Drowning

Drowning is defined by the American Academy of Pediatrics as death resulting from suffocation within twenty-four hours of submersion in water. Near-drowning applies to all other victims, whether or not they survive. For every child that drowns, four children are hospitalized for near-drowning, according to the National Center for Injury Prevention and Control. Children less than one year of age frequently drown in bathtubs and buckets; children aged one to four years most often drown in swimming pools; and children and adolescents aged five to nineteen years most frequently drown in natural bodies of water. Alcohol use in adolescents and adults is estimated to be associated with 25 to 50 percent of drownings. Males comprise the overwhelming majority of drowning victims.

Although people can hold their breath under-water for a limited amount of time, rising carbon dioxide levels in the blood initiate the need to take a breath. Most drowning victims quickly lose consciousness due to lack of oxygen and then inhale water. Death is typically a result of brain damage due to lack of oxygen and/or acute lung injury from aspirated fluids. Both sea and fresh water affect a substance called surfactant that coats the tiny air sacs, or alveoli, in the lungs. Lack of surfactant activity causes elevated surface tension in the lungs. This increases the effort required to inflate the alveoli and thus decreases the amount of air that can fill the lungs and the extent of oxygenation of the blood.

Treatment of a drowning victim is to restore breathing and circulation as soon as possible, because irreversible brain damage or death may occur in four to six minutes after breathing stops. Artificial respiration (mouth-to-mouth resuscitation) and cardiopulmonary resuscitation (CPR) are techniques used for this purpose.

See also: Causes of Death

Bibliography

American Academy of Pediatrics. "Drowning in Infants, Children, and Adolescents (RE9319)." Pediatrics 92 (1993):292–294.

Internet Resources

CDC–National Center for Injury Prevention and Control. "Drowning Prevention." In the Centers for Disease Control and Prevention [web site]. Available from www.cdc.gov/ncipc/factsheets/drown.htm

ALLISON K. WILSON