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Abstract
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We wholeheartedly support the call for research on drowning resuscitation in Tony Handley’s “devil’s advocacy” relating to Fukuda’s drowning study.1, 2 Advocacy statements on drowning research have been made since the beginning of the century, including in the World Health Organisation’s identification of drowning as a neglected issue. Drowning affects over 3 million people worldwide, most of all the poor, uninformed and unprepared.
Agenda-driven drowning resuscitation research has a short history and funding is little compared to primary cardiac arrest research. At the same time, hardly any conclusion from research into primary cardiac arrest applies to drowning. Drowning is a hypoxic event, and the heart stops beating, likely after 2–10 min underwater, due to lack of oxygen. Recirculation of anoxic blood by compression-only CPR repeats the process that has stopped the heart. It is for this simple physiological principle that the European Resuscitation Council, the International Lifesaving Federation and other organisations emphasise mouth-to-mouth-ventilation-first in drowning victims.
“Chest-compression-only after drowning”, may confuse readers, even when intended as a devils advocacy, and may result in inappropriate and spurious efforts to improve the outcome of resuscitation in drowning victims.
The devil is in the details of Fukuda’s study that does not reflect the typical drowning situation, as the authors of the publication pointed out in their recent publication about the same patient population.3 The age (average age: 72.4 ± 21 years), gender (male: 48.5%), and season (winter: 42,9 %) are out-lying when compared to any previous drowning study. The reason is that almost 70% of all drownings in Japan are persons found in traditional bathtubs: the incidence is as high as 10 per 100,000 inhabitants. Most of the victims drowned after ...
Language: en |