Drowning

Drowning is defined as the process of experiencing respiratory impairment from submersion or immersion in liquid. Outcomes are classified as death, survival with morbidity, and survival with no morbidity.

Drowning is a leading cause of injury and death among young people.

It has been estimated that 80% to 90% of all drownings are preventable.

Hypoxaemia is the primary cause of morbidity and mortality, and its reversal must remain the focus of treatment.

The 'Drowning Chain of Survival' refers to a series of interventions that, when put into action by laypersons or professionals, may reduce morbidity and mortality associated with drowning.

Drowning is the process of experiencing respiratory impairment from submersion or immersion in liquid.[1]Idris AH, Berg RA, Bierens J, et al. ​Recommended guidelines for uniform reporting of data from drowning: the "Utstein style". Circulation. 2003 Nov 18;108(20):2565-74. https://www.ahajournals.org/doi/10.1161/01.CIR.0000099581.70012.68 ​ This process is a continuum from respiratory impairment as the person's airway goes below the surface of the liquid (submersion) to water splashing over the face (immersion). If the person is rescued at any time, the process of drowning is interrupted, resulting in a non-fatal drowning. Any submersion or immersion incident without evidence of respiratory impairment (aspiration) should be considered a water rescue rather than a drowning. Terms such as 'near-drowning', 'dry or wet drowning', 'active and passive drowning', 'secondary', and 'delayed onset of respiratory distress' should not be used.[1]Idris AH, Berg RA, Bierens J, et al. ​Recommended guidelines for uniform reporting of data from drowning: the "Utstein style". Circulation. 2003 Nov 18;108(20):2565-74. https://www.ahajournals.org/doi/10.1161/01.CIR.0000099581.70012.68 ​​[2]Idris AH, Bierens JJLM, Perkins GD, et al. 2015 revised Utstein-style recommended guidelines for uniform reporting of data from drowning-related resuscitation: an ILCOR advisory statement. Resuscitation. 2017 Sep;118:147-58. http://www.ncbi.nlm.nih.gov/pubmed/28728893?tool=bestpractice.com

Adult and paediatric patients are covered in this topic. The approach to adults and children who have drowned is similar; any differences will be made explicit in the text.