Introduction:
Drowning is a common cause of accidental death, especially amongst children and toddlers. Contrary to popular opinion, a casualty who drowns does not usually inhale large amounts of water into the lungs.
90% of deaths from drowning are caused by a relatively small amount of water entering the lungs, interfering with oxygen exchange in the alveoli (wet drowning). The other 10% are caused by muscle spasm near the epiglottis and larynx blocking the airway (dry drowning). The victim will usually swallow large amounts of water, which might then be vomited as they are rescued or resuscitation takes place.
Summer is an exciting and happy time for families; it involves more family fun days filled with sports, outdoor and social activities. One of the most loved summer pastimes for families is an afternoon spent at the pool, beach or river. But a day spent in the water means an increase in danger, and every parent is all too familiar with the fear that accompanies the beloved summer activity.
It should be remembered that other factors may contribute to the cause of drowning – for example, hypothermia, alcohol, or an underlying medical condition such as epilepsy or a heart attack.
Where Should You Be Most Cautious?
Drowning can occur in as little as 30mm of water so it’s important that diligence is taken around all water environments. Common dangerous locations include pools, rivers, dams, beaches or bathtubs.
Seeing your child unresponsive in the water is every parent’s worst nightmare so when a child is spending time in or around water, no matter what the location or activity, it’s imperative they are always under adult supervision and are utilising appropriate water safety devices suitable to their age and swimming capabilities.
Drowning Signs And Symptoms:
- persistent coughing,
- difficulty breathing,
- tiredness,
- decreased activity,
- mental confusion,
- blue colour on skin and lips,
- loss of consciousness,
-
loss of bowel or bladder control
What happens after a person survives a drowning?
Right after a drowning, a person may:
- Be unconscious, unable to breathe, or without a heartbeat.
- Gasp for air, cough up pink froth, vomit, or breathe rapidly.
- Seem to be fine.
Even a little water in the lungs can cause serious lung problems in the next hours or days. Emergency medical care is critical after a person survives a drowning.
What is near-drowning?
Near-drowning is a common but out-of-date phrase for surviving a drowning event.
Drowning happens when a person is underwater and breathes water into the lungs. The airway (larynx) can spasm and close, or water can damage the lungs and keep them from taking in oxygen. In either case, the lungs can't supply oxygen to the body. This can be deadly.
Going without oxygen has a rapid effect on the body.
- Within 3 minutes underwater, most people lose consciousness.
- Within 5 minutes underwater, the brain's oxygen supply begins to drop. A lack of oxygen can
cause brain damage.
First Aid For Drowning:
If a child, adolescent or adult is drowning you must follow these critical First Aid for drowning steps immediately:
- DRSABCD
Once you get to C ‘CPR’ follow these steps for an adult or child:
-
Place casualty onto back
-
Place one index finger on the middle of the collarbone and the other index finger on the sternum (where the ribcage meets below the chest)
- Your two thumbs will meet in between your index fingers. This marks the location where you will place your right hand. Position the base of your hand (just above your wrist joint) here
-
Place your left hand on top of your right hand, clasp and push
- Provide 30 compression 1/3 of the depth of the casualties chest
- Tilt head back, lift chin, open mouth and pinch the soft part of the nose
- Provide 2 breaths – watch and listen for chest to rise and fall
- Repeat sequence until medical assistance arrives or the casualty becomes conscious
Once you get to C ‘CPR’ follow these steps for an infant:
- Place casualty onto back
- Place your index and middle finger over the lower half of sternum (breastbone)
- Provide 30 compression 1/3 of the depth of the casualties chest
- Slightly tilt head back
- Lift chin to move tongue away from back of throat
- Provide two soft puffs (not full breaths as this can damage the infants lungs)
- Repeat sequence until medical assistance arrives or the casualty becomes conscious.
When to call your doctor:
Call or other emergency services immediately if a drowning victim has:
- Lost consciousness.
