Drowning

Drowning is death due to asphyxia caused by immersion in fluid, usually water. Near drowning is initial survival of a drowning accident which can lead to serious secondary complications including death; cases of near drowning therefore require attention by medical professionals. Secondary drowning is death due to chemical and biological changes in the lungs after a near drowning incident or exposure to chemicals. In many countries, drowning is one of the leading causes of death for children under 14 years old.

Rescue and Treatment

Many pools and designated bathing areas either have either lifeguards, a pool safety camera system for local or remote monitoring, or computer aided drowning detection. However, bystanders play an important role in drowning detection and either intervention or the notification of authorities by phone or alarm.

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If a drowning occurs or a swimmer becomes missing, bystanders should immediately call for help. The lifeguard should be called if present. If not, Emergency medical services and Paramedics should be contacted as soon as possible.

Related Topics:
Lifeguard - Emergency medical services - Paramedics

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The first step in rescuing a drowning victim is to bring the victim's mouth and nose above the water surface. For further treatment it is advisable to remove the victim from the water. Conscious victims may panic and thus hinder rescue efforts. Often, a victim will cling to the rescuer and try to pull themselves out of the water, submerging the rescuer in the process. To avoid this, it is recommended that the rescuer approach the panicking victim with a buoyant object, or from behind, twisting the victim's arm on the back to restrict movement. If the victim pushes the rescuer under water, the rescuer should dive downwards to escape the victim.

Related Topics:
Panic - Buoyant

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After successfully approaching the victim, negatively buoyant objects such as a weight belt are removed. The priority is then to transport the victim to the water's edge in preparation for removal from the water. The victim is turned on his back. A secure grip is used to tow panicking victims from behind, with both rescuer and victim laying on their back, and the rescuer swimming a breaststroke kick. A cooperative victim may be towed in a similar fashion held at the armpits, and the victim may assist with a breaststroke kick. An unconscious victim may be pulled in a similar fashion held at the chin and cheeks, ensuring that the mouth and nose is well above the water.

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There is also the option of pushing a cooperative victim lying on his back with the rescuer swimming on his belly and pushing the feet of the victim, or both victim and rescuer lying on the belly, with the victim hanging from the shoulders of the rescuers. This has the advantage that the rescuer can use both arms and legs to swim breaststroke, but if the victim pushes his head above the water, the rescuer may get pushed down. This method is often used to retrieve tired swimmers. If the victim wears lifejacket, buoyancy compensator, or other flotation device that stabilizes his position with the face up, only one hand of the rescuer is needed to pull the victim, and the other hand may provide forward movement or may help in rescue breathing while swimming, using for example a snorkel.

Related Topics:
Lifejacket - Buoyancy compensator

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Special care has to be taken for victims with suspected spinal injuries, and a back board (spinal board) may be needed for the rescue. In water, CPR is very difficult, and the goal should be to bring the victim to a stable ground quickly and then to start CPR.

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If the approach to a stable ground includes the edge of a pool without steps or the edge of a boat, special techniques have been developed for moving the victim over the obstacle. For pools, the rescuer stands outside, holds the victim by his hands, with the victims back to the edge. the rescuer then dips the victim into the water quickly to achieve an upward speed of the body, aiding with the lifting of the body over the edge. Lifting a victim over the side of a boat may require more than one person. Special techniques are also used by the Coast Guard and military for helicopter rescues.

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After reaching dry ground, all victims should seek medical assistance, especially if unconscious or if even small amounts of water have entered the lungs. An unconscious victim may need artificial respiration or CPR.

Related Topics:
Artificial respiration - CPR

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The Heimlich maneuver is needed only for obstructed airways, not for water in the airways. Performing the Heimlich maneuver on drowning victims not only delays ventilation, it may induce vomiting - the vomit may then be aspirated, leading to serious injury or death. Furthermore, news articles have raised concerns that the entire concept is not only useless, but that Dr. Henry Heimlich used fabricated case reports to promote the idea: http://complaint.active.ws

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100% Oxygen is highly recommended, including an intubation if necessary. Treatment for hypothermia may also be necessary. Water in the stomach need not be removed. Other injuries should also be treated (see first aid). Victims that are alert, awake, and intact have nearly a 100% survival rate.

Related Topics:
Hypothermia - First aid

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Drowning victims should be treated even if they have been submerged for a long time. The rule "no patient should be pronounced dead until warm and dead" applies. Children in particular have a good chance of survival in water up to 3 minutes, or 10 minutes in cold water (10-15C or 50-60F). Submersion in cold water can slow the metabolism drastically. There are rare but documented cases of survivable submersion for extreme lengths of time. In one case a child survived drowning after being submerged in cold water for 70 minutes. In another, an 18 year old man survived 38 minutes under water. This is known as cold water drowning.

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