“We have a 4-year-old male in cardiac arrest after being found at the bottom of a community pool. Unknown time of submersion but the child was seen 5 minutes before by family.  Multiple rounds of medication given, the child has been intubated successfully and we will be at your facility in approximately 5 minutes. Any questions?”  This is a patch that can stop you cold in your tracks, regardless of how seasoned an emergency physician you are.  While this case is a hypothetical one, similar cases have presented to the department during my shifts in the past 10 years.  Drownings are an unfortunate tragedy that is one of the leading cause of death in children under the age of 5.  My wife reminded me that this would have been a fantastic post 3 months ago…here is too keeping everyone awake for the last few weeks of summer.

Did you know that half a million people drown every year worldwide?  Think about that number.  That’s a lot of people! In the United States that number is about 4000 people.  Drowning defined: to die from submersion in an inhalation of a liquid medium.  Other terms that are used but in appropriate by medical professionals are "near-drowning," "secondary drowning," and "wet drowning". 

Drowning is actually a common cause of accidental death in the United States and the leading cause of death in kids less than 5.  The stats show that males, African Americans, kids between 1-5, lower socioeconomic statuses and residents of Southern states tend to be the largest at risk groups.   There are actually 2 peaks of when drowning occurs.  The first is in children less than 5 years of age who are INADEQUATELY supervised in swimming pools, bathtubs or other liquid filled containers.  The second peak is typically in males between the ages of 15-25 in rivers, lakes and beaches  

So, what happens when you start to drown?  The first thing is a period of panic, which is not that shocking.  This will be followed by a loss of normal breathing pattern, breath-holding with a struggle to stay above water.  As soon as water hits the bottom of your lungs, your epiglottis (which is a flap of skin that can cover your wind pipe), will do just that. It reflexively covers your airway.  This will hold you for a few more seconds until you start to fill your lungs with water.  Death occurs from low blood oxygen that affects every organ system. 

So, what the hell do you do if it happens? The most important thing is RESCUE BREATHS.  Rescue and immediate resuscitation are the one things that has been shown to improve the outcome of drowning victims.  Rescue breathing should begin as soon as the rescuer reaches shallow water or a stable surface.  It’s important to tell you that the Heimlich maneuver or placing the victim in other positions are USELESS and only waste time.   Keep in mind that drowning victims are different than heart attack victims with CPR.  A drowning victim should receive 2 breaths before starting CPR.

I know we have a small following (feel free to like and follow) at the moment but if you can pass this on and share it, that would be great.  If we can bring awareness and save even 1 life it will be worth it.  Until next month...

Dr. Paul