- Stopped breathing.
- No heartbeat.
- Inhaled water and then gasped for air, coughed up pink froth, vomited, or breathed rapidly.
- Become confused or seems to be in an altered mental state.
Call a doctor now if a recent drowning victim has new breathing problems or signs of a lung infection, such as:
- A cough with or without colored mucus.
- Rapid breathing. Breaths may also be shallow.
- Shortness of breath.
- A fever.
- An unusual level of weakness.
- A whistling noise (wheezing) while breathing.
- Tightness in the chest.
Drowning Self-Care at Home:
In a drowning emergency, the sooner the victim is removed from the water and first aid is administered, the greater opportunity the victim has for surviving.
First aid for a drowning victim:
The focus of the first aid for a drowning victim in the water is to get oxygen into the lungs. Depending upon the circumstances, if there is concern that a neck injury is a possibility (for example, a diving accident) care should be taken to minimize movement of the neck.
When assessing a drowning victim, the first steps for care follow the initial American Heart Association guidelines.
- Is the victim awake?
- Are they breathing on their own?
- Do they have a heartbeat?
Rescue breathing can begin in the water, but all other care requires that the victim be safely out of the water. If other people are available, send person to get help and call emergency. Send another person to get an automated external defibrillator (AED).
If the victim is breathing, he or she should be placed on their side in the recovery position to prevent potential aspiration should vomiting occur (inhaling vomit into the lung).
If the victim is not breathing and has no pulse, begin cardiopulmonary resuscitation (CPR). This is one of the exceptions to the hands-only CPR guidelines. If possible, rescue breathing needs to be initiated in a possible drowning victim.
There are some controversies in medical research that potentially might confuse bystanders who are willing to help. It is important to remember that a drowning victim who is not breathing and does not have a pulse is effectively dead, and any attempts at helping are appropriate.
Recently, chest compression only resuscitation has been endorsed by the American Heart Association and the American College of Cardiology, and rescue breathing is not recommended. This is not the case with drowning, since the initial insult to the body is lack of oxygen. This requires providing oxygen to the victim as soon as possible. This is a different situation than a patient who collapses on dry land, usually has a heart rhythm disturbance and adequate oxygen levels are present in the blood for a few minutes.
It usually is recommended to start rewarming drowning victims by removing wet clothing and covering them in warm blankets. This is appropriate if the patient who has not lost their pulse, or has been resuscitated and is awake.
For a potential drowning victim who was administered CPR, and the pulse has returned, but is still not awake, keeping the patient cool may be appropriate.
More research is required to determine what new approaches might be applicable to effectively treat drowning victims.
Drowning Prevention
As with any accident, prevention is the key.
- Learning how to swim should be a priority for all children and for people of all ages.
- A home swimming pool should always be fenced and secure. Motion detectors may be helpful should the fence fail to keep out unsupervised children.
- When participating in water sports, the use of a personal floatation device (life jacket) is mandatory. Pool toys are not a substitute.
- Alcohol is a major contributor to drowning accidents. Water and alcohol don't mix.
- Never leave an infant unattended in a bath tub or near water.
- Never leave a child unattended near water, whether that is a swimming pool or natural water.
Know where you are swimming:
- Make certain the depth is at least 10 feet if you decide to dive into the water
- Know about the dangerous undercurrents and waves that occur in fresh or sea water
- Avoid dangerous marine animals such as jellyfish and fire coral
- Know the depth of ice before walking on it
- Never swim alone.
- Learn CPR
When spending time in any environment with a larger waterhole such as lakes, dams, rivers, lagoons or beaches the following must always be checked:
1. Ensure the environment is suitable to the individuals swimming capabilities
2. Ensure the individual wears flotation devices suitable to their swimming capabilities
3. Ensure adolescents and children are under adult supervision at all times
4. Ensure safety precautions are taken at all times (ie. No running, no diving in unmeasured waters).