The Cold Facts about Drowning
1TBD, Canadian Association of Emergency Physicians, Canada
Drowning is responsible for over a half-million deaths each year, is a leading cause of death in young people, but affects all age groups and is largely preventable. Cold water can predispose to drowning, but can also increase survival. The common denominator in all drownings is pulmonary injury, leading to anoxic brain damage. Even mild brain hypothermia can be neuroprotective, but long-term neurological outcome is difficult to predict, even in those with normal neuro exams and imaging .Treatment of the drowning victim begins at scene, continues with advanced-care paramedicine and transport to the ED. Cardiac injury is rarely primary and early attention to the airway and ventilation is therefore recommended. Ultimately, the only way to materially reduce the toll of drowning is through public health and education. The advocacy role of the emergency physician in this regard will be emphasized.