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Italian Journal of Pediatrics Jun 2023Drowning is the third leading cause of injury death in the pediatric population worldwide, with incidence peaking among those aged 1-4 years and again in adolescence.The... (Review)
Review
Drowning is the third leading cause of injury death in the pediatric population worldwide, with incidence peaking among those aged 1-4 years and again in adolescence.The purpose of this commentary is to review the basic pathophysiology of drowninginjury and factors that affect the outcome, such as submersion and hypothermia. We also discuss principles of prehospital and in-hospital management, comprising resuscitation and stabilization, administration of oxygen and intravenous liquids, and central reheating.Even though the mortality rate has decreased in recent years, further investments and safety measures are needed to prevent child drowning deaths.
Topics: Adolescent; Humans; Child; Drowning; Resuscitation; Oxygen
PubMed: 37316902
DOI: 10.1186/s13052-023-01464-1 -
Journal of Safety Research Jun 2023Amongst pool lifeguards, the capacity to identify drowning swimmers quickly and accurately depends on the interpretation of critical cues. However, assessing the...
INTRODUCTION
Amongst pool lifeguards, the capacity to identify drowning swimmers quickly and accurately depends on the interpretation of critical cues. However, assessing the capacity for cue utilization amongst lifeguards at present is costly, time-consuming, and largely subjective. The aim of this study was to test the relationship between cue utilization and the detection of drowning swimmers in a series of virtual public swimming pool scenarios.
METHOD
Eighty-seven participants with or without lifeguarding experience engaged in three virtual scenarios, two of which were target scenarios where drowning events occurred within a 13 minute or 23 minute period of watch. Cue utilization was assessed using the pool lifeguarding edition of the EXPERTise 2.0 software following which 23 participants were classified with higher cue utilization, while the remaining participants were classified with lower cue utilization.
RESULTS
The results revealed that participants with higher cue utilization were more likely to have acquired experience as a lifeguard, were more likely to detect the drowning swimmer within a three minute period, and, in the case of the 13 minute scenario, recorded a greater dwell time on the drowning victim prior to the drowning event.
CONCLUSION
The results suggest that cue utilization is associated with drowning detection performance in a simulated environment and could be employed as a basis for assessments of performance amongst lifeguards in the future.
PRACTICAL IMPLICATIONS
Measures of cue utilization are associated with the timely detection of drowning victims in virtual pool lifeguarding scenarios. Employers and trainers of lifeguards can potentially augment existing lifeguarding assessment programs to quickly and cost-effectively identify the capabilities of lifeguards. This is especially useful for new lifeguards or where pool lifeguarding is a seasonal activity that might be associated with skill decay.
Topics: Humans; Drowning; Cues; Swimming Pools; Records
PubMed: 37330888
DOI: 10.1016/j.jsr.2023.04.006 -
Injury Prevention : Journal of the... Apr 2022Drowning and climate change are both significant global health threats, yet little research links climate change to drowning risk. Research into the epidemiology, risk... (Review)
Review
Drowning and climate change are both significant global health threats, yet little research links climate change to drowning risk. Research into the epidemiology, risk factors and preventive strategies for unintentional drowning in high-income and in low-income and middle-income countries has expanded understanding, but understanding of disaster and extreme weather-related drowning needs research focus. As nation states and researchers call for action on climate change, its impact on drowning has been largely ignored. This state-of-the-art review considers existing literature on climate change as a contributor to changes in drowning risks globally. Using selected climate change-related risks identified by the World Meteorological Organization and key risks to the Sustainable Development Goals as a framework, we consider the drowning risks associated with heat waves, hydrometeorological hazards, drought and water scarcity, damaged infrastructure, marine ecosystem collapse, displacement, and rising poverty and inequality. Although the degree of atmospheric warming remains uncertain, the impact of climate change on drowning risk is already taking place and can no longer be ignored. Greater evidence characterising the links between drowning and climate change across both high-income and low-income and middle-income contexts is required, and the implementation and evaluation of drowning interventions must reflect climate change risks at a local level, accounting for both geographical variation and the consequences of inequality. Furthermore, collaboration between the injury prevention, disaster risk reduction and climate change mitigation sectors is crucial to both prevent climate change from stalling progress on preventing drowning and further advocate for climate change mitigation as a drowning risk reduction mechanism.
