| Drowning | |
|---|---|
 | |
| Vasily Perov: The Drowned, 1867 painting | |
| Specialty | Critical care medicine |
| Symptoms | Event: Often occurs silently with a person found unconscious[1][2] After rescue: Breathing problems, vomiting, confusion, unconscious[2][3] |
| Complications | Hypothermia, aspiration of vomit, acute respiratory distress syndrome[4] |
| Usual onset | Rapid[3] |
| Risk factors | Alcohol use, epilepsy, low socioeconomic status, access to water[5] |
| Diagnostic method | Based on symptoms[3] |
| Differential diagnosis | Suicide, seizure, hypoglycemia, heart arrhythmia[2] |
| Prevention | Fencing pools, teaching children to swim, safe boating practices[5][6] |
| Treatment | Rescue breathing, CPR, mechanical ventilation[7] |
| Medication | Oxygen therapy, intravenous fluids, vasopressors[7] |
| Frequency | 4.5 million (2015)[8] |
| Deaths | 324,000 (2015)[9] |
Drowning is defined as respiratory impairment as a result of being in or under a liquid.[7][10] Drowning typically occurs silently, with only a few people able to wave their hands or call for help.[1] Symptoms following rescue may include breathing problems, vomiting, confusion, or unconsciousness.[2][3] Occasionally symptoms may not appear until up to six hours afterwards.[3] Drowning may be complicated by low body temperature, aspiration of vomit, or acute respiratory distress syndrome.[4][11]
Drowning is more common when the weather is warm and among those with frequent access to water.[4][5] Risk factors include alcohol use, epilepsy, and low socioeconomic status.[5] Common locations of drowning include swimming pools, bathtubs, natural bodies of water, and buckets.[3][7] Initially the person holds their breath, which is followed by laryngospasm, and then low oxygen levels.[4] Significant amounts of water usually only enter the lungs later in the process.[4] It may be classified into three types: drowning with death, drowning with ongoing health problems, and drowning with no ongoing health problems.[10]
Efforts to prevent drowning include teaching children to swim, safe boating practices, and limiting or removing access to water such as by fencing pools.[5][6] Treatment of those who are not breathing should begin with opening the airway and providing five breaths.[7] In those whose heart is not beating and who have been underwater for less than an hour CPR is recommended.[7] Survival rates are better among those with a shorter time under the water.[7] Among children who survive, poor outcomes occur in about 7.5% of cases.[7]
In 2015, there were an estimated 4.5 million cases of unintentional drowning worldwide.[8] That year, there were 324,000 drowning deaths, making it the third leading cause from unintentional injuries after falls and motor vehicle collisions.[9] Of these deaths, 56,000 occurred in children less than five years old.[9] Drowning accounts for 7% of all injury related deaths, with more than 90% of these deaths occurring in developing countries.[5][9] Drowning occurs more frequently in males and the young.[5]
References edit
- ^ a b "Drowning". CDC. 15 September 2017. Archived from the original on 3 February 2017. Retrieved 9 August 2018.
- ^ a b c d Ferri, Fred F. (2017). Ferri's Clinical Advisor 2018 E-Book: 5 Books in 1. Elsevier Health Sciences. p. 404. ISBN 9780323529570. Archived from the original on 30 July 2020. Retrieved 4 August 2020.
- ^ a b c d e f "Drowning - Injuries; Poisoning - Merck Manuals Professional Edition". Merck Manuals Professional Edition. September 2017. Archived from the original on 9 August 2018. Retrieved 9 August 2018.
- ^ a b c d e Handley, AJ (16 April 2014). "Drowning". BMJ (Clinical Research Ed.). 348: g1734. doi:10.1136/bmj.g1734. PMID 24740929.
- ^ a b c d e f g "Drowning". World Health Organization. 15 January 2018. Archived from the original on 23 August 2018. Retrieved 9 August 2018.
- ^ a b Preventing drowning: an implementation guide (PDF). WHO. 2015. p. 2. ISBN 978-92-4-151193-3. Archived (PDF) from the original on 28 July 2018. Retrieved 9 August 2018.
- ^ a b c d e f g h Mott, TF; Latimer, KM (1 April 2016). "Prevention and Treatment of Drowning". American Family Physician. 93 (7): 576–82. PMID 27035042.
- ^ a b GBD 2015 Disease and Injury Incidence and Prevalence, Collaborators. (8 October 2016). "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1545–1602. doi:10.1016/S0140-6736(16)31678-6. PMC 5055577. PMID 27733282.
{{cite journal}}:|first1=has generic name (help)CS1 maint: numeric names: authors list (link) - ^ a b c d GBD 2015 Mortality and Causes of Death, Collaborators. (8 October 2016). "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1459–1544. doi:10.1016/s0140-6736(16)31012-1. PMC 5388903. PMID 27733281.
{{cite journal}}:|first1=has generic name (help)CS1 maint: numeric names: authors list (link) - ^ a b van Beeck, EF; Branche, CM; Szpilman, D; Modell, JH; Bierens, JJ (November 2005). "A new definition of drowning: towards documentation and prevention of a global public health problem". Bulletin of the World Health Organization. 83 (11): 853–6. PMC 2626470. PMID 16302042.
- ^ Wall, Ron (2017). Rosen's Emergency Medicine: Concepts and Clinical Practice (9 ed.). Elsevier. p. 1802. ISBN 978-0323354790.