Drowning is also the second leading cause of death from injury among persons aged 1-14 years. Many of these injuries occur in recreational water settings, including pools, spas/hot tubs, and natural water settings (e.g., lakes, rivers and oceans). Water recreation provides hours of enjoyment and exercise for children, yet water and children can be a deadly mix when an unsafe environment and inadequate supervision is present. Drowning is a silent death. There is no splash or cry for help. People drown in more quiet, less attention-getting ways. For each drowning death, it is estimated that at least 1 to 4 children suffer a serious nonfatal submersion event, many of which leave children with permanent disabilities. Near-drowning, the initial survival after submersion, is sometimes fatal, the majority of children who survive without neurological consequences are discovered within two minutes of submersion.
5 Stages to a Drowning
SURPRISE – In this stage, the victim recognizes danger and becomes afraid. The victim assumes a near-vertical position in the water, with little or no leg movement. The arms will be at or near the water’s surface, making random grasping or flipping motions. The head will be tilted back with the face turned up. Victims rarely make any sounds; they are struggling just to breath.
INVOLUNTARY BREATH HOLDING – The victim has now dropped below the static water line and the body, in an attempt to protect itself initiates involuntary breath holding. This occurs because water has entered the mouth and causes the epiglottis to close over the airway. Though a victim may continue to struggle, he/she will not usually make any sounds as he/she cannot breathe. Without oxygen, the victim will lose consciousness.
UNCONSCIOUSNESS – Because the victim has been without oxygen, the body shuts itself down as unconsciousness results. In this stage, the victim will be motionless. Because breathing has stopped, he/she is in respiratory arrest. There is no chest movement or breathing sounds. At this point, the victim sinks to the bottom of the water, either slowly or rapidly, depending on factors such as the amount of air trapped in the lungs, body weight, and muscle mass. The victim will remain unconscious unless breathing is reestablished.
HYPOXICCONVULSION – Due to the lack of oxygen in the brain, the victim may look as if he/she is having a convulsion, which is why this stage is called the hypoxic convulsion stage. The victim’s skin turns blue, especially in the lips and fingernail beds, and the body may appear rigid. There may be violent jerking of the
body and frothing (foaming saliva).
CLINICAL DEATH – The final stage in the drowning process is death. Clinical death occurs when both breathing and circulation stop. The victim is in cardiac arrest. The heart stops pumping blood. The organs are no longer receiving oxygen rich blood. The lack of oxygen causes the skin to turn blue.
– Jeff Ellis & Associates
Maryland Department of Health and Mental Hygiene
Division of Community Services
Rhonda Stokes, Morgan State University