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Drowning Prevention

Drowning Prevention Quick Overview

  • According to the World Health Organization, drowning is defined as "...the process of experiencing respiratory impairment from submersion/immersion in liquid. "While there may be dry, wet, or "near" drowning, depending upon whether some water is inhaled into the lungs, there is no clinical difference in how the victim is treated or whether the final outcome is good or bad. (The term "near" drowning used to refer to a victim who did not die, however, this term is no longer widely used.)
  • The causes of drowning are accidental and usually preventable. The accident often occurs within a short distance of safety like in a bathtub or close to shore.
  • Other factors that contribute to drowning include
  • Symptoms of drowning may not be easily seen by bystanders. The victim may be expending all their energy keeping their head above water and may not be able to shout for help. If they breathe in water (aspirate), their vocal cords may go into spasm; this prevents the person from shouting for help. There is usually very little thrashing and the victim is often found floating or at the bottom of the pool, tub, or body of water.
  • Treatment for the drowning victim begins by deciding if the victim is awake, and if not, if they are breathing. This is one of times when rescue breathing is required to help revive the victim. (Basic life support otherwise recommends hands only CPR). If there has been trauma, like diving into shallow water, there is risk of spinal cord injury and it is also important to protect the neck from moving. All drowning victims should be transported to a hospital for care. Activating emergency services by calling 911 is appropriate.
  • Tips to prevent drowning are
    • Infants should never be left in the bathtub alone, even for a few seconds, and the caregiver should not be distracted by other tasks or chores.
    • Toddlers and small children should not be unattended near backyard or neighborhood pools.
    • Everybody should learn how to swim and the buddy system is important for every age. Never swim alone.
    • When in natural water, like rivers and lakes, it is important to know the depth of the water, its temperature, and whether any dangerous currents exist.
    • While enjoying watercraft, boats, kayaks, SUPs, etc. on lakes, rivers, or in the ocean; floatation devices should be available to every person on the vessel. Check the "A Boater's Guide to the Federal Requirements for Recreational Boats."
    • Boating while intoxicated (BWI) is against the federal law. Alcohol should not be used in excess when swimming or boating and its use is commonly associated with teenage drowning deaths.
  • Tips for recognizing a person who is drowning are
    • It may be difficult to recognize a person having trouble in the water.
    • Often there is no thrashing, and the event may appear very quiet.
    • The victim may bob in the water in an uncoordinated way, with their head back and mouth open.
    • There may be weak and ineffective attempts at swimming.
  • The outlook for a drowning victim is excellent if they arrive in the hospital alert and breathing on their own. For patients in a coma, the prognosis depends upon how long they were underwater and how long it took to start artificial respiration and breathing. The prognosis also depends upon the cleanliness and temperature of the water.

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" drowning)
  • 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.

Medically Reviewed by a Doctor on 6/26/2015

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