Drowning Prevention: A Contemporary Health Issue That Impacts Everyone

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Drowning prevention is something we all need to know more about. When you are in near or on the water you should be aware of the dangers that water represents and how you can stay safe and keep your …

Drowning prevention is something we all need to know more about. When you are in near or on the water you should be aware of the dangers that water represents and how you can stay safe and keep your family and friends safe. Learn to swim. Teach your children to swim early. Wear USCG approved life jackets. Follow the Safer Three: Safer Water, Safer Kids, Safer Response. Respect the awesome power of water.

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  • 1. Drowning Prevention A Contemporary Health Issue That Impacts Everyone The Importance of Learning Life Saving Water Safety Skills Presented By Audrey Dalton
  • 2. Picture a four year old child Under the water She hit her head on the rock you see in this photograph She is trying to open her mouth and breathe She does not understand why her mouth is filling with water She is drowning Pictured, right: Wawayanda Lake, Highland Lakes ,New Jersey Personal photo
  • 3. That child was me. I was found floating right side up My lungs had filled with water I was pronounced Dead On Arrival at the hospital I was in a coma for ten days Doctors told my parents I would be a vegetable If I survived Photo courtesy copyright free photo bank
  • 4. I survived • MOST CHILDREN DON’T • For every one drowning death there are approximately one and a half non-fatal incidents. (Source: CDC) • Typical medical costs for a nonfatal drowning victim can range from $80,000 for initial emergency room treatment to $200,000 a year for long-term care. • A nonfatal drowning that results in brain damage can ultimately cost more than $4.6 million dollars. ( Source: Joe DiMaggio Children’s Hospital)
  • 5. Drowning Prevention • According to the World Health organization: Despite limited data, several studies reveal information on the cost impact of drowning. WHO Fact Sheet N347, October 2012 • In the USA, 45% of drowning deaths are among the most economically active segment of the population. • Coastal drowning in the USA alone accounts for US $273 million each year in direct and indirect costs. Photo courtesy copyright free photo bank
  • 6. Ratio of Drownings to Non-fatal Drownings For every child less than 15 years old who dies from drowning in a pool, another 10 receive emergency department care for nonfatal submersion injuries.3 Source: CDC; WISQARS
  • 7. Why use Drowning Prevention Methods? It is estimated that more than 85% of cases of drowning can be prevented by supervision, swimming instruction, technology, regulation, and public education.
  • 8. Key risk factors for drowning: • Male sex (4) • Age of less than 14 years (6) • Alcohol use (7) • Low income (1) • Poor education (5) • Rural residency (5) • Aquatic exposure (6,7) (*being in near or on any body of water) • Risky behavior (6,7) • Lack of supervision (6) • For people with epilepsy, the risk of drowning is 15 to 19 times as high as the risk for those who do not have epilepsy. (8) • Risk factors increase by as much as 89% in summer months, according to a study by SafeKids Wordwide (8) Source for list of risk factor statistics: New England Journal of Medicine, Current Concepts: Drowning, David Szpilman, M.D., Joost J.L.M. Bierens, M.D., Ph.D., Anthony J. Handley, M.D., and
  • 9. Risk factors for drowning are extremely high for children with Autism According to a research project titled “Causes of Death in Autism”; drowning is one of the major causes of accidental deaths among children with Autism. Pub: Journal of Autism and Developmental Disorders, vol. 31, No 6, December 2001
  • 10. Drowning Prevention Research Recommendations Pictured, right: Table 3, Guidelines for Prevention of Drowning The New England Journal of Medicine
  • 11. Why should you care? •The total annual cost of drownings among children ages 14 and under is approximately $6.8 billion. •Children ages 4 and under account for $3.4 billion, or nearly half, of these costs. National Safekids Campaign, Drowning Fact Sheet •This affects all of us.
  • 12. Early Childhood Drowning Prevention Did you know: Enough children to fill three to four preschool classrooms drown every year in Florida and do not live to see their fifth birthday
  • 13. Leading Causes of Unintentional Injury Deaths United States: CDC 2010 (most recent national data)
  • 14. Why does it happen? Children with little or no swimming abilities include: • 70 % of African American children • 60 % of Hispanic/ Latin-American children • 42% of Caucasian children Source: Constraints Impacting Minority Swimming Participation; Irwin, C., Irwin, R., Martin, N. & Ross, S.
