“Every year, drowning affects nearly 500,000 people worldwide and 1,600 people in France, with a mortality rate of 30%, explains Professor Pierre Michelet, head of the emergency department at La Timone Hospital in Marseille, on October 15. In France, it mainly affects adults in the sea and children in pools. Drowning is an acute respiratory failure that results from the submersion of the airways.” The trainee instructors are listening attentively. It’s an opportunity to review the different stages of drowning (from grade 1 to grade 4), the mechanisms involved, the main clinical manifestations, and the required care. And advice for everyday situations.
To prevent drownings in pools, vigilance must be constant with children; accidents happen very quickly,” reminds the emergency physician. “Moreover, if a child who has just swallowed water – a frequent occurrence! – has not returned to normal within 5 minutes and shows persistent coughing, blue lips, or unusual fatigue, you must immediately call for help,” adds the doctor. This is sometimes incorrectly referred to as ‘dry drowning.’ The condition of a young conscious victim who speaks but has inhaled water into the lungs can indeed deteriorate in the hours that follow because they can no longer oxygenate sufficiently. While awaiting specialized advice, let the child assume the position they prefer, sitting or standing.
In general, if the victim – who must be quickly removed from the water – is breathing, they should be placed in the recovery position while waiting for help because a stomach filled with water will cause vomiting. “If the person is in cardiac arrest, they must first be ventilated,” explains the doctor. “Cardiac massage without initial ventilation will not help a drowning victim since the cause of the arrest is lack of oxygen.” Pierre Michelet emphasizes that “the first hours, and especially the first minutes, are crucial in the survival of drowning victims.”
To go further
Research is currently being conducted by Professor Michelet’s team to explore all the causes leading to accidents. Some cases of drowning are probably related to cardiovascular or neurological pathologies causing discomfort or loss of consciousness. This, in an aquatic environment, can be unforgiving. One particular avenue interests the physician-researcher, a specialist in drowning, that of immersion pulmonary edema (the passage of fluid from the bloodstream into the lungs), which may be the cause of certain diving accidents. These are topics on which the doctor is leading research to improve the care of victims.
