Wednesday, June 27, 2018

Is drowning a mere matter of resuscitation?

Title: Is drowning a mere matter of resuscitation?
Authors: Szpilman D, de Barros Oliveira R, Mocellin O, Webber J
Journal: Resuscitation, June 2018

While much of the focus of media and research is on drowning cases which require resuscitation or hospitalization, the reality of lifeguarding is that the vast majority of interventions performed by lifeguards don't involve such severe cases. To highlight the need for better surveillance of what lifeguards do most, these authors analyzed 6 summers worth of data from a Brazilian lifesaving agency and categorized interventions based on 3 broad categories from the Drowning Chain of Survival (prevention, rescue, first aid).

Study Findings
  • 1,565,699 reported lifeguard actions
    • 1,563,300 preventative (99.8%)
    • 2044 recognizing distress and rescuing (0.1%)
      • 1689 no evidence aspiration
      • 14 (0.7%) Grade 5 or 6 (needed respiratory or cardiac resus)
    • 355 needed medical assistance
      • Grade 1: 234 (66%)
      • Grade 2: 78 (22%)
      • Grade 3: 22 (6%)
      • Grade 4: 7 (2%)
      • Grade 5: 4 (1%)
      • Grade 6: 10 (3%)
Summary
  • For each rescue made, the were 765 preventative actions
  • Of all rescues made, 17% needed medical assistance, 0.7% needed resuscitation
  • Of all lifeguard interventions, 0.0009% needed resuscitation
This study highlights the fact that the vast majority of interventions performed by lifeguards are not associated with resuscitation or severe drowning injury. Better surveillance and data collection of non-fatal and Grade 1-4 drownings is needed to truly understand burden and properly target interventions.

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