Submersion Injury: Prevention is Key

This is another post derived from a presentation given at the 2011 Annual Summer Meeting of the Wilderness Medical Society. Tracy Cushing, MD, of the University of Colorado School of Medicine gave an excellent presentation on submersion injury—i.e., the dangers of becoming submerged under water. What follows is some of what we learned.

Historically there have been many terms and definitions, such as “drowning,” “near-drowning,” “dry drowning,” and others. Current experts favor the term “submersion injury” as any adverse effect from submersion in water. This commonly causes difficulty breathing, for many reasons. “Immersion syndrome” refers to the situation where there is a lethal heart rhythm during or after a cold-water exposure, usually attributed to stimulation of the vagus nerve, which slows the heart rate. “Shallow water blackout” refers to a person becoming unconscious after hyperventilating prior to attempting a lengthy period of breath-holding underwater. 

Drowning is the fifth leading cause of accidental death worldwide when all age groups are combined. The vast majority of drowning deaths occur in economically poor and developing nations. In the U.S., drowning is the sixth leading cause of accidental deaths. For every death, there are also 500 to 600 victims of submersion events who are medically treated. Sadly, this is often an affliction of young children and teenagers. Males more commonly drown than females. Swimming pools are the most common location, followed by boating, bathtubs, and submerged automobiles. African Americans and Native Americans have a higher risk than do Caucasians.

Prevention is the name of the game. Although it has been argued back and forth, recent opinion favors swimming lessons as the best means of preventive care. Please take note that alcohol drinking is associated with up to half of recreational water drownings in the U.S. The presence of lifeguards lowers the risk, as does fencing in swimming pools to a sufficient height and providing self-closing or latching locks. Personal flotation devices and helmets save lives. Prompt rescue can be critical to preventing drowning, so training rescue personnel and teams is very important.