  • 15. How does it happen? • It’s not always an accident • It happens • More frequently than you know Click on the links below to read about one of the most atrocious ways that children drown
  • 16. Child Death Review Teams: Why use them for drowning prevention? • Florida Department of Health • Each health department in every county in Florida is required to review causes of child mortality. • Each county's department of health sends child mortality statistics to the state to compile. • Those statistics are sent to the National Center for Child Death Review. • Awareness of causes of death helps prevent them. • National MCH Center for Child Death Review • Reviews mortality rates and statistics of all types of child deaths • Drowning is the third leading cause of unintentional death • Florida child mortality rates 2010 Source: National MCH Center for Child Death Review
  • 17. Florida: NEGLECT: THE LEADING FACTOR UNDERLYING CHILD DEATHS • Listed below is the categorization and number of children who died due to neglect: •32 Drowning • 30 Unsafe sleep • 10 Motor vehicle-related • 7 Medical neglect • 5 Drug toxicity deaths • 4 Firearm-related •Drowning kills more children in Florida than car accidents, drugs and guns combined Source: 2012 Florida Annual Child Abuse Death Review
  • 18. Statistics are brutal: Nearly all children who require CPR after a submersion incident die or are left with severe brain injury. Source: Safe Kids Worldwide Irreversible brain damage occurs after four to six minutes and determines the immediate and long-term survival of a child.
  • 19. Where does it happen? • Lakes • Rivers • Canals • The Ocean • Your backyard • Above ground pools • Puddles • Toilets • Sinks • Summer Camp • Public pools • Apartment pools • Hotel pools • Icy ponds • Floods • Hurricanes
  • 20. Where does it happen? • More than half of drownings among infants (under age 1) occur in bathtubs. • Buckets • Residential swimming pools • Spas & Hot tubs • Boats & Personal Watercrafts Source: National Safe Kids Campaign
  • 21. Definitions: • Drowning: Submersion in water causing suffocation and death within the first 24 hours; “Drowning  is  the  process  of  experiencing  respiratory  impairment  from  submersion/immersion  in  liquid.” (New England Journal of Medicine) • Non-fatal Drowning: A submersion incident in which there is survival for at least 24 hours irrespective of eventual outcome. • Non-fatal-Drowning with delayed death: When a non-fatal drowning victim later dies.
  • 22. Updated Terminology: • The terms near fatal drowning and near- drowning are no longer used in the field of medicine. • Non-fatal is the term that is used. Source: 2002 World Congress on Drowning
  • 23. Drowning doesn’t look like drowning According to Dr. Frank Pia, in his paper; "OBSERVATIONS ON THE DROWNING OF NONSWIMMERS”; Originally published in Journal of Physical Education, 1974; One of the most frequently asked questions of first responders is; “How will I know when someone is drowning ?"
  • 24. What does drowning really look like? When drowning, the person: • Rarely is able to call out for help. • Has instinctual arm movements which, unlike the hailing or waving of persons in distress, appear to push the victim upward in the water by thrashing the water with both arms partially extended from his sides. • Usually manages to turn toward shore, with his body in an upright position, with no apparent support kick. Watch an instructive video HERE
  • 25. Drowning Prevention Saves Lives *Formal swimming lessons reduce the risk of drowning by 88% *National Institutes of Health • Click HERE to read article from the American Red Cross •In 2009 a formal case study was conducted to show correlation between swimming lessons & risk of drowning for children aged 1 to 19 years
  • 26. What can you do? • Wear a US Coast Guard approved Life Jacket • It is estimated that 85 percent of boating-related drownings could have been prevented if the victim had been wearing a personal flotation device. Source: USCG Boating Safety
  • 27. Wear a Life Jacket When Using a Recreational Water Device Paddleboarding, Or On a Boat In 2009, 3,358 people were injured and 736 died in boating incidents. Of those who drowned, 9 out of 10 were not wearing life jackets. CDC Boating Safety
  • 28. Drowning Prevention is the key It has been estimated that over 80% of all drownings can be prevented, and prevention is the key management intervention (World Congress on Drowning, 2002; Mackie,2005).
