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Drowning: Prevention, Rescue, Treatment

17/07/2015

MODULE 1:

DROWNING: PREVENTION, RESCUE, TREATMENT

Drowning

Drowning is the process of respiratory impairment due to immersion or submersion in a medium liquid. It may lead to morbidity, no morbidity and mortality.

The terms secondary drowning, dry drowning, wet drowning and near-drowning have been abandoned.

In the majority of the drowning episodes that lead to death, there is even a small amount of liquid in the lungs of the victim. If there is not, then the victim died possibly by another cause before entering into the water.

A drowning episode, except death leads to several other consequences. One possible consequence is that 90% of the couples whose child died by drowning, divorce within 5 years. The costs for hospitalizing a drowning survivor are high both for the family and the society. The life of those that care for the life of a drowning survivor with neurological problems is seriously loosing in quality both emotionally, financially and socially. A small percent among the 20% of those that visited the “other side” had a distressing near-death experience that describes it as hellish and unpleasant.

Water Safety Tips

  • Teach children water safety and swimming skills as early as possible.
  • Always brief babysitters on water safety, emphasizing the need for constant supervision.
  • Appoint a “designated watcher” to monitor children during social gatherings at or near pools.
  • Equip doors and windows that exit to a pool area with alarms.
  • Install a poolside phone, preferably a cordless model, with emergency numbers programmed into speed-dial.
  • Post CPR instructions and learn the procedures. Keep rescue equipment poolside. Don’t wait for the paramedics to arrive because you will lose valuable life-saving seconds. Four to six minutes without oxygen can cause permanent brain damage or death.
  • Keep a first aid kit at poolside.
  • Install four-sided isolation fencing, at least five feet high, equipped with self-closing and self-latching gates, that completely surrounds the pool and prevents direct access from the house and yard.
  • Maintain constant visual contact with children in a pool or pool area.
  • If a child is missing, check the pool first; seconds count in preventing death or disability.
  • Don’t use flotation devices as a substitute for supervision.
  • Never allow a young child in a pool without an adult.
  • Don’t leave objects such as toys that might attract a child in the pool and pool area.
  • Never prop the gate to a pool area open.
  • Don’t rely on swimming lessons, life preservers, or other equipment to make a child water safe.
  • Never assume someone else is watching a child in a pool area.
  • Don’t leave chairs or other items of furniture where a child could use them to climb into a fenced pool area.
  • Don’t think you’ll hear a child who’s in trouble in the water; child drowning is a silent death, with no splashing to alert anyone that the child is in trouble.

Should Your Child Take Swimming Lessons?

  • · Can your child roll over, float on his/her back, and yell for help? This is the most important technique children can use to protect themselves from drowning while alerting others to their danger.
  • · Does your child take refresher swimming classes every year? Rapidly changing skills, different levels of development, and a limited attention span require that a child’s swimming abilities be continually updated.
  • · Can your child swim above water? Children need to know how to swim on top of the water to get adequate air and to find their way to safety.


Epidemiology

It is impossible to fully report the drowning episodes because the countries that are in the danger of ranking higher, are those that do not have a reliable reporting system. For example, if the victim never reaches the hospital, it does not count as a drowning death for the national statistics of this country. In addition, the most vulnerable countries, there is also a lack of hospitals! Also the death by a tsunami or after the fall of a car or airplane in the water is not classified as drowning; as a result the drowning problem is severely underestimated.

About one million people die by drowning each year (i.e., about one person every 30 seconds) while about four more millions are admitted to the hospital for precautions. The male to female rates are 4:1.

Many incidents take place within the first 10m from the land and rarely in distances greater than 50m. Most of these incidents are preventable. The high risk time is between 12-4pm; the high risk people are those between 0-5 years old and the elderly, those that consume alcohol and exhibit a risk taking behavior.

Prevention

To avoid drowning, apply the following safety rules:

  1. Attend organized swimming lessons.
  2. Follow the safety rules of the aquatic facility.
  3. Swim always together with others and ideally supervised by a lifeguard.
  4. Children should always be supervised by an adult when near the water.
  5. Always swim 3 hours after the meal.
  6. Do not stay long in cold water.
  7. Do not swim far from the shore. Swim parallel to the beach.
  8. Never overestimate your ability.
  9. Do not participate in games that could endanger yours or the other’s safety.
  10. If someone is in danger and you can’t help, warn the lifeguard.
  11. If you ever visit for first time an aquatic area, seek advice by the locals about potential dangers.
  12. If you have been caught in a current, swim parallel to the beach and then vertically to return to safety.

Rescue

To save someone, apply one of the following methods:

1. Shout rescue. Sit on the edge of the land and direct the victim to swim towards the safety.
2. Reach rescue. Lay down on the land and extend your hand, leg or an object. Instruct the victim to grab your limb or object so you can pull them out.
3. Throw rescue. Throw a rope; throw bag, circular buoy, lifejacket, ball, or whatever that has some buoyancy. When the victims grab the buoyant object, encourage them to keep the head above the water surface and kick the legs until they will reach the land.
4. Wade rescue. Walk in the water up the point where you can stand up. Reach your hand or another object to the victim (e.g., wood, pole etc). Give instructions. Pull the victim out.
5. Row rescue. The use of a boat requires that the rescuer will know how to use it. Its advantages are that the rescuer can approach quicker than by swimming the victim and return safely back to the land.
6. Swim-with-aid rescue. Before you enter the water, take with you something that has some buoyancy. Approach the victim and extend the buoant object to avoid body contact. The object can be anything like a rescue tube or can, a lifejacket or a ball, an umbrella or a t-shirt. The aim is to maintain some safety distance between you and the casualty.
7. Body contact tow rescue. It is the most difficult and demanding technique. It must be applied only by a trained person. The rescuer approaches the victims from the rear, to avoid a potential grab. A towing method can be made if the victims are grabbed by the shoulders, clothes, wrist, arm, armpits, or the jaw with one or two arms. If the casualties are conscious, reassure them. If they submerge, bring them to the safety and administer a mouth-to-nose resuscitation.

The safest methods for a trained person are the first four. The “golden rule” of safety is that the rescuer should not place his life at risk.

Treatment

After the water rescue, the drowning victim needs additional treatment:

  1. IF there is not breathing, it is necessary to call the ambulance and provide basic life support (cardiopulmonary resuscitation and the placing into the recovery position), until ambulance arrives to provide defibrillation and advanced life support.
  2. If the victims are breathing, reassure them.
  3. If they are cold, cover them with something warm.
  4. If the victims are concerned about their personal belongings or their relatives, make sure that the last will be notified about the situation.


TEST OF UNDERSTANDING

You have read the module “Drowning: Prevention, Rescue, Treatment”. Great!

Now, why don’t you take 20 more minutes, to answer some questions, for testing your understanding? If you answer correctly, you will get a Certificate of Accomplishment.

To start the test, click here

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