Feature Article - April 2008
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Life Preservers

Meeting the Challenges of 21st Century Aquatic Risk

By Hayli Morrison

The Linguistics Solution

Researchers now have a hard time compiling studies on drowning statistics because there is no uniform language used in incident reports. Even if there were uniformity, it would be difficult to find words that translate to mean the same thing across many different languages. This dilemma was the focus of an international congress that convened in Amsterdam in 2002, with the results published the following year by the American Heart Association. The professionals convened to discuss recommended guidelines and terminology for reporting drowning data, in the interests of facilitating future research studies and accurate record-keeping.

The group looked at many drowning-related terms, among them the terms "active drowning" and "passive drowning." The group determined that those terms should be done away with. Their rationale was that the term "passive drowning" can be misleading, in that no one saw the victim enter the water and there is no apparent movement.

"Underwater cameras, however, have shown that even victims who are apparently motionless to observers at the surface usually make some movement. In addition, cloudy or murky water may preclude accurate observation," the report states. It goes on to suggest that the terms "active" and "passive" be replaced with "witnessed" and "unwitnessed" drownings.

The report discusses different precipitating events that can increase the likelihood of drowning. These include loss of consciousness from cardiac arrhythmia, stroke, concussion or any other cause. Other circumstances include major trauma or spinal injury which may be associated with vehicular accidents or diving. Seizures, hypothermia, or alcohol and drug use can also impact the likelihood of drowning. The report states that any precipitating events or contributing circumstances should be noted in incident reports, though this is sometimes easier said than done.

"In some situations it may be difficult to identify the primary cause of death as drowning or another condition," the report states. "For example, drowning in an older person may trigger a heart attack, whereas a heart attack may precipitate a drowning event."

The report cites studies from around the world that state drowning is a leading cause of cardiac arrest in children and adolescents. Hypothetically, if such were the case, where the final cause of death could be directly linked to drowning, the incident should be labeled a "death due to drowning."

The most common cause of death in hospitalized drowning victims is posthypoxic encephalopathy, having to do with inadequate oxygen supply to the brain. This is an example of a case where death could occur after weeks of hospitalized treatment, but would still be labeled a "death due to drowning." On the other hand, if the final cause of death was something that could not be definitively linked to drowning, the incident report should refer to it as a "death not related to drowning."