Figures
- FIGURE 1
Drowning chain of survival. Reproduced from [6] with permission from the publisher.
- FIGURE 2
Drowning severity classification and flow chart strategy decision based on evaluation of 87 339 rescues [1, 4, 30]. CPR: cardiopulmonary resuscitation; ABC: airway, breathing, compression; CPA: cardiopulmonary arrest. Reproduced from [1], with permission.
Tables
- TABLE 1
Sports undertaken in, on, near, under, over and in water or ice, which may lead to drowning
In water Swimming (pool and natural water) Swimming pool (synchronised swimming, water polo and water aerobics) Surfing and board sports (stand-up paddle boarding, skimboarding, kitesurfing, water skiing and others) On water Sailing, boating, kayaking and similar Near water Rock, pier and beach fishing Under water Diving and shallow water blackout Over water Skydiving, hang-gliding, paragliding, parasailing and powered paragliding Ice-water sports - TABLE 2
Preventive measures
Watch children carefully, 84% of drownings occur because of bad adult supervision; the majority in or after the lunch hour. Begin swimming lessons from the age of 2 years, but be very careful at this time Avoid inflatable swimming aids such as “floaties”; they can give a false sense of security. Use a lifejacket! Never try to help rescue someone without being able to do it. Many people have died trying to do so Avoid drinking alcohol and eating before swimming Don't dive in shallow water, there is a risk of cervical spine injury Beaches Always swim in a lifeguard-supervised area
Ask the lifeguard for safe places to swim or play
Read and follow warning signs posted on the beach
Do not overestimate your swimming capability; 46.6% of drowning victims thought they knew how to swim
Swim away from piers, rocks and stakes
Take lost children to the nearest lifeguard tower
>80% of drownings occur in rip currents (the rip is usually a falsely calm deep place between two sand bars). If caught in a rip, swim transversally to the sand bar or let it take you away without fighting and wave for help
If you are fishing on rocks be cautious about waves that may sweep you into the ocean
Keep away from marine animalsPools and similar >65% of deaths occur in fresh water, even on the coast
Fence off your pool and include a gate; approved fencing can decrease drowning by 50–70%
Avoid toys around the pool; they are very attractive to children
Whenever infants or toddlers are in or around water, be within arm's length, providing “touch supervision”
Turn off motor filters when using the pool
Always use portable phones in pool areas, so you are not called away to answer
Don't attempt hyperventilation to increase submersion time
Use warning sign to indicate shallow water
Learn how to react to a drowning situation, >42% of pools owner are not aware of first-aid techniques; be careful! - TABLE 3
Drowning: when to initiate cardiopulmonary resuscitation (CPR) and when to discontinue
Recommendations When to begin? Give ventilatory support for respiratory distress/arrest to avoid cardiac arrest
Start CPR in all submersions lasting <60 min that do not present obvious physical evidence of death (rigor mortis, body decomposition or dependent lividity)When to discontinue? Basic life support should continue until signs of life reappear, rescuer exhaustion or advanced life support takes over
Advanced life support should be ongoing until the patient has been rewarmed (if hypothermic) or asystole persists for >20 minReproduced from [1], with permission.
- TABLE 4
Who needs further medical help after rescue from the water?
Send to hospital Any patient who lost consciousness, even for a brief period
Any patient who required expired air resuscitation (rescue breathing)
Any patient who required cardiopulmonary resuscitation
Any patient in whom a serious condition is suspected, such as heart attack, spinal injury, other injury, asthma, epilepsy, jellyfish stings, intoxication, delirium, etc.Consider for release from care at the scene If, after 10–15 min of careful observation, while being warmed with blankets or other coverings as required, the patient has ALL of the following: No cough
Normal rate of breathing
Normal circulation as measured by pulse strength and rate and blood pressure (if available)
Normal colour and skin perfusion
No shivering
Fully conscious, awake and alert
In such cases, it is unwise for the patient to drive a vehicle and the patient should be so advised If any of these conditions do not apply or if the lifesaver has any doubt, then the patient should be advised to seek early medical attentionThere is always a risk of delayed lung complications All immersion victims should therefore be warned that if they later develop cough, breathlessness, fever or any other worrying symptom, they should seek medical advice immediately. It is preferable that these cases do not return to a home environment where they are alone for the next 24 h
Vol 25 Issue 141
Table of Contents
Sports related to drowning
