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Academic Forensic Pathology Mar 2018Drowning, which typically involves a watery environment, remains a serious public health concern claiming an estimated 362 000 lives per year worldwide across all... (Review)
Review
Drowning, which typically involves a watery environment, remains a serious public health concern claiming an estimated 362 000 lives per year worldwide across all socioeconomic classifications and has remained under close observation by the World Health Organization and its signatories. A significant number of water-related deaths are attributed to accidental drowning, while a smaller but still significant number represent suicidal or homicidal drowning. Others involve a combination of drowning precipitated by injury, intoxication, or environmental extremes. Still others involve victims that die from injury, intoxication, or a natural disease entity of such significance as to preclude the drowning process, while near or in water. While there may be an initial presumption that all water-related deaths are accidental drownings, other possibilities must be considered in the investigation of these types of deaths, as drowning as a cause of death is a diagnosis based on the exclusion of other potential causes. The coordinated investigative efforts of multiple agencies and disciplines are required not only for the designation as drowning as the cause of death but also for death certification. The ongoing analysis and dissemination of data generated from all levels of investigation augment our understanding of the impact on public health and safety, guiding allocation of monetary and educational resources in an effort to prevent further mortality and disability.
PubMed: 31240023
DOI: 10.23907/2018.002 -
Diagnostic and Interventional Imaging Feb 2017Suicide is the eighth cause of mortality in France and the leading cause in people aged between 25 and 34 years. The most common methods of suicide are hanging,... (Review)
Review
Suicide is the eighth cause of mortality in France and the leading cause in people aged between 25 and 34 years. The most common methods of suicide are hanging, self-poisoning with medicines and firearms. Postmortem computed tomography (CT) is a useful adjunct to autopsy to confirm suicide and exclude other causes of death. At autopsy, fractures of the hyoid bone or thyroid cartilage, or both, are found in more than 50% of suicidal hangings. Cervical vertebra fractures are rare and only seen in suicide victims jumping from a great height. Three-dimensional reconstructions from CT data are useful to visualize the ligature mark on the neck. In suicides by firearm, postmortem CT shows entry and exit wounds, parenchymal lesions along the bullet path, as well as projectiles in case of penetrating trauma. However, in the chest and abdomen it is more difficult to identify the path of the projectile. Postmortem CT also shows specific features of suicide by drowning or stabbing, but its use is limited in cases of self-poisoning. The use of postmortem CT is also limited by decomposition and change of body position. This article presents the imaging features seen on postmortem CT according to the method of suicide.
Topics: Asphyxia; Autopsy; Drowning; Forensic Pathology; Gastrointestinal Contents; Humans; Lung; Neck Injuries; Poisoning; Suicide; Tomography, X-Ray Computed; Wounds, Gunshot; Wounds, Stab
PubMed: 27687828
DOI: 10.1016/j.diii.2016.06.023 -
BMJ Paediatrics Open Jun 2022Drowning is one of the major public health concerns, and children are the most vulnerable victims of drowning death in Bangladesh, which has been a paramount threat to...
Drowning is one of the major public health concerns, and children are the most vulnerable victims of drowning death in Bangladesh, which has been a paramount threat to child survival. Based on available data, we intend to underline the prevalence and associated risk factors for child drowning deaths in Bangladesh. According to the Center for Injury Prevention and Research, Bangladesh, about 19 000 people of all ages drown per year across the country, where approximately 77% are children (<18 years), which means that over 40 Bangladeshi children drown per day. A recent survey reported that as of data collected from January 2020 to June 2021, 83% of drowning victims were children. Insufficient parental supervision, mother's illiteracy, lack of swimming ability, male gender, children under 5 years, geographical and environmental conditions, seasonality, and disasters significantly contribute to child drowning deaths in Bangladesh. We urge the governments and local administrations to address the current crisis by coordinating and integrating several effective efforts to prevent child drowning deaths.