  • 29. Links with Resources for Drowning Prevention • Safer 3 Water Safety Foundation • Nova Drowning Prevention • Palm Beach County Drowning Prevention Coalition • Broward County Drowning Prevention Task Force • CPSC Drowning Prevention Toolkit • National Drowning Prevention Alliance • Pool Safety.Gov • Children’s Safety Network • Joshua Collingsworth Foundation
  • 30. • Swim lessons do NOT “drown proof” children. • “No amount of swim lessons can drown proof any child or adult” • Use layers of protection • Constant adult supervision around any water whether it be in a bathtub, backyard pool or at a beach. • Physical barriers surrounding pools and spas: four-sided fencing with self-closing, self-latching gates. • Proper safety equipment, including a well-stocked first aid kit and U.S. Coast Guard-approved personal floatation devices. • Alarms on exterior doors of homes and for the pools themselves. Source: Archive of Pediatric and Adolescent Medicine REMEMBER:
  • 31. Thank you for your time. Drowning Prevention A Contemporary Health Issue That Impacts Everyone The Importance of Learning Life Saving Water Safety Skills Presented By Audrey Dalton Photo, right: Audrey Dalton, practicing her daily laps conquered her life-long fear of water and learning how to swim at the age of 27. Since that time Audrey has swam the distance from New York to San Francisco and back.
  • 32. Information referenced on slides: (*Referenced information and statistics begin on slide 4) SLIDE 4: Statistics 1: CDC Web-based Injury Statistics Query and Reporting System (WISQARS) System Produced by Office Of Statistics and Programming, National Center For Injury Prevention and Control, Centers for Disease Control and Prevention 2: courtesy of Joe DiMaggio Children’s Hospital, Water Smart Babies Guide (*updated to reflect 2013 estimates for hospitalization costs from 5 years prior) 1005 Joe DiMaggio Drive Hollywood, FL 33021: http://browardchd.org/LinkClick.aspx?fileticket=SdE1Jlj976I%3D&tabid=75 SLIDE 5: World Health Organization Drowning Fact Sheet N347 October 2012 WHO website: http://www.who.int/mediacentre/factsheets/fs347/en/ SLIDE 6: Web-based Injury Statistics Query and Reporting System (WISQARS). Atlanta: Centers for Disease Control and Prevention, 2009; 3.Gipson K. Pool or Spa Submersion: Estimated Injuries and Reported Fatalities, 2010 Report. U.S. Consumer Product Safety Commission, May 2010. Available online at http://www.cpsc.gov/library/foia/foia10/os/poolsub2010.pdf
  • 33. References continued: SLIDE 7: 57:Quan L, Bennett E, Branche CM. Interventions to prevent drowning. In: Doll LS, Bonzo S E, Sleet DA, et al., eds. Hand- book  of  injury  and  violence  prevention.  New York: Springer, 2007:81-96. Copyright © 2012 Massachusetts Medical Society. SLIDE 8: Statistics: Safekids Worldwide U.S. Summer Safety Ranking Report, released May 2007; chart referenced: Page 10, Child Unintentional Deaths, Drowning rates years 2001-2004. Study methodology compiled by Safe Kids Week 2007 Summer Advisory Committee. Full Report: http://issuu.com/safekids/docs/summer_safety_ranking_by_state?e=4874392/2095 979 ; Low income,1:Peden M, McGee K, Sharma K. The injury chart book: a graphical overview of the global burden of injuries. Geneva: World Health Organization, 2002. Male sex 4: Borse NN, Gilchrist J, Dellinger AM, Rudd RA, Ballesteros MF, Sleet DA. CDC childhood injury report: patterns of unintentional Injuries among 0–19 year olds in the United States, 2000–2006. Atlanta: Centers for Disease Control and Prevention, 2008. Age of less than 14 years,6: Modell JH. Prevention of needless deaths from drowning. South Med J 2010;103:650-653, CrossRef | Web of Science
