CHENNAI: Veteran actress Sridevi's death due to ‘accidental drowning’ has become a debatable topic, but it is not as uncommon as believed. As per World Health Organisation, accidental drowning is the third most common cause of accidental death in the world. Drowning stops the oxygen supply to brain, leading to unconsciousness and cardiac arrest as the blood flow is disrupted.
Though it is believed that a person would call for help when drowning, accidental drowning is silent mostly. Accidental drowning usually occurs silently and quickly following unconsciousness or distress, while one is in swimming pool or even in bathtub. Experts and medical journals discuss various risk factors causing death due to accidental drowning, causes and characteristic of accidental drowning.
Death due to drowning: “Drowning ultimately produces tissue hypoxia, which affects virtually all tissues and organs within the body. However, if the patient does not respond to the delivery of two rescue breaths that make the chest rise, the rescuer should immediately begin performing cardiopulmonary resuscitation (CPR) and recovery is possible with rescue breathing),” said Dr K.K. Aggarwal, former national president, IMA. Complete recovery of patients with hypothermia and cardiac arrest has been well documented despite prolonged resuscitation (sometimes up to several hours). “Postural water drainage techniques to remove water from the lungs are of no proven value, and rescue breathing should not be delayed in order to perform these techniques,” he adds.
Accidental drowning, not so uncommon: World Health Organisation said that accidental drowning is the third most common cause of accidental death in the world. The highest drowning rates were found to be among children 1-4 years, followed by children 5-9 years, mostly due to lack of supervision. There are an estimated 3,60,000 annual drowning deaths worldwide as per the global report on drowning by WHO, however, global estimates may significantly underestimate the actual public health problem related to drowning, it said. The numbers are high in Japan where annual mortality from accidental drowning in persons aged older than 75 years is 33 deaths per 1,00,000 population.
Causes of accidental drowning: The bathtub is the most common site of seizure-induced drowning, and patients with epilepsy should be told to take showers instead of baths. Heart attack leading to unconsciousness and subsequent falling in the tub often leads to water inhalation. “Irregular heartbeat, which is mostly undetected, can lead to accidental drowning after physical exercise or strain. Changes in the calcium channels of the heart called as cardiac ryanodine receptor (RyR)-2 gene are also a reason for death with unexplained drowning,” said Dr Suresh Rao, cardiologist.
Risk factors: The risk of death is very high if the duration of submersion under water is more than five minutes. The consumption of alcohol, illicit drugs, hypothermia, seizures, and developmental disorders increase the risk of death manifold, say medicos. Hypothermia can lead to rapid exhaustion or abnormal heartbeat causing accidental death. Concomitant trauma, paralysis or heart attack can cause death in case of drowning.
Increased risk due to alcohol consumption: As per The American Journal of Forensic Medicine & Pathology, a total of 268 victims were found unconscious or dead during tub bathing in 2013 in America and 24 per cent cases were due to accidental drowning. Deaths due to water inhalation were observed more frequently in victims with other backgrounds such as alcohol intake, mobility disturbance, and history of epilepsy. Forensic Science International conducted a retrospective review of 92 deaths in the bathtub in Maryland in 2015 and it was found that drug/alcohol consumption was among the three leading contributory factor other than cardiovascular disease and seizure disorder.
