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Abstract
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When a person falls under water, a strong urge comes to his aunt. He strives to get out and stand on the surface of the water, often makes unadapted movements. In the chagish wagon, the Chagger, holding a breath, comes out to the surface of the water and, being air, sinks back into the water. Continuous breathing and holding the breath stopped carbon dioxide on the day. This in turn leads to involuntary breathing. At this time, water in large quantities falls on the trachea, bronchi and alveoli. Underwater regular breathing lasts up to a few seconds. Then there will be a stop of secondary breathing for up to a minute, and then agonal breathing.
According to the World Health Organization, globally drowning claims the life of one person every 1.5 s [1]. International data severely underestimates actual drowning numbers, even in high-income countries [2]. The accepted definition of drowning is "the process of experiencing respiratory impairment from submersion or immersion in liquid". This definition was established in 2002 and adopted by the International Liaison Committee on Resuscitation in 2003, and the WHO in 2005 [3,4] There are three possible outcomes from a drowning event: death, survival with morbidity, and survival without morbidity.
Almost all drowning victims are able to help themselves or are rescued in time by bystanders or professional rescuers. One study revealed that in areas where lifeguard services operate, less than 6% of all rescued persons need medical attention, 0.5% require cardiopulmonary resuscitation (CPR), and of these more than half (0.34%) died [2]. By contrast, Venema reported almost 30% of persons rescued from drowning by bystanders required CPR [5]. This difference may be explained by the fact lifeguards have be shown to detect persons in distress faster that non-lifeguards and can execute a rescue in less time and much more safer than a bystander [2,6]. Lifeguards also have a duty of care, so are trained and equipped to initiate resuscitation, whereas a member of the public is under no obligation to perform CPR. Prompt initiation of ventilations and CPR on-scene is the most important intervention for any person that is in respiratory or cardiac arrest due to drowning [2]. In addition, epidemiologic data in almost every country lacks reports for more than 94% of drowning incidents because non-fatal drowning is still not recorded in any national or international database unless it results in hospitalization or death. Health professionals may encounter drowning patients in a critical condition in the pre-hospital setting, but also in the hospital emergency department, intensive care unit or ward. There is an urgent need therefore to understand what drowning is (and isn't), in terms of interventions needed to properly care for these patients. In addition, all health professionals have a duty to properly inform and educate patients and families about injury prevention. It is impossible to properly educate patients if the wrong information is communicated.
The 'Drowning Chain of Survival' comprises five life-saving steps for lay and professional rescuers. The steps of the chain are: Prevent drowning, recognise distress and call for help, provide flotation, remove from water and provide [first ad advanced aid] care as needed [7]. Unfortunately, and probably for cultural reasons, most interventions and media campaigns tend to focus on providing rescue and first aid education or care instead of preventing the event from occurring; the so called preventative actions.
The aim of this study is to raise public awareness of the fact we are only seeing the "tip of the iceberg" if we measure drowning outcomes by the number of resuscitation attempts, hospitalizations and fatalities. We report on the statistical occurrence of Drowning Chain of Survival actions in a retrospective analysis of a fully operational beach lifeguard service over six summer seasons.
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Language: en |