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Wilderness Medical Society issues official guidelines for prevention and treatment of drowning

Drowning is a global threat to human health. Each year, more than 372,000 people die as a result of drowning, with many of those deaths being preventable by simple water safety measures. In order to arm professionals with the most up-to-date clinical protocols, the Wilderness Medical Society (WMS) has issued a new set of practice guidelines for both the treatment and prevention of drowning, published in the society’s official journal, Wilderness & Environmental Medicine.

On average, drowning is responsible for 10 deaths per day in the United States and over 3,800 deaths annually. These numbers, provided by the Centers for Disease Control and Prevention, exclude deaths occurring from floods and other natural disasters. Sadly, the highest risk age group for drowning is children 1 to 4 years old in residential pools. Drowning deaths are also 48% more likely to occur on a weekend and 53% of all male and 26% of all female drowning deaths occur in natural bodies of water such as oceans, lakes, rivers, ponds, and streams.

In order to gather the latest and most accurate information to inform the creation of the new guidelines, the WMS assembled a team of doctors with extensive clinical and research experience in drowning prevention, education, and training, as well as practical wilderness medical knowledge. Using both the available literature on drowning and their own clinical expertise, the team of physicians graded evidence according to the American College of Chest Physicians criteria. The result of their efforts is a comprehensive and current guide for the treatment and prevention of drowning.

With the release of these comprehensive guidelines, the WMS hopes practitioners and other rescue personnel will be equipped with the most recent information to effectively treat and counsel patients. “Drowning is a process defined by hypoxemia, with outcomes ranging from no morbidity to severe morbidity, and eventually death,” explained lead author Andrew C. Schmidt, DO, MPH, Assistant Professor of Emergency Medicine, University of Florida College of Medicine, Jacksonville, and Director of Lifeguards Without Borders.

The new recommendations are grouped by categories: initial resuscitation, postresuscitation management, disposition in the wilderness, disposition in the ER, prevention, and special situations. For each category, the panel has provided specific guidelines for many different circumstances and scenarios.

These in-depth recommendations offer clinicians and rescue personnel the most accurate and thorough evaluation of the different techniques and protocols around drowning. Key takeaways for each category include:

Rescue of a Drowning Patient

  • Only those with formal water rescue training should attempt in-water rescues.
  • People without formal water rescue training should avoid entering the water and should instead try to reach the drowning person with a rope or pole, throw the person a floatation device, or reach the person by boat. The mantra “Reach, Throw, Row. Don’t Go” can be a helpful way to remember the best ways to help a drowning person.
  • If a vehicle is submerging, the best time to escape is immediately after it enters the water during the initial floating phase. This is contrary to many depictions in popular culture in which people wait until the car is fully submerged to try and escape.
  • In-water resuscitation should only be attempted by rescuers with adequate training in the procedure and when conditions allow for safely preforming the associated tasks.

Initial Resuscitation