Key words
Introduction
World Health Organization. Global report on drowning: preventing a leading killer. Available at: http://www.who.int/violence_injury_prevention/global_report_drowning/en/. Accessed November 24, 2014.
Methods
Grade | Description | Benefits vs risks and burdens | Methodological quality of supporting evidence |
---|---|---|---|
1A | Strong recommendation, high-quality evidence | Benefits clearly outweigh risks and burdens or vice versa | RCTs without important limitations or overwhelming evidence from observational studies |
1B | Strong recommendation, moderate-quality evidence | Benefits clearly outweigh risks and burdens or vice versa | RCTs with important limitations or exceptionally strong evidence from observational studies |
1C | Strong recommendation, low-quality or very low-quality evidence | Benefits clearly outweigh risks and burdens or vice versa | Observational studies or case series |
2A | Weak recommendation, high-quality evidence | Benefits closely balanced with risks and burdens | RCTs without important limitations or overwhelming evidence from observational studies |
2B | Weak recommendation, moderate-quality evidence | Benefits closely balanced with risks and burdens | RCTs with important limitations or exceptionally strong evidence from observational studies |
2C | Weak recommendation, low-quality or very low-quality evidence | Uncertainty in the estimates of benefits, risks and burden; benefits, risk and burden may be closely balanced | Observational studies or case series |
Epidemiology
Villaveces A, Mutter R, Owens PL, Barrett ML. Causes of injuries treated in the emergency department, 2010: HCUP Statistical Brief #156. Agency for Healthcare Research and Quality, Rockville, MD. Available at: http://www.hcup-us.ahrq.gov/reports/statbriefs/sb156.pdf. Accessed December 1, 2014.
Terminology
Rescue of the Drowning Patient
Rescuer Safety
Reaching The Patient
Patients in Submerged Vehicles
Transport Canada. Trends in motor vehicle traffic collision statistics 1988–1997. Available at: http://ntl.bts.gov/lib/35000/35600/35634/Trends_88-97.pdf. Accessed September 10, 2014.
In-Water Resuscitation
The United States Lifeguard Standards Coalition. United States Lifeguard Standards. Available at: http://www.lifeguardstandards.org/. Accessed November 17, 2014.
International Life Saving Federation. Medical position statement: in water resuscitation. Available at: http://www.ilsf.org/about/position-statements. Accessed November 15, 2014.
Water Safety Products. BigEasy rescue breathing mask kit. Available at: http://www.watersafety.com/store/lifeguard-equipment/bigeasy-rescue-breathing-mask-kit.html. Accessed August 1, 2015.
Initial Resuscitation
Hypothermia
Cardiopulmonary Resuscitation and Prioritization of Airway
- Soar J.
- Perkins G.D.
- Abbas G.
- et al.
Oxygenation
Automated External Defibrillator
Zoll Medical. Technical report: defibrillation on a wet or metal surface. Available at: http://r.think-safe.com/documents/Defibrillation_on_a_wet_or_metal_surface.pdf. Accessed December 12, 2014.
Heimlich Maneuver
Cervical Spinal Immobilization
- 1.Significant mechanism for cervical spine injury
- 2.Altered mental status (Glasgow Coma Scale [GCS] < 15; evidence of intoxication)
- 3.Focal neurological deficit
- 4.Significant distracting injury
Postresuscitation Management
Ventilation
Mechanical ventilation
ARDS Clinical Network. Mechanical ventilation protocol summary. Available at: http://www.ardsnet.org/files/ventilator_protocol_2008-07.pdf. Accessed December 13, 2014.
Noninvasive positive-pressure ventilation
Diagnostics
Radiologic testing
Laboratory testing
Other Treatments
Antibiotics
Corticosteroids
Therapeutic hypothermia
World Congress on Drowning. Recommendations of the world congress on drowning. Available at: http://www.ilsf.org/drowning-prevention/report. Accessed November 3, 2013.
Disposition in the Wilderness
Decision To Evacuate
Grade | Pulmonary examination | Cardiac examination | Mortality (%) |
---|---|---|---|
0 | Normal auscultation, - cough | Radial pulses | 0 |
1 | Normal auscultation, + cough | Radial pulses | 0 |
2 | Rales, small foam in airway | Radial pulses | 0.6 |
3 | Acute pulmonary edema | Radial pulses | 5.2 |
4 | Acute pulmonary edema | Hypotension | 19 |
5 | Respiratory arrest | Hypotension | 44 |
6 | Cardiopulmonary arrest | 93 |
Ceasing Water-Based Rescue and Resuscitation Efforts
Disposition in the Emergency Department
Prevention
Participant Screening
Swimming Ability
International Life Saving Federation. Lifesaving position statement: basic aquatic survival skill. Available at: http://www.ilsf.org/about/position-statements. Accessed March 8, 2016
Royal Life Saving Society Australia. Guidelines for safe pool operation. Available at: http://guidelines.royallifesaving.com.au/. Accessed July 3, 2015.
Personal Flotation Devices
United States Coast Guard. 2013 Recreational Boating Statistics. Available at: http://www.uscgboating.org/assets/1/AssetManager/2013RecBoatingStats.pdf. Accessed November 10, 2014.
Drowning Prevention Strategies
United States Coast Guard. 2013 Recreational Boating Statistics. Available at: http://www.uscgboating.org/assets/1/AssetManager/2013RecBoatingStats.pdf. Accessed November 10, 2014.
Branche CM, Stewart S. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Lifeguard effectiveness: a report of the working group. 2001. http://www.cdc.gov/HomeandRecreationalSafety/pubs/LifeguardReport-a.pdf. Accessed February 19, 2016.
United States Lifesaving Association. 2013 National Lifesaving Statistics. Available at: http://arc.usla.org/Statistics/public.asp. Accessed October 3, 2014.
Special Situations
Cold-Water Survival


Swimming-Induced Pulmonary Edema
Conclusions
Conflicts of Interest
References
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