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HIGH-YIELD FACTS

  • Drowning is the second most common cause of unintentional death in children and adolescents worldwide, with a bimodal distribution of peak incidence between the ages of 1 and 4 years, and 11 and 14 years.

  • Poor prognostic indicators include prolonged submersion, asystole upon emergency department (ED) arrival, and delay in effective cardiopulmonary resuscitation.

  • Patients who have a normal chest radiograph and oxygenation saturation and who remain asymptomatic may be discharged after a 6-hour observation period.

Drowning is a major global health problem, with significant mortality and morbidity in children.1,2 Children younger than 14 years of age comprise about 20% of all drowning victims. One in every five emergency department (ED) visits for submersion-related injuries results in death secondary to drowning, and it is the most preventable cause of unintentional injury in children.3

Drowning is the leading cause of death in children from 1 to 4 years of age and the second leading cause of death from unintentional injuries worldwide in children from 1 to 14 years of age.4 The most common site of occurrence is backyard swimming pools.

RISK FACTORS

  • Males are more likely to drown than females, in all age groups, with the highest rate being in the newborn to 4-year-old age group.5–7, 8,9

  • African-American children are three times more likely to drown compared to Caucasian children.

  • Poverty, low parental education level, number of children in the family, and ethnicity have also been associated with an increased risk of drowning.7

  • The majority of drowning-related deaths (98.1%) occur in low- and middle-income countries as compared to high-income countries.5

  • Children are specifically at increased risk by seas/oceans, lakes, streams, swimming pools, and bathtubs, and specific cases have also been reported involving wells, cisterns, buckets, spas, and garden ponds.10

In the past, there have been a number of terms associated with drowning that have caused much confusion when labeling the official cause of injury or death.11 Therefore in 2002, the World Congress on Drowning and the World Health Organization published the following consensus definition for drowning.4,12

“Drowning is a process resulting from primary respiratory impairment from submersion/immersion in a liquid medium.”4 Drowning outcomes have been classified as: “death,” “morbidity,” and “no morbidity.” These patient outcomes can be further categorized as “moderately disabled,” “severely disabled,” “vegetative state/coma,” and “brain death.”

According to the advisory statement recommendations presented by The International Liaison Committee on Resuscitation, outdated and nonspecific terminology including “dry drowning,” “wet,” “active,” “silent,” “secondary,” and “near drowning” should no longer be utilized.13

DROWNING PROCESS

The drowning process is comprised of a continued series of events beginning from the point when the victim’s airway is submerged under the liquid surface. This results in a lack of oxygen ...

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