Drowning -- first aid, emergency treatment and complications

Did you know India has the highest children's death due to drowning? Know the key role of first aid and emergency care in saving these victims.

According to the World Health Organisation (WHO), drowning is the 3^rd leading cause of all injury-related deaths worldwide. And, it has been estimated that more number of children die due to drowning in India than anywhere else in the world.

'The term 'drowning' refers to a condition of breathing insufficiency due to immersion,' says Dr Talat Halim, director, Emergency and Trauma Services, Fortis Memorial Research Institute (FMRI). It is an accident that can occur in anyone's life irrespective of whether the person is a swimmer or non-swimmer. Therefore, using a life jacket is highly recommended whenever you're around a water body.

How does the emergency occur? Who is at risk?

In rural areas, such mishaps take place more during monsoons and due to flooded rivers. In cities, accidental falls near swimming pools and at beaches are more common. 'Incidence of drowning in bath-tubs is common in neonates and children. Drowning is also common in patients with epilepsy, hypoglycemia and swimmers who suffer head injuries by hitting the swimming pool and in those who panic under such situations,' says Dr Halim.

What should be the immediate action taken to save a drowning victim?

Mr Anoop Madhavan, founder of the non-profit organization Survival Instincts and a certified lifeguard professional, explains key steps to save a drowning victim. 'If you see a person drowning, remember do not jump into the water. The person who's drowning can instead put your life at risk while struggling to come up. Unless you're trained in rescuing procedures, don't take the risk. Here's something that you should do:

• Extend your hand to the victim or throw a study rope or a long pole towards him.
• Call out loudly for help
• In case, the incident takes place near a swimming pools or a sea shore, use the floatation device (buoy) to pull the victim out safely.'

Here's more information on first aid for drowning victim

What first aid is required to save the individual?

'Initial management should place emphasis on immediate resuscitation (CPR) and treatment of respiratory failure, including airway protection if victim is unconscious,' says Dr Halim. CPR is a crucial technique that works to restart a person's heart as well their breathing process. Here a step-by-step guide on performing CPR

What are the possible complications and the treatment given to the victims when presented at the hospital?

'One of the most important consideration in drowning individuals is lack of oxygen in the body due to a spasm in the larynx. This happens in almost one-third of drowning cases. The situation was earlier referred to as dry drowning. Another possibility of emergency may occur when the water enters the lungs. In order to reach the de-oxygenation level, the lungs need only about 2ml of water/kg of body weight (100ml in 50 kg individual),' says Dr Halim.

'All drowning victims who reach the de-oxygenation level are treated with 100% oxygen supply during their evaluations. We also need to evaluate the victims for injuries. A cervical spine injury may complicate airway management. One third of survivors may develop neurological problems. Therefore frequent neurological assessment should be done in such individuals,' he explains.

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