Topics: Climate Change; Disasters; Drowning; Ecosystem; Humans; Sustainable Development
PubMed: 35197275
DOI: 10.1136/injuryprev-2021-044486 -
Journal of Community Health Jun 2023Adult drowning is a complex and multifactorial public health challenge requiring community, national and global efforts to mitigate impacts. This study updates the... (Review)
Review
Adult drowning is a complex and multifactorial public health challenge requiring community, national and global efforts to mitigate impacts. This study updates the evidence base for public health interventions that address adult fatal and non-fatal drowning. A systematic review was undertaken of the peer-reviewed literature for English-language primary studies published between 2011 and 2021describing a drowning intervention with adults. Twenty-two studies were included. Most studies (n = 16) were conducted in high-income countries. Yearly trends in drowning prevention intervention publications were analysed with 2015 (n = 6) the peak publishing year. Over half of the study designs were pre-post (n = 15). Intervention duration ranged from 4 hours to 11 years. Ten studies described either behaviour change theory or formative evaluation to inform design. Thirteen studies targeted interventions at a population level, seven at a group level and two at individual level. Studies identified a range of prevention strategies, categorised as behavioural (n = 9) (e.g., swimming lessons), socio-ecological (n = 8) (e.g., mandatory personal flotation devices) and mixed (n = 5) (e.g., awareness campaign and barriers to prevent access to water). A range of outcomes were described including changes in awareness, water safety knowledge, attitudes, water safety behaviours and skills, environmental, policy and regulation changes and drowning rates. Findings indicate a small but important increase in the evaluation and publication of effective interventions to prevent adult drowning. The complexity of the issues surrounding drowning requires multi-strategy and context -specific adult focused prevention interventions. Contemporary evidence that identifies effective interventions that contribute to prevention efforts is an essential first step in addressing the challenge.
Topics: Humans; Adult; Drowning; Swimming; Research Design; Water
PubMed: 36653593
DOI: 10.1007/s10900-023-01189-6 -
Fa Yi Xue Za Zhi Feb 2022Drowning is the death caused by asphyxiation due to fluid blocking the airway. In the practice of forensic medicine, it is the key to determine whether the corpse was... (Review)
Review
Drowning is the death caused by asphyxiation due to fluid blocking the airway. In the practice of forensic medicine, it is the key to determine whether the corpse was drowned or entered the water after death. At the same time, the drowning site inference and postmortem submersion interval (PMSI) play an important role in the investigating the identity of the deceased, narrowing the investigation scope, and solving the case. Based on diatoms testing, molecular biology, imaging and artificial intelligence and other technologies, domestic and foreign forensic scientists have done relative research in the identification of the cause of death, drowning site inference and PMSI, and achieved certain results in forensic medicine application. In order to provide a reference for future study of bodies in the water, this paper summarizes the above research contents.
Topics: Artificial Intelligence; Diatoms; Drowning; Forensic Pathology; Humans; Lung; Water
PubMed: 35725698
DOI: 10.12116/j.issn.1004-5619.2021.410625 -
Pediatric Emergency Care Jul 2023Drowning is a serious and underestimated public health problem, with the highest morbidity and mortality reported among children. Data regarding pediatric outcomes of...
BACKGROUND
Drowning is a serious and underestimated public health problem, with the highest morbidity and mortality reported among children. Data regarding pediatric outcomes of drowning are often inadequate, and data collection is poorly standardized among centers. This study aims to provide an overview of a drowning pediatric population in pediatric emergency department, focusing on its main characteristics and management and evaluating prognostic factors.
METHODS
This is a retrospective multicenter study involving eight Italian Pediatric Emergency Departments. Data about patients between 0 to 16 years of age who drowned between 2006 and 2021 were collected and analyzed according to the Utstein-style guidelines for drowning.
RESULTS
One hundred thirty-five patients (60.9% males, median age at the event 5; interquartile range, 3-10) were recruited and only those with known outcome were retained for the analysis (133). Nearly 10% had a preexisting medical conditions with epilepsy being the most common comorbidity. One third were hospitalized in the intensive care unit (ICU) and younger males had a higher rate of ICU admission than female peers. Thirty-five patients (26.3%) were hospitalized in a medical ward while 19 (14.3%) were discharged from the emergency department and 11 (8.3%) were discharged after a brief medical observation less than 24 hours. Six patients died (4.5%). Medium stay in the ED was approximately 40 hours. No difference in terms of ICU admission was found between cardiopulmonary resuscitation performed by bystanders or trained medical personnel ( P = 0.388 vs 0.390).