Topics: Bangladesh; Child; Child, Preschool; Drowning; Family; Humans; Male; Prevalence; Risk Factors
PubMed: 36053622
DOI: 10.1136/bmjpo-2022-001464 -
Sensors (Basel, Switzerland) May 2022The purpose of this research was to develop an algorithm for a wearable device that would prevent people from drowning in swimming pools. The device should detect...
The purpose of this research was to develop an algorithm for a wearable device that would prevent people from drowning in swimming pools. The device should detect pre-drowning symptoms and alert the rescue staff. The proposed detection method is based on analyzing real-time data collected from a set of sensors, including a pulse oximeter. The pulse oximetry technique is used for measuring the heart rate and oxygen saturation in the subject's blood. It is an optical method; subsequently, the measurements obtained this way are highly sensitive to interference from the subject's motion. To eliminate noise caused by the subject's movement, accelerometer data were used in the system. If the acceleration sensor does not detect movement, a biosensor is activated, and an analysis of selected physiological parameters is performed. Such a setup of the algorithm allows the device to distinguish situations in which the person rests and does not move from situations in which the examined person has lost consciousness and has begun to drown.
Topics: Drowning; Humans; Oximetry; Oxygen; Swimming Pools; Wearable Electronic Devices
PubMed: 35632232
DOI: 10.3390/s22103823 -
Scandinavian Journal of Trauma,... Mar 2018The Utstein style for drowning (USFD) was published in 2003 with the aim of improving drowning research. To support a revision of the USFD, the current study aimed to... (Review)
Review
BACKGROUND
The Utstein style for drowning (USFD) was published in 2003 with the aim of improving drowning research. To support a revision of the USFD, the current study aimed to generate an inventory of the use of the USFD parameters and compare the findings of the publications that have used the USFD.
METHODS
A search in Pubmed, Embase, the Cochrane Library, Web of Science and Scopus was performed to identify studies that used the USFD and were published between 01-10-2003 and 22-03-2015. We also searched in Pubmed, Embase, the Cochrane Library, Web of Science, and Scopus for all publications that cited the two publications containing the original ILCOR advisory statement introducing and recommending the USFD. In total we identified 14 publications by groups that explicitly used elements of the USFD for collecting and reporting their data.
RESULTS
Of the 22 core and 19 supplemental USFD parameters, 6-19 core (27-86%) and 1-12 (5-63%) supplemental parameters were used; two parameters (5%) have not been used in any publication. Associations with outcome were reported for nine core (41%) and five supplemental (26%) USFD parameters. The USFD publications also identified non-USFD parameters related to outcome: initial cardiac rhythm, time points and intervals during resuscitation, intubation at the drowning scene, first hospital core temperature, serum glucose and potassium, the use of inotropic/vasoactive agents and the Paediatric Index of Mortality 2-score.
CONCLUSIONS
Fourteen USFD based drowning publications have been identified. These publications provide valuable information about the process and quality of drowning resuscitation and confirm that the USFD is helpful for a structured comparison of the outcome of drowning resuscitation.
Topics: Biomedical Research; Cardiopulmonary Resuscitation; Drowning; Humans; Publications
PubMed: 29566700
DOI: 10.1186/s13049-018-0488-z -
Injury Prevention : Journal of the... Jun 2016Drowning is a leading cause of unintentional death. Rivers are a common location for drowning. Unlike other location-specific prevention efforts (home swimming pools and... (Review)
Review
INTRODUCTION
Drowning is a leading cause of unintentional death. Rivers are a common location for drowning. Unlike other location-specific prevention efforts (home swimming pools and beaches), little is known about prevention targeting river drowning deaths.
METHODS
A systematic literature review was undertaken using English language papers published between 1980 and 2014, exploring gaps in the literature, with a focus on epidemiology, risk factors and prevention strategies for river drowning.
RESULTS
Twenty-nine papers were deemed relevant to the study design including 21 (72.4%) on epidemiology, 18 (62.1%) on risk factors and 10 (34.5%) that proposed strategies for prevention. Risk factors identified included age, falls into water, swimming, using watercraft, sex and alcohol.
