To drown (synonyms: Near drowning; near drowning; dry drowning; secondary drowning; bath death; ICD-10-GM T75.1: Drowning and nonfatal submersion) occurs when submersion in a liquid causes it to enter the respiratory tract. Breathing is thereby impeded and respiratory insufficiency occurs, resulting in acute hypoxia (oxygen deprivation), which can lead to death. If the victim survives the drowning accident for more than 24 hours, it is called near drowning. The following forms of drowning are distinguished:
- typical drowning (drowning death).
- The person is initially fully conscious. In a more or less long struggle against sinking, inspiration (inhalation of air) and aspiration (inhalation of fluid) alternate. Eventually, the person sinks (see “Stages of drowning” under “Etiology/causes”).
- atypical drowning
- Someone is forcibly pushed/brought under water (homicide). The person suffocates very quickly without taking repeated breaths at the water surface. Inspiration (inhalation of air) is thus absent; instead, water is aspirated (inhaled). A struggle for survival is absent.
From drowning must be distinguished the bathing death. One speaks of a “bathing death in the narrower sense”, if it comes to a reflex-triggered circulatory arrest, for example, by the cold of the water. People with a poor constitution or intoxications (poisoning) are particularly at risk. In a “bathing death in the broader sense,” the person dies of a natural cause, e.g., myocardial infarction (heart attack), and happens to be in the water at the time. Physical exertion of the swimmer and the coldness of the water are favoring factors (triggers). As with atypical drowning, there is no struggle for survival in swim death. The person simply goes under. Sex ratio: in 2017, 80% of drownings were men. Frequency Peak: Drowning victims include both younger persons and older persons. In 2017, drowning victims were primarily in the 16- to 25-year-old age groups and the 71- to 85-year-old age groups. According to drowning statistics, at least 404 people drowned in Germany in 2017. Of these:
- 157 in rivers,
- 137 in a lake or pond,
- 28 in the sea,
- 22 in a channel,
- 13 in a stream,
- 12 in a swimming pool,
- 10 in water-filled ditches,
- 2 in harbors (docks),
- 2 in the swimming pool and
- 21 in other waters.
The distribution shows that inland waters are the greatest source of danger. This is due to the fact that these waters are often unguarded, unlike swimming pools and coasts. In 2017, the most people drowned in Bavaria. There, it was 86 people. In Saarland, one person drowned in 2017. Between them, the number of drownings by state is distributed as follows:
- Lower Saxony and North Rhine-Westphalia: 55.
- Baden-Wuerttemberg: 38
- Saxony: 34
- Mecklenburg-Western Pomerania: 32
- Brandenburg: 22
- Hesse: 19
- Rhineland-Palatinate: 17
- Saxony-Anhalt: 15
- Schleswig-Holstein: 14
- Berlin and Hamburg: 5 each
- Thuringia: 4
- Bremen: 2
Most people drowned in the months from May to August (207 deaths; 2017). Course and prognosis: drowning leads to death in the worst case. The crucial factor is time, which determines the extent or consequences of oxygen deprivation. Hypoxia (lack of oxygen) can lead to neurological damage. The brain is the most sensitive organ of the human body. Brain damage is irreversible (cannot be reversed). Special care must be taken with children if they have swallowed a lot of water while bathing or swimming. In the case of dry drowning, the inhaled liquid leads to a spasm of the glottis of the larynx (laryngospasm). This is a physiological protective reflex of the body to prevent water from entering the lungs. The spasm causes the airway to close, resulting in shortness of breath. This condition is immediately recognizable.In secondary drowning, the spasm of the glottis is released and the inhaled water enters the lungs. There, inflammatory reactions and edema can occur. Gas exchange is disturbed, resulting in oxygen deficiency, which leads to death if left untreated. In secondary drowning, it can take up to 24 hours for symptoms to develop.Dry and secondary drowning occur very rarely. In 2014, seven children between the ages of zero and five drowned in this way, according to the DLRG. Reasons for drowning, among others, are the decreasing swimming skills of children, which is also caused by the closure of more and more swimming pools in Germany. Already a quarter of elementary schools cannot offer swimming lessons because no swimming pool is available. In the meantime, every second primary school pupil is no longer a safe swimmer.In the case of young victims, overconfidence and alcohol consumption lead to careless behavior in water. In the elderly, pre-existing cardiovascular (CV) conditions may also play a role (see “Etiology/Causes” for more). Rescuing drowning children requires a trained eye. Children drown differently than adults. When adults are in distress, they flail their arms, making them easy for lifeguards to spot among the bathers. The panicked body movements of children are too small and thus difficult to detect. Children drown silently. They simply go under.
