Drowning timeline: a new systematic model of the drowning process

Szpilman, David; Tipton, Michael J.; Sempsrott, Justin; Webber, Jonathon; Bierens, Joost J.L.M.; Dawes, P. J. D.; Seabra, Rui; Barcala-Furelos, Roberto; Queiroga, Ana Catarina

doi:10.1016/j.ajem.2016.07.063

Cited by 41 publications

(37 citation statements)

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“…A "drowning water safety score" (DSS) to measure the strength of the interventions implemented was estimated for each State by multiplying the number of years of affiliation to SOBRASA by the number of water safety interventions [preparation/education and/or prevention (active and reactive)] conducted in that state (Szpilman et al, 2016). This coefficient was used to rank the affiliated member states and served as an indication of their prevention and water safety promotion efforts.…”

Section: States Of Brazilianmentioning

confidence: 99%

“…The Brazilian Lifesaving Society (SOBRASA) was founded in 1995 by firefighters who were experts in lifesaving with the mission to reduce drowning mortality and morbidity through implementation of water safety programs grounded on prevention. Since then, its mission has been targeted to two main approaches: first, bringing together professionals with a duty of care in each state to exchange information and share the best practice on preparation, prevention, rescue and mitigation of drowning (Szpilman et al, 2016), and second, creating and promoting prevention and water safety campaigns and providing information that is freely available to all. Since its foundation in 1995, more than 30 different prevention and water safety programs comprising all aquatic scenarios, activities, and ages impacted by drowning have been created and promoted.…”

Section: Introductionmentioning

confidence: 99%

“…In its 2014 Global Report on Drowning, the World Health Organization (WHO) outlined 10 actions deemed to be effective, feasible, and scalable to reduce drowning 1 . Although drowning prevention strategies have been widely described and promoted worldwide as the first and most important step in reducing mortality and morbidity (Szpilman, et al, 2016;Szpilman, et al, 2014), most evidence is still based on expert opinion grounded on a small number of studies. Only a few studies have addressed the effectiveness of drowning prevention programs (Brenner, et al, 2009;Bugeja & Franklin, 2013;Cummings, et al, 2011;Rahman, et al, 2009;Rahman, et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

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Association of Drowning Mortality with Preventive Interventions: A Quarter of a Million Deaths Evaluation in Brazil

Szpilman¹,

Mello²,

Queiroga³

et al. 2020

IJARE

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In 2015, drowning in Brazil was responsible for 6,043 deaths and was the second leading cause of death in children. Although several prevention strategies have been promoted to reduce drowning, most are still based on low levels of evidence. This study evaluated the effectiveness of prevention and water safety interventions in reducing drowning mortality. Data obtained from the National Mortality System for 36 years were split in two time periods to allow the comparison of drowning mortality numbers before and after implementation of SOBRASA's drowning prevention and water safety programs and to check for any positive effects attributable to such programs. To assess differences between the two periods, a "drowning water safety score" (DSS) was estimated and compared to mortality/100,000 of population. There were 258,834 drowning deaths over 36 years. A significant decrease of 27% in drowning rates (5.2 to 3.8/100,000; p<0.05) was observed when comparing the pre and post-preventive interventions time periods. Males died 5.3 times more frequently than females, and mortality was higher in the 15-19-year age group (16.4%;4.7/100,000) than in other age groups. A linear dependent association was observed between prevention and water safety interventions and years affiliated to the national lifesaving organization (SOBRASA). A strong and significant association (OR=241.7; CI95% [9.0-64.84]) between DSS and drowning reduction was observed. The DSS is a fundamental measure for institutions/municipalities/states/countries to estimate the efforts needed to achieve their drowning reduction goals. From this study, a DSS above 100 (i.e.: 10 actions implemented over 10 years) was able to reduce drowning deaths by as much as 2.3% a year.

