Interventions for Drowning

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Age Cohort: 5 - 11 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Community awareness about the risks and prevention of childhood drowning	Teaching swimming and water safety skills to school-age children Close and constant supervision during swimming Physical barriers to stop children coming into contact with open water sources Use of doorway barriers, pool fencing, and cistern, tank or well covering	Recognition of drowning signs and symptoms	First aid (ABC) Immediate transfer to a higher-level health care facility
Primary Care
Health education about the risks and prevention of childhood drowning	Basic swimming and water safety skills Close and constant supervision during swimming Barriers that fully enclose pools, water points and wells.	History Physical examination Pulse oximetry Chest radiography*	First aid: artificial respiration Adequate oxygenation, Prevent aspiration Stabilise body temperature Immediate transfer to a higher-level health care facility
Referral Facility: General
Formal basic swimming skills and water safety lessons in schools to reduce the risk of drowning Legislation and enforcement of safe boating, shipping and ferry regulation	Building protective barriers around pools, wells, dams, and ponds Teach basic swimming and water safety skills. Prevent unintended, unsupervised access to water, pools, beaches	History Physical examination Basic metabolic panel Pulse oximetry Chest radiography ECG	Continuous vital sign monitoring Management Grade II & III drowning Prevention of hypothermia Oxygen supply Mechanical ventilation
Referral Facility: Specialist
Health education about the risks and prevention of drowning	Building protective barriers around pools, wells, dams, and ponds Teach basic swimming and water safety skills. Prevent unintended, unsupervised access to water, pools, beaches	History Physical examination Basic metabolic panel Pulse oximetry Chest radiography ECG	Continuous vital sign monitoring Management of Grade IV & V drowning Warmed IV Fluids Humidified oxygen delivery Mechanical ventilation

Age Cohort: 25 - 59 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Formal basic swimming skills and water safety lessons in schools to reduce the risk of drowning	Building protective barriers around pools, wells, dams, and ponds Teach basic swimming and water safety skills. Prevent unintended, unsupervised access to water, pools, beaches		Early recognition of the need for referral for drowning
Primary Care
Formal basic swimming skills and water safety lessons in schools to reduce the risk of drowning Legislation and enforcement of safe boating, shipping and ferry regulation	Building protective barriers around pools, wells, dams, and ponds Teach basic swimming and water safety skills. Prevent unintended, unsupervised access to water, pools, beaches		History and physical examination for drowning Prevent hypothermia Early recognition of the need for referral for drowning
Referral Facility: General
Formal basic swimming skills and water safety lessons in schools to reduce the risk of drowning Legislation and enforcement of safe boating, shipping and ferry regulation	Building protective barriers around pools, wells, dams, and ponds Teach basic swimming and water safety skills. Prevent unintended, unsupervised access to water, pools, beaches		History and physical examination for drowning Maintaining adequate oxygenation Prevention of aspiration Chest x-ray EEG Monitoring Stabilise body temperature Early recognition of the need for referral Resuscitation using iv fluids crystalloid solution Appropriate management of seizures should be Blood glucose monitoring and management
Referral Facility: Specialist
Formal basic swimming skills and water safety lessons in schools to reduce the risk of drowning Legislation and enforcement of safe boating, shipping and ferry regulation	Building protective barriers around pools, wells, dams, and ponds Teach basic swimming and water safety skills.		History and physical examination for drowning Maintaining adequate oxygenation Prevention of aspiration Chest x-ray EEG Monitoring Stabilise body temperature Early recognition of the need for referral Resuscitation using iv fluids crystalloid solution Appropriate management of seizures should be Blood glucose monitoring and management

Age Cohort: 12 - 24 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Community awareness about the risks and prevention of childhood drowning	Teaching swimming and water safety skills to school-age children Close and constant supervision during swimming Physical barriers to stop children coming into contact with open water sources Use of doorway barriers, pool fencing, and cistern, tank or well covering	Recognition of drowning signs and symptoms	First aid (ABC) Immediate transfer to a higher-level health care facility
Primary Care
Health education about the risks and prevention of drowning		History Physical examination Pulse oximetry Chest radiography	First aid: artificial respiration Adequate oxygenation, Prevent aspiration Stabilise body temperature Immediate transfer to a higher-level health care facility
Referral Facility: General
Health education about the risks and prevention of drowning		History Physical examination Basic metabolic panel Pulse oximetry Chest radiography ECG	Continuous vital sign monitoring Management Grade II & III drowning Prevention of hypothermia Oxygen supply Mechanical ventilation
Referral Facility: Specialist
Health education about the risks and prevention of drowning		History Physical examination Basic metabolic panel Pulse oximetry Chest radiography ECG	Continuous vital sign monitoring Management of Grade IV & V drowning Warmed IV Fluids Humidified oxygen delivery Mechanical ventilation

Age Cohort: < 5 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Community awareness about the risks and prevention of childhood drowning	Safe places away from water for pre-school children Close and constant supervision during swimming Physical barriers to stop children coming into contact with open water sources Use of playpens, doorway barriers, pool fencing, and cistern, tank or well covering	Recognition of drowning signs and symptoms	First aid (ABC) Immediate transfer to a higher-level health care facility
Primary Care
Health education about the risks and prevention of childhood drowning		History Physical examination Pulse oximetry Chest radiography	First aid: artificial respiration Adequate oxygenation, Prevent aspiration Stabilise body temperature Immediate transfer to a higher-level health care facility
Referral Facility: General
Health education about the risks and prevention of childhood drowning		History Physical examination Basic metabolic panel Pulse oximetry Chest radiography ECG	Continuous vital sign monitoring Management Grade II & III drowning Prevention of hypothermia Oxygen supply Mechanical ventilation
Referral Facility: Specialist
Health education about the risks and prevention of childhood drowning		History Physical examination Basic metabolic panel Pulse oximetry Chest radiography ECG	Continuous vital sign monitoring Management of Grade IV & V drowning Warmed IV Fluids Humidified oxygen delivery Mechanical ventilation