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Drowning Prevention

Drowning Overview

According to the World Health Organization, drowning is defined as "the process of experiencing respiratory impairment from submersion/immersion in liquid." Drowning may result in death or complete recovery. However, victims may often sustain long term physical or mental disability. Most drownings occur within a short distance of safety, whether in the bathtub, the edge of a pool or by the shoreline, and most are often preventable.

Because the head is submerged, air and oxygen can't get into the lungs and the victim suffocates. The tissues and organs in the body require oxygen to function, and begin to fail within a matter of minutes if deprived of it. Without oxygen, the heart muscle can become irritable and cause its electrical system to malfunction, preventing the heart from beating. Brain damage occurs within six minutes when deprived of oxygen rich blood flow.

Who is likely to drown, when, and where?

  • The World Health Organization estimates that there are 359,000 drowning deaths worldwide each year. In the Unites States, the latest yearly statistics from the CDC reported more than 38,000 people had died from drowning.
  • Statistics are unreliable in regard to those who survive a drowning episode. Many countries do not keep records of non-fatal drownings (near drownings)
  • Drowning is the third leading cause of accidental death in the United States. It is the second leading cause of accidental death in school-age children, and the number one cause of death in preschoolers.
  • More than half of drowning deaths occur in swimming pools.
  • One-quarter to one-third of drowning victims have had swimming lessons.
  • Infants younger one year of age usually drown in bathtubs because they are not coordinated or strong enough to lift themselves or their heads out of the water.
  • Children aged 1-4 most often drown in swimming pools.
  • As children age, the percentage that drown in natural water such as rivers, lakes, ponds, and oceans begins to increase. For those older than age 15, 65% of drownings occur in natural water.
  • Alcohol is a factor in up to half of adolescent and adult drowning deaths.

Mammalian Dive Reflex

Drowning suffocation causes a lack of oxygen, resulting in death in only a few minutes. An exception to this rule appears in victims who have been suddenly and rapidly submerged into ice-cold water. Some of these victims have been reported to survive up to an hour underwater without any physical damage. This phenomenon is known as the mammalian dive reflex, which is activated when the face and body plunge into ice-cold water. The acute cooling results in the very quick slowing of body metabolism and diverts blood to the essential organs of the body, the heart, lungs, and brain. With very slow metabolism, the amount of residual oxygen in the blood stream may be enough to maintain basic organ function for many minutes.

The mammalian diving reflex is most well developed in children, and gradually decreases with age. The drowning victim may appear deceased since the heart may be beating so slowly that rescuers cannot count a heartbeat, and blood pressure may drop so low it cannot be detected. It is very important to begin resuscitation attempts in this situation and not presume that the victim is deceased.

The mammalian dive reflex situation does not apply to victims who have gradually cooled and have developed hypothermia or low body temperature.

Drowning Risks

The following are drowning risks in infants and children:

  • Lack of supervision in the bathtub or other body of water
  • A swimming pool is a risk factor in itself. Children, who have drowned, usually have been out of sight for less than 5 minutes.
  • Lack of life jackets (personal floatation devices) on boats. Pool toys are not a substitute for a "real" life jacket.
  • Child abuse or neglect

The following are drowning risks in teenagers and adults:

  • Alcohol consumption. Alcohol use is a factor in half of all teenage and adult drowning deaths.
  • Inability to swim
  • Medical emergency in the water. This includes victims who experience a heart attack, stroke or seizure in the water. It also includes open water drowning victims who sustain an animal bite or evenomation (sting).
  • Fatigue or exhaustion when swimming. The buddy system is meant to prevent drowning associated with unsupervised swimming or failing to follow water safety rules.
  • Not appreciating the environment. This includes diving into shallow water and sustaining a head or neck injury, or falling into the water when walking on thin ice.
  • Boating accidents
  • Lack of life jackets (personal floatation devices or PFDs)
  • Scuba diving accidents
  • Suicide attempts
Medically Reviewed by a Doctor on 7/7/2014
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