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DROWNING & PREVENTION Lora E Fleming MD PhD MPH MSc University of Miami School of Medicine.

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DROWNING & PREVENTION Lora E Fleming MD PhD MPH MSc University of Miami School of Medicine
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Page 1: DROWNING & PREVENTION Lora E Fleming MD PhD MPH MSc University of Miami School of Medicine.

DROWNING & PREVENTION

Lora E Fleming MD PhD MPH MSc

University of Miami School of Medicine

Page 2: DROWNING & PREVENTION Lora E Fleming MD PhD MPH MSc University of Miami School of Medicine.

Outline

• Definitions• Statistics• Risks• Causes• Prevention

Page 3: DROWNING & PREVENTION Lora E Fleming MD PhD MPH MSc University of Miami School of Medicine.

Drowning: Definitions

• Drowning– A suffocation resulting in death < 24 hours of

being submerged in water

• Near Drowning– An incident resulting in survival > 24 hours

after being submerged in water

Page 4: DROWNING & PREVENTION Lora E Fleming MD PhD MPH MSc University of Miami School of Medicine.

Drowning Statistics

• In 2000, there were 3482 unintentional drownings in the United States, an average of 9/day.– U.S. Centers for Disease Control and Prevention

 • It is estimated that for each drowning death, there are

1 to 4 nonfatal submersions serious enough to result in hospitalization……..with at least half of survivors suffering significant neurologic impairment.– American Academy of Pediatrics

 

Page 5: DROWNING & PREVENTION Lora E Fleming MD PhD MPH MSc University of Miami School of Medicine.

Drowning Statistics

• Drowning is the 2nd leading cause of injury-related death among children < 15 years.– U.S. Centers for Disease Control and

Prevention

• 19% drowning deaths involving children occur in public pools with certified lifeguards present. – Drowning Prevention Foundation

Page 6: DROWNING & PREVENTION Lora E Fleming MD PhD MPH MSc University of Miami School of Medicine.

Why Should We Care?

• The State of Florida averages 400 deaths/yr

• California, Arizona & Florida

– Leading cause of injury related death for children < 5 years

• Cost of Drowning & Near Drowning

– $400,000,000/year

Page 7: DROWNING & PREVENTION Lora E Fleming MD PhD MPH MSc University of Miami School of Medicine.

Who is Affected?

Vulnerable Populations

– Geography: Southern States

– Gender: Males > 81% of drowning victims

– Age: Children are the most vulnerable

Page 8: DROWNING & PREVENTION Lora E Fleming MD PhD MPH MSc University of Miami School of Medicine.

Differences by Race

Vulnerable Populations

• Race

– Blacks: age adjusted drowning rate > 1.5 times

– Difference dependent on age range:

< 4 yrs: Whites have a higher rates

> 4 yrs: Black children 2.5 times

Page 9: DROWNING & PREVENTION Lora E Fleming MD PhD MPH MSc University of Miami School of Medicine.

Differences by Race

Vulnerable Populations

• Race

– American Indians & Alaska Native children 2x

– Unlike white children, they tend to drown in natural bodies of water

Page 10: DROWNING & PREVENTION Lora E Fleming MD PhD MPH MSc University of Miami School of Medicine.

"(She) was left unattended for about one or two minutes when she drowned Monday, police

said." (AP)

Jacksonville was the location of the tragedy, the victim aged 18 months, the setting a bathtub.

But 15 times in 1998 similar stories were repeated in Lee County. Six (6) of the dead

were < 18 years.

Why do people drown?

Page 11: DROWNING & PREVENTION Lora E Fleming MD PhD MPH MSc University of Miami School of Medicine.

Why to people Drown?

Page 12: DROWNING & PREVENTION Lora E Fleming MD PhD MPH MSc University of Miami School of Medicine.

Why do people drown?

Causes• Access• Ethanol

– > 50% for Adolescents & Adults• Adult Supervision

– Children• Lack of Education

Page 13: DROWNING & PREVENTION Lora E Fleming MD PhD MPH MSc University of Miami School of Medicine.

Where: Bathtubs

Page 14: DROWNING & PREVENTION Lora E Fleming MD PhD MPH MSc University of Miami School of Medicine.

Where: Buckets & Toilets

Page 15: DROWNING & PREVENTION Lora E Fleming MD PhD MPH MSc University of Miami School of Medicine.

Where: Pools

pool

Page 16: DROWNING & PREVENTION Lora E Fleming MD PhD MPH MSc University of Miami School of Medicine.

Marine Waters

Page 17: DROWNING & PREVENTION Lora E Fleming MD PhD MPH MSc University of Miami School of Medicine.

Where: Lakes & Other Water Bodies

Page 18: DROWNING & PREVENTION Lora E Fleming MD PhD MPH MSc University of Miami School of Medicine.

Where: Recreational Water Activities

Page 19: DROWNING & PREVENTION Lora E Fleming MD PhD MPH MSc University of Miami School of Medicine.

Where: Occupational Water Activities

Page 20: DROWNING & PREVENTION Lora E Fleming MD PhD MPH MSc University of Miami School of Medicine.

Ethanol & Water Activities

Page 21: DROWNING & PREVENTION Lora E Fleming MD PhD MPH MSc University of Miami School of Medicine.

Prevention

f

Page 22: DROWNING & PREVENTION Lora E Fleming MD PhD MPH MSc University of Miami School of Medicine.

Prevention: Pool Fencing

Page 23: DROWNING & PREVENTION Lora E Fleming MD PhD MPH MSc University of Miami School of Medicine.

Prevention: Education & Warnings

Buckets

Page 24: DROWNING & PREVENTION Lora E Fleming MD PhD MPH MSc University of Miami School of Medicine.

Prevention: Education & Warnings

Page 25: DROWNING & PREVENTION Lora E Fleming MD PhD MPH MSc University of Miami School of Medicine.

Prevention: Targeted Education

Page 26: DROWNING & PREVENTION Lora E Fleming MD PhD MPH MSc University of Miami School of Medicine.

Prevention: Swimming & CPR

Page 27: DROWNING & PREVENTION Lora E Fleming MD PhD MPH MSc University of Miami School of Medicine.

Conclusions

Drowning is preventable– Warnings

• Supervision

– Targeted Education• Age etc

• Access

– Intervention

Page 28: DROWNING & PREVENTION Lora E Fleming MD PhD MPH MSc University of Miami School of Medicine.

Thank you

Gina Mena (2001)


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