Drowning

Drowning is the potentially fatal experience of impaired breathing from being submerged in or under a liquid.

The World Health Organization (2015) defines drowning as the “process of experiencing respiratory impairment from submersion/immersion in liquid.” When people's noses and mouths are under water for longer than they can hold their breath, the normal reflex is to take a breath or gasp for air. When they do inhale, water enters the respiratory passages, people no longer get oxygenated air to the lungs and tissues, and they become unconscious. If aid is not given immediately, drowning victims die.

Men are at greater risk of drowning than women. Approximately 80 percent of those who die from drowning are boys or men. African Americans are at greater risk of drowning than Caucasians. Children are also at high risk of drowning. Drowning is the leading cause of injury-related death for children 1 to 4 years of age, and the second-highest cause of unintentional injury-related death in children 1 to 14 years of age. Child drownings most often occur in home swimming pools. The risk of dying by drowning in natural settings such as lakes, rivers, and oceans increases with age.

Factors associated with the risk of drowning include being unable to swim; lack of supervision; lack of pool fencing; failure to wear life jackets when boating; use of alcohol while in or near the water; and having a seizure disorder.

According to the Centers for Disease Control and Prevention in 2015, drowning was the fifth-leading cause of unintentional injury death in the United States, resulting in about 10 deaths per day. About 20 percent of those who die from drowning are children 14 years of age or younger. Most drownings in the United States occur during the summer months; are more common in rural areas; and are more common in the South and West than in other parts of the country. The World Health Organization reports that drowning is the third-most-common cause of accidental death worldwide.

People who are having difficulty in the water may be thrashing about, appear anxious and confused, call for help, and have difficulty breathing. Many times people who are drowning are unusually quiet in the water, maintaining their focus on not drowning. Lifeguards are trained to look for individuals in distress who are quiet. Usually, a drowning victim is found floating unconscious in the water.

The immediate treatment for a victim of drowning is to call for help and initiate cardiopulmonary resuscitation * (CPR). If a drowning is related to a diving injury—such as diving head first into a pool, lake, river, or ocean—and the neck may have been injured, the neck and spine should be immobilized to prevent further damage to the spine.

When emergency personnel arrive, they continue CPR and transport the person to the emergency department of the nearest hospital for further evaluation and treatment. Even if a person has been revived with CPR, he or she should be taken to the emergency department for evaluation.

In the emergency department, the patient is examined, and laboratory tests and x-rays are performed to determine the extent of injury. Treatment centers on improving oxygen supply to the body tissues to prevent brain damage or other organ failure. It is also important for the doctors to know whether the drowning occurred in warm or cold water, as drowning in cold water requires restoration to normal body temperature as well as providing adequate oxygen to the patient.

The chances of drowning can be dramatically decreased in the following ways:

See also Cold-Related Injuries • Emergency Resuscitation (CPR) • Spinal Cord Injury

* cardiopulmonary resuscitation (CPR) is an emergency procedure during which one breathes for a person who is not breathing and provides chest compressions to initiate a heartbeat for someone whose heart is not beating.