  • 34. References continued: SLIDE 8 Continued: Alcohol use,7: Cummings P, Mueller BA, Quan L. Association between wearing a personal floatation device and death by drowning among recreational boaters: a matched cohort analysis of United States Coast Guard data. Inj Prev 2011;17:156-159 Rural residency,5: Linnan M, Anh LV, Cuong PV, et al. Special series on child injury: child mortality and injury in Asia: survey results and evidence. Florence, Italy: UNICEF Innocenti Research Center, 2007. Aquatic exposure,6,7 ; Risky behavior,6,7 and lack of supervision. 6: Modell JH. Prevention of needless deaths from drowning. South Med J 2010;103:650-653; 7 Cummings P, Mueller BA, Quan L. Association between wearing a personal floatation device and death by drowning among recreational boaters: a matched cohort analysis of United States Coast Guard data. Inj Prev 2011;17:156-159 New England Journal of Medicine, Current Concepts: Drowning, Page 1; David Szpilman, M.D., Joost J.L.M. Bierens, M.D., Ph.D., Anthony J. Handley, M.D., and James P. Orlowski, M.D., May 31, 2012 Bell GS, Gaitatzis A, Bell CL, Johnson AL, Sander JW. Drowning in people with epilepsy: how great is the risk? Neurology 2008;71:578-582
  • 35. References continued: SLIDE 8 continued: http://www.nejm.org/doi/full/10.1056/NEJMra1013317 : Web-based Injury Statistics Query and Reporting System (WISQARS). Atlanta: Centers for Disease Control and Prevention, 2009 (http://www.cdc.gov/injury/wisqars). http://www.pediatricsdigest.mobi/content/112/2/440.full Image upper right hand corner: Family Health Spending to Rise Rapidly Costs Are Becoming Unsustainable for Families with Employee-Sponsored Care By Sonia Sekhar, September 15, 2009; Published, website: “Center for American Progress”; http://www.americanprogress.org/issues/healthcare/news/2009/09/15/6699/ family-health-spending-to-rise-rapidly/ SLIDE 9: Journal of Autism and Developmental Disorders, Vol. 31, No. 6, December 2001, page 570. Webpage, full article: http://www.lifeexpectancy.org/articles/a2.pdf
  • 36. SLIDE 10: Table 3 Page 10; Current Concepts Drowning; New England Journal of Medicine; David Szpilman, M.D., Joost J.L.M. Bierens, M.D., Ph.D., Anthony J. Handley, M.D., and James P. Orlowski, M.D.; N Engl J Med 2012;366:2102-10. Copyright © 2012 Massachusetts Medical Society. SLIDE 11: Page 2, Why should you care: National SAFE KIDS Campaign (NSKC). Drowning Fact Sheet. Washington (DC): NSKC, 2004. SLIDE 12: Florida Department of Health: Injury Prevention Program; Early Childhood Drowning Prevention: Statistics: Unintentional Injuries in Childhood, The Future of Children, 2000; and “A National Study Of Child Drowning and Related Attitudes and Behavior, Safekids USA, 2004”. FDH Injury Prevention Program Website pages: http://www.doh.state.fl.us/demo/InjuryPrevention/DrownPrevent.html SLIDE 13: CDC Web-based Injury Statistics Query and Reporting System (WISQARS) System Produced by Office Of Statistics and Programming, National Center For Injury Prevention and Control, Centers for Disease Control and Prevention; National Center For Health Statistics (NCHS); National Vital Statistics System
  • 37. SLIDE 14: Constraints Impacting Minority Swimming Participation, PHASE II; Irwin, C., Irwin, R., Martin, N. & Ross, S.; Department of Health & Sport Sciences, University of Memphis; Presented to USA Swimming Foundation May 2010 USA Swimming Foundation Webpage: http://www.usaswimming.org/_Rainbow/Documents/121d4497-c4be-44a6-8b28- 12bf64f36036/2010%20Swim%20Report-USA%20Swimming-5-26-10.pdf SLIDE 15: Photo images and stories taken from: Photo Left: Published February 18, 2012/ Fox News Latino http://latino.foxnews.com/latino/news/2012/02/16/california-mom-drowns- toddler-in-bathtub-5-year-old-in-critical-condition/ Photo & story Lower Right: “Lukas Pinski's Parents, Emilie And Thomas Pinski, Charged In Toddler's Drowning Death”, Huffington Post, By JIM SUHR 07/09/12 06:40 PM ET : http://www.huffingtonpost.com/2012/07/10/lukas-pinski- drowned-emilie-pinski-thomas-pinski_n_1661407.html Photo and story upper right: By David Boroff / NEW YORK DAILY NEWS Tuesday, April 2, 2013, 11:17 AM Minnesota woman drowns her two young children before taking own life in murder-suicide, authorities say: http://www.nydailynews.com/news/national/minn-woman-drowns-daughters-life- article-1.1305458