CONCLUSIONS
This study offers several perspectives on ED victims who drowned. One of the major finding is that no difference in outcomes was seen in patients who received cardiopulmonary resuscitation performed by bystanders or medical services, highlighting the importance of a prompt intervention.
Topics: Male; Child; Humans; Female; Drowning; Cardiopulmonary Resuscitation; Retrospective Studies; Hospitalization; Patient Discharge; Near Drowning
PubMed: 37335544
DOI: 10.1097/PEC.0000000000002987 -
Injury Prevention : Journal of the... Oct 2023To characterise risk factors for fatal drowning in California, USA to inform priorities for prevention, policy and research.
OBJECTIVE
To characterise risk factors for fatal drowning in California, USA to inform priorities for prevention, policy and research.
METHODS
This retrospective population-based epidemiological review of death certificate data evaluated fatal drowning events in California from 2005 to 2019. Unintentional, intentional, and undetermined drowning deaths and rates were described by person (age, sex, race) and context-based variables (region and body of water).
RESULTS
California's fatal drowning rate was 1.48 per 100 000 population (n=9237). Highest total fatal drowning rates occurred in the lower population density northern regions, among older adults (75-84 years: 2.54 per 100 000 population; 85+: 3.47 per 100 000 population) and non-Hispanic American Indian or Alaska Native persons (2.84 per 100 000 population). Male drowning deaths occurred at 2.7 times the rate of females; drowning deaths occurred mainly in swimming pools (27%), rivers/canals (22.4%) and coastal waters (20.2%). The intentional fatal drowning rate increased 89% during the study period.
CONCLUSIONS
California's overall fatal drowning rate was similar to the rest of the USA but differed among subpopulations. These divergences from national data, along with regional differences in drowning population and context-related characteristics, underscore the need for state and regional level analyses to inform drowning prevention policy, programmes and research.
Topics: Female; Humans; Male; Infant; Aged; Drowning; Retrospective Studies; Risk Factors; California; Rivers
PubMed: 37208006
DOI: 10.1136/ip-2023-044862 -
The Lancet. Public Health Sep 2021Drowning is a leading killer, particularly of children and young adults, yet has been greatly neglected. Despite accounting for a higher number of deaths than many other... (Review)
Review
Drowning is a leading killer, particularly of children and young adults, yet has been greatly neglected. Despite accounting for a higher number of deaths than many other substantial public health issues, drowning has not benefitted from the targeted attention it requires, which is particularly tragic because low cost and effective drowning prevention interventions exist. Therefore, the recent UN General Assembly's adoption of a resolution on global drowning prevention is a historic first, and offers an exciting opportunity by providing a comprehensive framework and a practical roadmap that a range of actors and sectors, including governments, can follow to address the challenge of drowning prevention.
Topics: Drowning; Global Health; Humans; Public Health; United Nations
PubMed: 34310906
DOI: 10.1016/S2468-2667(21)00165-1 -
Journal of the American College of... May 2021
Topics: Drowning; Electronic Mail; Humans
PubMed: 33197409
DOI: 10.1016/j.jacr.2020.10.009 -
International Journal of Environmental... Apr 2022Drowning causes significant mortality and morbidity globally, and infants (0-4 years of age) are disproportionately impacted. In a groundbreaking approach to pediatric... (Review)
Review
Drowning causes significant mortality and morbidity globally, and infants (0-4 years of age) are disproportionately impacted. In a groundbreaking approach to pediatric drowning prevention, ecological psychology has been used to investigate the relationship between infants' perceptual-motor development and their behavior around bodies of water. In this review, we summarize recent research findings in the field of ecological psychology and apply these to the prevention of infant drowning. Studies have linked infants' avoidance of falls into the water with locomotor experience and type of accessway into bodies of water. Through crawling experience, infants learn to perceive the risk of falling into water and start adapting their behavior to avoid drop-offs leading into water. Infants tend to enter deep water more when the access is via a slope than via a drop-off. We propose that ecological psychology can enhance infant drowning prevention interventions. The aim is to create an additional layer of protection, the perceptual information layer, in addition to existing strategies, such as supervision and barriers. This new protective layer can be a powerful tool to further highlight the risk of entering the water and reduce infant drowning-related mortality and morbidity.
Topics: Child; Drowning; Humans; Infant; Water
PubMed: 35457435
DOI: 10.3390/ijerph19084567