Characteristics and Outcomes of Bath-Related Out-of-Hospital Cardiac Arrest in Japan

Specific Problems With Accidental Deaths in Japan – Cardiac Arrest From Hot Baths and Foreign Body Airway Obstruction in Elders –

“…3 Hori 5 reported the same finding that deaths in bathtubs occurred mainly in winter in Yamagata, Tokyo and Saga. Bath-related accidents, which included rescue from the bathtub, and acute illness or trauma in the bathroom, but did not include bath-related cardiac arrest, also occurred mainly in winter.…”

“…According to Utstein-style data collection, more than 70% of bath-related OHCA are classified as presumed cardiac origin, and drowning is less than 25%. 3 There would be some limitation to estimating the real origin of death in the Utstein style database as the current authors describe. 3 We need to seek the reason why some elderly people with good ADL are becoming immobile or unconscious in the bathtub.…”

“…3 There would be some limitation to estimating the real origin of death in the Utstein style database as the current authors describe. 3 We need to seek the reason why some elderly people with good ADL are becoming immobile or unconscious in the bathtub. Fever is reported to be associated with triggering fetal arrhythmia in both long QT syndrome and Brugada syndrome, 7 but very few victims presented with shockable arrest rhythm.…”

“…Fever is reported to be associated with triggering fetal arrhythmia in both long QT syndrome and Brugada syndrome, 7 but very few victims presented with shockable arrest rhythm. 3 Four possible explanations are presented: (1) heat stroke in the bath leads to unconsciousness; (2) sudden decrease in blood pressure immediately after standing up in the bathtub leads to a description of syncope; (3) seated position in the bathtub and hot water induce vasodilation that leads to neurally mediated syncope; and (4) some type of arrythmia. 8 The seasonal distribution in both bathrelated cardiac arrest and accidents could be explained by the weather, as elderly people are more sensitive to severe weather conditions.…”

Association Between Bathing and Sudden Death

“…Kiyohara et al reported that bath-related cardiac arrests mainly occur in winter, and the outcome of victims was exceedingly poor. 11 In this issue of the Journal, Suzuki and colleagues 12 report B athing every day or more frequently is associated with good health status, 1 but sudden death during bathing has been reported to occur particularly during normal daily life of the elderly (≥65 years) in Japan. 2-6 A trend towards growth in the elderly population is seen mainly in developed countries, and in Japan the growth rate of the elderly population is considerably higher than elsewhere.…”