DROWNING - Medicine for Mountaineering and Other Wilderness Activities - page 424

CHAPTER 28
DROWNING
Andrea R. Gravatt, M.D.
Gordon G. Giesbrecht, Ph.D.
James A. Wilkerson, M.D.
Principal Contributors
Oceans with sun-drenched beaches, streams and rivers cascading over boulders, thundering
waterfalls,tree-linedswimmingholes,peacefullakesandpondsteemingwithfish,sparkling
swimming pools, romantic hot tubs—all of these are favorite places for relaxation not usu-
ally thought of as death scenes, but they can be. Buckets filled with water, bathtubs, and
toilets are more practical facilities but also are associated with a significant drowning mor-
tality.
Drowning is a major world health problem that causes significant morbidity and mortal-
ity. The Centers for Disease Control and Prevention (CDC) reported 3582 drowning deaths
in the United States during 2005, an average of ten per day. More than one in four were in
children younger than fifteen years. (These numbers may be low as the result of underre-
porting.) That statistic does not include boating-related accidents that, according to the U.S.
Coast Guard, accounted for approximately 710 additional drownings in 2005.
Drowningisthesecondmostcommoncause(aftermotorvehicleaccidents)ofaccidental
death in children between the ages of one and fourteen years and the third most common
cause of accidental death overall. It ranks fourth among all causes of childhood death. Of
individuals who drown, 40 to 50 percent are four years old or younger; the only other large
group is teenage males.
Foreverychildfourteenyearsandyoungerwhodiedfromdrowning,fourreceivedemer-
gency department care for nonfatal submersion injuries. More than half these children re-
quired hospitalization. Nonfatal drownings can cause brain damage that results in long-term
disability ranging from memory problems and learning disabilities to the permanent loss of
all sensible brain function (permanent vegetative state).
The financial cost of drowning is one of the highest for any injury group because many
who have drowned require prolonged hospitalization and long-term care. One series repor-
ted that for every three deaths one individual suffers brain damage from drowning.
DEFINITIONS RELATED TO DROWNING