Drowning
 

BY Julie T. Vieth
MBChB, FAAEM, FACEP

As hot days extend into cool summer nights, many warm-weather activities are taking place throughout the North Country.

With the abundance of public swimming areas, lakes, and pools, both children and adults find relief from hot weather in the cool waters. Although swimming and other water activities should be enjoyed by all for the duration of the summer, special concern and caution should be taken to prevent water related traumatic incidents, one of which is drowning.

By definition, drowning is the condition of being submerged in liquid, which then results in a person ceasing to breathe.

Drowning occurs when the head and face are submerged in a body of water and the victim is unable to come up for air. Drowning can also happen when just the face is immersed in very shallow amounts of water, as in the case of bathtub and backyard kiddie pool drowning events.

Through a series of reflexes, breathing quickly stops and oxygen can no longer be delivered to the body. When the brain loses a supply of vital oxygen, the body quickly loses consciousness and death will follow unless breathing is restored.

Drowning exists in many classifications, including mild, moderate, and severe, and is also defined as having fatal or non-fatal outcomes.

According to the Centers for Disease Control drowning is the fifth leading cause of death in the United States. Children under five, teenagers, and young adults from ages 15-25 are most at risk.

Although much of the concern for drowning is during the summer months, it should also be noted that an incident can occur any time of year.

Drowning is an extremely common but under-appreciated issue from a public health standpoint. For every case of fatal drowning, there are at least five cases of non-fatal drowning which still require medical care and monitoring.

Additionally, for every fatal drowning there are 200 rescues made by adults and lifeguards, which do not require any medical assistance.

Over the last several years, other terms describing drowning have emerged in the media.

These phrases include but are not limited to: dry drowning, near drowning, and secondary drowning, all of which have been used to describe a possible drowning event.

However, the only medically accepted expressions, as adopted by multiple national and international health organizations, are the terms fatal and non-fatal drowning.

These other terms were picked up by the media due to several tragic cases where children died hours or even days after what medical professionals would call a non-fatal drowning episode.

The parents of these victims became appropriately concerned that the deaths of their children were related to a prior drowning event, but following autopsies, none of these cases were attributed to any effects of drowning.

Unfortunately, the realities of these unfortunate situations were never widely reported, and the unofficial terms related to drowning (dry drowning, near drowning, secondary drowning) had already permeated the lay press, despite lack of medical accuracy attributed to these expressions or relationship to a non-fatal drowning event.

What does this really mean for concerned parents and their children?

Parents can be reassured that a death from drowning never occurs hours or weeks later in a child who was otherwise completely fine after the non-fatal drowning incident.

The fatal effects of a drowning event present themselves directly following the event.

Difficult to identify and usually a silent event, actual drownings almost never look like the dramatized drownings portrayed on television.

Half of all pediatric drownings occur within a short distance of parents or caregivers, and since a drowning victim cannot breathe, they also cannot speak or call for help. As well, the natural response when the body begins to drown is to try to rise to the surface.

This means the arms are not flailing around for attention and the body may be bobbing up and down in the water, a reaction much different than the yelling and waving seen in drowning events on TV.

In reality, there is an intense panic response, and the survival mechanism of the brain tries to take over. Shockingly, the entire drowning episode can be fatal in less than one minute.

When drowning victims are identified, they need to immediately be rescued, without putting the rescuer in danger. Call 911 for emergency personnel, and signal others for help when possible. Drowning victims may start breathing on their own once removed from the water. This is considered a non-fatal drowning.

Any victim that needs reviving or does not immediately breathe on their own should be transported to an emergency department right away. Even if the drowning episode was brief, if the victim has any symptoms after the event, including vomiting, trouble breathing, excessive sleepiness or they are just not acting “right,” they should always be evaluated in an emergency department without delay.

Patients and families should always err on the side of caution after a drowning event to avoid any possible complications. The treatment received may simply be a period of observation making sure that breathing and oxygen levels remain normal, or there may be more invasive treatments that must be performed when drowning victims are critically ill.

Prevention of drowning is the most important way to reduce the number of drowning victims.

Backyard pools must be enclosed and not accessible to young children without adult supervision. Children should always be supervised whenever they are near any body of water, which includes bathtubs and small kiddie pools. Children can drown in very shallow water, and this can occur very quickly.

Children should be taught to swim early on, and even when they become confident swimmers, the buddy system should still be used so they are not swimming alone. (This applies to adults as well.)

Alcohol and swimming can also be a dangerous combination and adults must remain cautious. Adults and children who cannot swim should use life jackets when on boats, and there should always be the correct number of life jackets to ensure that each boater has their own.

Children should avoid using any type of air-filled or foam toy as a water safety device. Used as toys, pool noodles, boogie boards and other floating devices are fine, but even arm flotations can encourage an over-confidence in the non-swimmer and a false sense of security and should not be trusted to keep a child from drowning.

Finally, parents should learn basic CPR. Classes are taught throughout our county, and can save a life.

In total, drownings are traumatic and unfortunately sometimes fatal events which are sorely misunderstood in the media and by most people. Drownings are completely preventable events which all community members should be aware of.

Being aware of and on the lookout for the signs of a drowning can potentially save the life of a child or adult; more discussion and prevention will keep families and communities safer.

 

 About St. Lawrence Health System

St. Lawrence Health System was established in December, 2013 with the mission to improve health, to expand access, and to lower costs through coordination and integration of services. Encompassing several corporations, including Canton-Potsdam Hospital, Potsdam, NY, and Gouverneur Hospital, Gouverneur, NY, St. Lawrence Health System also operates extension outpatient facilities in Antwerp, Brasher Falls, Canton, Colton, DeKalb Junction, Edwards, Gouverneur, Massena, Norfolk, and Potsdam. The largest employer in St. Lawrence County, with just over 1,400 employees, St. Lawrence Health System has 130 full-time medical staff members and annual net operating revenues of $180 million.