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Section: States Of Brazilianmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Association of Drowning Mortality with Preventive Interventions: A Quarter of a Million Deaths Evaluation in Brazil

Szpilman¹,

Mello²,

Queiroga³

et al. 2020

IJARE

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“…The actions that lifeguards perform when incidents happen in aquatic environments are defined by the drowning timeline, that includes preparation, prevention, rescue and mitigation [3]. Mitigation refers to the skills for the evaluation and treatment of the victim after an incident.…”

Section: Introductionmentioning

confidence: 99%

ABCDE approach to victims by lifeguards: how do they manage a critical patient? A cross sectional simulation study

Fernández-Méndez

Otero-Agra

Abelairas‐Gómez

et al. 2019

Preprint

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6Introduction: Decision-making in emergencies is a multifactorial process based on the 7 rescuer, patient, setting and resources. The eye-tracking system is a proven method for 8 assessing decision-making process that has been used in different fields of science. Our 9 aim was to evaluate the lifeguards' capacity to perform the ABCDE (Airway-Breathing-10 Circulation-Dissability-Exposure) approach when facing a simulated critically ill-11 drowned victim. 12 Methods:A cross sectional simulation study was designed to assess the skills and 13 sequence of the ABCDE approach by 20 professional lifeguards. They had to assess a 14 victim and act according to his/her clinical status following the ABCDE primary 15 assessment approach. Two kind of variables were recorder: those related to quality of 16 each step of the ABCDE approach; visual behaviour using a portable eye-movement 17 system. The eye-tracking system was the Mobile Eye system (Bedford, USA). 18Results: None of the study participants was able to complete correctly the ABCDE 19 approach. Lifeguards spent more time in the Circulation step: Airway (15.5±11.1 s), 20 Breathing (25.1±21.1 s), Circulation (44.6±29.5 s), Disability (38.5±0.7 s). Participants 21 spent more time in viewpoints considered as important (65.5±17.4 s) compared with 22 secondary ones (34.6±17.4 s, p = 0.008). This also was represented in the percentage of 3 23 visual fixations (fixations in important viewpoints: 63.36±15.06; fixation in secondary 24 viewpoints: 36.64±15.06). 25 Conclusion: Professional lifeguards failed to fully perform the ABCDE sequence. 26 Evaluation by experts with the help of eye-tracking technology detected lifeguards' 27 limitations in the assessment and treatment of an eventual critically ill victim. Such 28 deficits should be considered in the design and implementation of lifeguards' training 29 programmes.30

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“…We characterised the spectrum of ocean lifeguard prevention activities in Newport Beach, California using a Computer-Aided-Dispatch (CAD) system that collects data in real time, described primary drowning prevention as actions occurring in the pre-event phase, secondary drowning prevention as ocean rescues occurring in the event phase10 and examined variation of preventative actions and rescues by time and location in order to identify opportunities for increased efficacy of lifeguard primary prevention.…”

Section: Introductionmentioning

confidence: 99%

The ocean lifeguard drowning prevention paradigm: how and where do lifeguards intervene in the drowning process?

2017

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Drowning is a global health problem that can be addressed with multiple strategies including utilisation of lifeguards in recreational swim areas. However, few studies have described lifeguard prevention activities. We conducted a retrospective analysis using lifeguard activity data collected in real time with a Computer-Aided-Dispatch (CAD) system to characterise the nature of lifeguard primary and secondary drowning prevention at a popular ocean beach in California. Preventative actions constituted the majority (232 065/423 071; 54.8%) of lifeguard activities, while rescues represented 1.9%. Most preventative actions and rescues occurred during summer months, weekends and afternoons. Statistically significant geographical clusters of preventative actions were identified all over the beach, while rescue clusters were primarily restricted to two sites. Using the most reliable and valid collection system to date, these data show spatial and temporal patterns for ocean lifeguard provision of primary prevention as well as secondary drowning prevention (rescue).

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Drowning timeline: a new systematic model of the drowning process

Cited by 41 publications

References 10 publications

Association of Drowning Mortality with Preventive Interventions: A Quarter of a Million Deaths Evaluation in Brazil

Association of Drowning Mortality with Preventive Interventions: A Quarter of a Million Deaths Evaluation in Brazil

ABCDE approach to victims by lifeguards: how do they manage a critical patient? A cross sectional simulation study

The ocean lifeguard drowning prevention paradigm: how and where do lifeguards intervene in the drowning process?

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