DISCUSSION
Gaps were identified in the published literature. These included a lack of an agreed definition for rivers, rates for fatal river drowning (however, crude rates were calculated for 12 papers, ranging from 0.20 to 1.89 per 100 000 people per annum), and consensus around risk factors, especially age. There was only one paper that explored a prevention programme; the remaining nine outlined proposed prevention activities. There is a need for studies into exposure patterns for rivers and an agreed definition (with consistent coding).
CONCLUSIONS
This systematic review has identified that river drowning deaths are an issue in many regions and countries around the world. Further work to address gaps in the published research to date would benefit prevention efforts.
Topics: Accident Prevention; Accidents; Drowning; Environment Design; Health Knowledge, Attitudes, Practice; Humans; International Classification of Diseases; Preventive Health Services; Risk Factors; Rivers; Swimming
PubMed: 26728005
DOI: 10.1136/injuryprev-2015-041750 -
Journal of Safety Research Dec 2023Lifeguards must maintain alertness and monitor an aquatic space across extended periods. However, lifeguard research has yet to investigate a lifeguard's ability to...
INTRODUCTION
Lifeguards must maintain alertness and monitor an aquatic space across extended periods. However, lifeguard research has yet to investigate a lifeguard's ability to maintain performance over time and whether this is influenced by years of certified experience or the detection difficulty of a drowning incident. The aim of this study was to examine whether lifeguard experience, drowning duration, bather number, and time on task influences drowning detection performance.
METHOD
A total of 30 participants took part in nine 60-minute lifeguard specific tasks that included 11 drowning events occurring at five-minute intervals. Each task had manipulated conditions that acted as the independent variables, including bather number and drowning duration.
RESULTS
The experienced group detected a greater number of drowning events per task, compared to novice and naïve groups. Findings further highlighted that time, bather number, and drowning duration has a substantial influence on lifeguard specific drowning detection performance.
PRACTICAL APPLICATIONS
It is hoped that the outcome of the study will have applied application in highlighting the critical need for lifeguard organizations to be aware of a lifeguard's capacity to sustain attention, and for researchers to explore methods for minimizing any decrement in vigilance performance.
Topics: Humans; Drowning; Wakefulness; Attention; Awareness
PubMed: 38081714
DOI: 10.1016/j.jsr.2023.08.014 -
Injury Prevention : Journal of the... Apr 2022Drowning is a leading cause of death in children ≤5 years old. Detailed data on the epidemiology of drowning in this high-risk population can inform preventative...
BACKGROUND
Drowning is a leading cause of death in children ≤5 years old. Detailed data on the epidemiology of drowning in this high-risk population can inform preventative efforts. We aimed to study trends in incidence and case fatality rates (CFR) in the USA among young children hospitalised after drowning.
METHODS
Children ≤5 years old hospitalised in the USA after drowning were identified from the Kids Inpatient Database 2000-2016. Incidence and CFRs by calendar year, age, sex, race/ethnicity and hospital region were calculated. Trends over time were evaluated. Factors associated with fatal drowning were assessed.
RESULTS
Among 30 560 804 hospitalised children ≤5 years old, 9261 drowning cases were included. Patients were more commonly male (62.3%) and white (47.4%). Two years old had the highest incidence of hospitalisation after drowning, regardless of race/ethnicity, sex and region. Overall drowning hospitalisations decreased by 49% from 2000 to 2016 (8.38-4.25 cases per 100 000 children). The mortality rate was 11.4% (n=1060), and most occurred in children ≤3 years old (83.0%). Overall case fatality decreased between 2000 and 2016 (risk ratio (RR) 0.44, 95% CI 0.25 to 0.56). The lowest reduction in incidence and case fatality was observed among Black children (Incidence RR 0.92, 95% CI 0.75 to 1.13; case fatality RR 0.80, 95% CI 0.41 to 1.58).