  • 38. SLIDE 16: National MCH Center for Child Death Review; 2011 Annual Child Abuse Death Review, page 6 Website: National MCH Center For Death Review: http://www.childdeathreview.org/causesD.htm Florida Statistics: http://www.childdeathreview.org/statisticsFL.htm SLIDE 17: Florida Child Abuse Death Review Committee; Child Abuse Death Review Annual Reports; National Center for Child Death Review Case Reporting System; Drowning Death Demographics; Review Year Range: 2012 to 2012, Florida, Child Deaths Reviewed, All Cases; Page 1 PDF Online: http://www.flcadr.org/attach/drowningDemographics.pdf SLIDE 18: Statistics: National SAFE KIDS Campaign (NSKC). Drowning Fact Sheet. Washington (DC): NSKC, 2004. SLIDE 19 and SLIDE20: Statistics: National SAFE KIDS Campaign (NSKC). Drowning Fact Sheet. Washington (DC): NSKC, 2004. National Drowning Prevention Alliance
  • 39. SLIDE 21: New England Journal of Medicine, Current Concepts: Drowning, Page 2; David Szpilman, M.D., Joost J.L.M. Bierens, M.D., Ph.D., Anthony J. Handley, M.D., and James P. Orlowski, M.D., May 31, 2012; 2. Injuries and violence prevention: non-communicable  diseases  and  mental  health: fact sheet on drowning. Geneva:  World Health Organization, 2003  WHO Drowning statistics: http:// www.who.int/violence_injury_prevention/other_injury/drowning/en/index.html . Link to full article: http://www.readcube.com/articles/10.1056/NEJMra1013317 SLIDE 22: 2002: World Congress On Drowning; 02. DEFINITION OF "DROWNING" ; World Health Organization; A new definition of drowning: towards documentation and prevention of a global public health problem E.F. van Beeck, C.M. Branche, D. Szpilman, J.H. Modell, & J.J.L.M. Bierens ; SLIDE 23 and SLIDE 24: Dr. Frank Pia “OBSERVATIONS ON THE DROWNING OF NONSWIMMERS”; Journal of Physical Education, 1974; Link to full article: http://webcache.googleusercontent.com/search?q=cache:XbraoUnCUKEJ:www.pia- enterprises.com/observations.rtf+OBSERVATIONS+ON+THE+DROWNING+OF+NONSWIMMER S&cd=1&hl=en&ct=clnk&gl=us ; See Paragraph 8 for “when drowning the person”…
  • 40. SLIDE 25: US National Library of Medicine, National Institutes of Health: Arch Pediatr Adolesc Med. 2009 Mar;163(3):203-10. doi: 10.1001/archpediatrics.2008.563. Association between swimming lessons and drowning in childhood: a case-control study. Brenner RA, Taneja GS, Haynie DL, Trumble AC, Qian C, Klinger RM, Klebanoff MA. Source National Institute of Child Health and Human Development, Bethesda, MD 20892, USA. Archive of Pediatric and Adolescent Medicine; American Red Cross; Plourde, Kate. (Spring 2009). New Student Finds Protective Association Between Swim Lessons and Drowning Risk. American Red Cross Aquazine, 5. Citation: Ruth A. Brenner, Gitanjali Saluja Taneja, Denise L. Haynie, Ann C. Trumble, Cong Qian, Ron M. Klinger, and Mark A. Klebanoff. Association Between Swimming Lessons and Drowning in Childhood: A Case-Control Study, Archive of Pediatric and Adolescent Medicine, Mar 2009; 163: 203 - 210. Link to full abstract: http://www.ncbi.nlm.nih.gov/pubmed/19255386 Photo courtesy The Josh Project; Non-profit foundation work to raise awareness and educate youth and their families about water safety to prevent drowning. SLIDE 26: National SAFE KIDS Campaign (NSKC). Drowning Fact Sheet. Washington (DC): NSKC, 2004. SLIDE 27: CDC Boating Safety: http://www.cdc.gov/features/boatingsafety/ ; USCG Boating Safetyhttp://www.uscgboating.org/safety/life_jacket_wear_wearing_your_life_jacket.aspx
  • 41. SLIDE 28: World Health Organization: CHAPTER 2: Drowning and injury prevention, 2.1.2 Preventive and management actions; CHAPTER 2. DROWNING AND INJURY PREVENTION, Page 15 Link to full article: http://www.who.int/water_sanitation_health/bathing/srwe2chap2.pdf SLIDE 30: Drowning Prevention rules to follow: Read Full article here: http://www.campusrecreation.txstate.edu/Aquatics-and-Safety/Swim- Lessons/Youth-Group-Swim- Lessons/contentParagraph/01/content_files/file/assoc%20btw%20swi m%20lessons%20and%20drowning.pdf