Drowning

Scope of the Problem

In most industrialized countries, drowning ranks second or third behind motor vehicles and fires as a cause of unintentional injury deaths to children under the age of 15. In the United States, nearly 5,000 people die each year from drowning, including 1,000 boating-related drownings. Death rates from drowning are highest in children less than 5 years old and in teens and young adults 15-24 years. 

It has been estimated that for each childhood drowning fatality, about 4 children are hospitalized and 14 are seen in the emergency department and released. However, among those sustaining immersion and losing consciousness, the morality rate is as high as 50%. The outcome for most children with immersion is determined by their status on arrival to the emergency department; medical and ICU care appear to have relatively little impact on outcome. Contrary to popular notion, most drownings do not involve loud thrashing or verbalization of distress. Hence, prevention is key to decreasing morbidity and mortality from drowning. 

Among children, the risks of drowning are age and, to some degree, location-related. For infants, bathtub drowning poses the greatest hazard. Once children attain mobility as toddlers, pools pose the greatest risk of immersion injury. Certain interventions, such as floating pool covers (as opposed to externally-supported rigid pool covers) may increase the risk of drowning in a pool. Pools continue to play a role in drowning among young, school-age children, but immersion in natural bodies of water either while swimming or boating plays an increasingly important role as children move into adolescence. Among adolescents, alcohol use around water has been found to be associated with as many as one-half of drowning incidents. 

Unfortunately, while many studies have been done on the incidence and epidemiology of drowning, few studies have evaluated intervention programs for their effectiveness. In this review we examine 11 different potential prevention strategies for child and adolescent drowning. 
  Prevention Interventions

• Adult supervision
• Boating safety training programs
• Decreased alcohol use
• Lifeguards
• Personal flotation devices
• Pool alarms
• Pool covers
• Pool fencing
• Swimming lessons
• General education programs
• Drowning Interventions Misc.

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