Saturday, July 19, 2014

Unintentional drowning mortality, by age and body of water: an analysis of 60 countries

Title: Unintentional drowning mortality, by age and body of water: an analysis of 60 countries
Authors: Lin C,Y Wang YF, Lu TH, Kawach I.
Journal: Injury Prevention, June 18 2014

In an effort to compare the burden of drowning in multiple countries, these authors used WHO databases to calculate mortality rates for unintentional drownings, and, if available, determine rates for various bodies of water.  To improve data collection and results, they combined data from the past 3 years and only reported countries with > 150 deaths for all age groups during that time.

The following is a summary of the interesting results:

  • Highest mortality rates for all ages (per 100,000)
    • Guayana (9.2)
    • Belarus (8.6)
    • Lithuania (8.5)
  • Highest mortality rates for ages 0-4
    • Kyrgyzstan (12)
    • Thailand (12)
    • Guayana (8.2)
  • Highest mortality rates for ages 65+
    • Japan (19)
    • Guayana (17.7)
    • Greece (10.5)
  • United States Statistics
    • All ages: 1.3
    • 0-4: 2.4
    • 65+: 1.5
  • UK Statistics
    • All ages: 0.4
    • 0-4: 0.4
    • 65+: 0.5
  • Australia Statistics
    • All ages: 1.1
    • 0-4: 2.1
    • 65+: 1.7
  • Of countries reporting high quality data for body of water (14)
    • Natural water was main body in 13
    • Bath tub was main body in Japan (mostly older adults, likely cardiac arrests)
    • Swimming pool deaths highest in US (18%) and Australia (13%)
    • US swimming pools
      • Majority of black victims drowned in public pools
      • Majority of white victims drowned in residential pools
      • Majority of hispanic victims drowned in neighborhood pools

As with any study looking at data of this nature, the authors found large variations in data quality between countries.  Unfortunately, countries like India and Bangladesh, both of which are known to have devastating mortality rates, had no WHO data available.


Lin CY, Wang YF, Lu TH, Kawach I. Unintentional drowning mortality, by age and

body of water: an analysis of 60 countries. Inj Prev. 2014 Jun 18.

Wednesday, July 2, 2014

Drowning Chain of Survival

Article: Creating a drowning chain of survival
Author: Szpilman D, et al.
Journal: Resuscitation, July 2014

Many folks are familiar with the Cardiac Chain of Survival, a teaching tool used to simplify and visually depict the most important steps to take to improve survival in out-of-hospital cardiac arrest.  It makes sense then that drowning, its own disease entity with its own important steps in treatment, could use its own chain of survival.  Since 2002, when the Congress on Drowning called for a more standardized definition and reporting of drowning, the development of a drowning chain of survival has been evolving.

During the 2013 Conference on Drowning Prevention in Potsdam, Germany, we had the pleasure of participating in a workshop with the best and the brightest in international drowning prevention and treatment to create the final graphic image and descriptions for the chain.  This month, Dr David Szpilman was lead author on a paper in Resuscitation describing the Drowning Chain of Survival.

Summary of chain links

  • Prevent Drowning
    • Stay within arms reach of children
    • Swim in waters guarded by lifeguards
  • Recognize distress
    • Learn subtle signs of drowning
    • Call for help
  • Provide flotation
    • Avoid entering the water unless trained to do so
    • Throw floating object to victim
  • Remove from water
    • Attempt to instruct victim on returning to shore
    • Reach, throw, row to victim
  • Provide care as needed
    • If not breathing, start CPR including ventilations
    • Consider oxygen and AED if available
    • Seek medical attention if any symptoms present

It was very interesting to be a part of these discussions and I am excited to see them released in a major journal.  People from every different level of training and experience had different things they wanted to highlight, but in the end, I think this chain provides a sound foundation for public and basic lifeguard/medical training.  Keep this in mind, share it with others, and save a life.

Download open source version of article

Szpilman D, et al. Creating a drowning chain of survival. Resuscitation (2014), (Link to abstract)