panel delegated by FINA may jump into the pool to signal that a competition program may be interrupted due to any incident," Merkely said.
"No such signal was received from the judges during Wednesday's final, and no matter if a coach signals to them they are not allowed to intervene.
"After the coach jumped into the pool at her own risk, the local lifeguards, sensing the danger....decided to intervene immediately, so the American competitor finally got out of the pool with their help."
FINA - the international governing body of swimming - also pointed out that the incident ended well.
"FINA has been in close contact with Anita Alvarez, her team and the medical staff following a medical emergency during the solo free final of the artistic swimming," it said in a statement.
"Ms Alvarez was immediately treated by a medical team in the venue and is in good health."
Alvarez was taken on a stretcher to the pool's medical centre, with teammates and fans in visible distress while watching on, with some in tears and consoling each other.
The USA artistic team released a statement from Fuentes, saying Alvarez had fainted due to the effort expended during the routine.
"We sometimes forget that this happens in other high-endurance sports," the statement said.
"Marathon, cycling, cross country ...our sport is no different than others, just in a pool, we push through limits and sometimes we find them.
"Anita feels good now and the doctors also say she is OK."
Alyssa Jacobs, a spokeswoman for the US team, said the incident was not the first time Alvarez had fainted.
"This happened to her once last year at the Olympic Qualification Tournament when competing her duet," Jacobs said.
"Prior to that, she has had sporadic issues with fainting but never in competition."
In a staggering twist, Jacobs said Alvarez could still take part in the Team Free Final on Friday.
"Anita is doing fine and taking today to rest. She has been fully evaluated by both our team doctor and event medical staff," she said.
"She currently has one final event left to participate in at the 2022 World Championships and she will decide if she feels up to compete tomorrow if she is cleared medically."
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