CONCLUSIONS
Hospitalisations and CFRs for drowning among children ≤5 years old have decreased from 2000 to 2016. Two years old are at the highest risk of both fatal and non-fatal drowning. Disparities exist for Black children in both the relative reduction in drowning hospitalisation incidence and case fatality. Interventions should focus on providing equitable preventative care measures to this population.
Topics: Child; Child, Preschool; Drowning; Hospitalization; Humans; Incidence; Infant; Male; Retrospective Studies; Risk Factors
PubMed: 34462333
DOI: 10.1136/injuryprev-2021-044257 -
The Medical Clinics of North America Mar 2016Injuries result in nearly 6 million deaths and incur 52 million disability-adjusted life-years annually, making up 15% of the global disease burden. More than 90% of... (Review)
Review
Injuries result in nearly 6 million deaths and incur 52 million disability-adjusted life-years annually, making up 15% of the global disease burden. More than 90% of this burden occurs in low- and middle-income countries. Given this burden, it is not unexpected that injuries are the leading cause of death among travelers to low- and middle-income countries, namely, from road traffic crashes and drowning. Therefore, pretravel advice regarding foreseeable dangers and how to avoid them may significantly mitigate injury risk, such as wearing seatbelts, helmets, and personal flotation devices when appropriate; responsibly consuming alcohol; and closely supervising children.
Topics: Accidents, Traffic; Developing Countries; Drowning; Humans; Risk; Safety; Travel; Wounds and Injuries
PubMed: 26900117
DOI: 10.1016/j.mcna.2015.07.011 -
Clinical Microbiology and Infection :... Jan 2023Pneumonia is the most frequent infectious complication in patients who have experienced drowning that requires intensive care unit (ICU) admission. We aimed to describe...
OBJECTIVE
Pneumonia is the most frequent infectious complication in patients who have experienced drowning that requires intensive care unit (ICU) admission. We aimed to describe clinical, microbiological, and therapeutic data as well as predictors and impacts of such pneumonia on patients' outcomes.
METHODS
We conducted a retrospective, multicentre study (2013-2020) of 270 consecutive patients admitted for drowning to 14 ICUs in Western France. Their baseline characteristics and outcomes were compared according to the occurrence of drowning-associated pneumonia (DAP), defined as pneumonia diagnosed within 48 hours of ICU admission. A Cox regression model was used to compare survival on day 28, and logistic regression was used to identify risk factors for DAP. Microbiological characteristics and empirical antibacterial treatment were also analysed.
RESULTS
Among the 270 patients admitted to the ICU for drowning, 101 (37.4%) and 33 (12.2%) experienced pneumonia and microbiologically proven DAP, respectively. The occurrence of pneumonia was associated with higher severity scores at ICU admission (median Simplified Acute Physiology Score II, 34 [interquartile range {IQR}, 25-55] vs. 45 [IQR, 28-67]; p 0.006) and longer ICU length of stay (2 days [IQR, 1-3] vs. 4 days [IQR, 2-7]; p < 0.001). The 28-day mortality rate was higher among these patients (29/101 [28.7%] vs. 26/169 [15.4%]; p 0.013). Microbiologically proven DAP remained associated with higher 28-day mortality after adjustments for cardiac arrest and water salinity (adjusted hazard ratio, 1.86 [95% CI, 1.06-3.28]; p 0.03). A microbiological analysis of respiratory samples showed a high proportion of gram-negative bacilli (23/56; 41.1%), with a high prevalence of amoxicillin-clavulanate resistance (12/33; 36.4%).
CONCLUSIONS
Pneumonia is a common complication in patients admitted in the ICU for drowning and is associated with increased mortality.
Topics: Humans; Cohort Studies; Retrospective Studies; Drowning; Hospitalization; Pneumonia; Intensive Care Units; Hospital Mortality
PubMed: 35944877
DOI: 10.1016/j.cmi.2022.07.027