Drowning

Drowning / near drowning
Vasily Perov: The drowned, 1867
Classification and external resources
Specialty	Critical care medicine
ICD-10	T75.1
ICD-9-CM	994.1
DiseasesDB	3957
MedlinePlus	000046
eMedicine	emerg/744
MeSH	C23.550.260.393
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Drowning is defined as respiratory impairment from being in or under a liquid. It is further classified by outcome into: death, ongoing health problems, and no ongoing health problems. Using the term near drowning to refer to those who survive is no longer recommended. Drowning itself is quick and silent, although it may be preceded by distress which is more visible.

Generally in the early stages of drowning very little water enters the lungs: a small amount of water entering the trachea causes a muscular spasm that seals the airway and prevents the passage of both air and water until unconsciousness occurs. This means a person drowning is unable to shout or call for help, or seek attention, as they cannot obtain enough air. The instinctive drowning response is the final set of autonomic reactions in the 20–60 seconds before sinking underwater, and to the untrained eye can look similar to calm safe behavior.Lifeguards and other persons trained in rescue learn to recognize drowning people by watching for these movements.

In 2013 there were about 1.7 million cases of drowning. Unintentional drowning is the third leading cause of unintentional injury resulting in death worldwide. In 2013 it was estimated to have resulted in 368,000 deaths down from 545,000 deaths in 1990. Of these deaths 82,000 occurred in children less than five years old. It accounts for 7% of all injury related deaths (excluding those due to natural disasters), with 91% of these deaths occurring in low-income and middle-income countries. Drowning occurs more frequently in males and the young. The rate of drowning in populations around the world varies widely according to their access to water, the climate and the national swimming culture.

Drowning is most often quick and unspectacular. Its media depictions as a loud, violent struggle have much more in common with distressed non-swimmers, who may well drown but have not yet begun to do so. In particular, an asphyxiating person is seldom able to call for help. The instinctive drowning response covers many signs or behaviors associated with drowning or near-drowning:

Frank Pia, a lifeguard and researcher of rescue techniques and drowning, notes that drowning begins at the point a person is unable to keep their mouth above water; inhalation of water takes place at a later stage. Most people demonstrating the instinctive drowning response do not show prior evidence of distress.

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Wikipedia