What is accidental drowning? Six things to be careful about while using a bathtub

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New Delhi: Mystery deepened over the untimely demise of Bollywood actress Sridevi, who passed away in Dubai on Saturday night (February 24), after the post-mortem report claimed that the actor had drowned in her hotel apartment’s bathtub following a loss of consciousness. The Dubai government of Monday said that the actor died after she fainted and drowned in the bathtub of her hotel room. Earlier, it had been reported that the 54-year-old actor died of cardiac arrest while attending a family wedding in the UAE. While we all are in shock, wondering what actually took the life of the legendary actress so soon, we decode the possible mechanism of death by drowning, based on research studies and the information found on the web.

What is drowning? What factors influence drowning risk?
The World Health Organisation (WHO) in 2005 defined drowning as ‘the process of experiencing respiratory impairment from submersion/immersion in liquid. There may be dry (drowning in which no water enters the lungs), wet (drowning in which water enters the lungs), or ‘near’ drowning, depending upon whether some water is inhaled into the lungs. However, there is no clinical difference in how the victim is treated or whether the final outcome is good or bad. The term ‘near’ drowning is used to refer to a victim who did not die, however, this term is no longer widely used.

Experts say drowning can happen quickly and quietly anyplace where there is water – such as bathtubs, swimming pools etc, apart from natural reserves and sources of water such as rivers, ponds, and the ocean. According to a report in the Telegraph, in 2012, Japan’s health ministry had launched an investigation after it was estimated that 14,000 people died every year in the tub. In America, someone drowns in a bathtub – hot tub or spa – almost every day, and the deaths occur proportionately in Western states, as per a report in the Seattlepi. The report added that these victims are often drunk or take drugs while soaking in hot water.

“You get into a hot tub to relax and you drink to relax. When you put those two things together, you get more than you bargain for. The heat leads to dilation of the blood vessels, along with the alcohol. People are basically having a drop of blood pressure and having the equivalent of a faint,” Jonathan Howland, an epidemiologist at Boston University and a national expert on death by drowning, was quoted as saying by the Seattlepi.

According to CDC, alcohol intoxication or substance abuse accounts for up to 70% of deaths associated with water recreation in adolescents and adults. For people with seizure disorders, drowning is the most common cause of unintentional injury death, with the bathtub as the site of highest drowning risk. Risk factors that may contribute to drowning include other medical emergencies such as heart attacks, hypoglycemic or diabetic coma, stroke, etc.

In children, accidental drowning can happen if a kid suffers an injury while in the water like getting hit by an object. Estimates show that children under the age of five are most at risk of unintentional or accidental injury and account for nearly half of all child injury deaths. Among children ages 1 to 4, most drownings occur in home, swimming pools, says CDC.

Can a person suffer cardiac arrest while drowning?
According to The New England Journal of Medicine, if a person is not rescued, aspiration of water continues, and hypoxemia (abnormally low level of oxygen in the blood) quickly leads to loss of consciousness and apnea. The sequence of cardiac-rhythm deterioration is usually tachycardia (a heart rate that exceeds the normal resting rate) followed by bradycardia (slower heart rhythm), pulseless electrical activity, and, finally, asystole, which is the most serious form of cardiac arrest and is usually irreversible. And the whole drowning process, from submersion or immersion to cardiac arrest, usually occurs in seconds to a few minutes. But in unusual situations, such as hypothermia or drowning in ice water, this process can last for an hour.

Safety in the bathroom
Here are five things to keep in mind while using a bathtub. Follow these tips to ensure that your bathroom remains a safe and relaxing place:

The water should feel warm, not hot on your skin. The water temperature should be less than 105°F (40.5°C) – bath water that is too hot can cause burns with even brief exposure. So, always test the water temperature before to prevent burns.
Put a rubber mat or nonskid treads on the bottom of the tub to prevent falls.
Always fill the tub until the tub is about 2/3 full. This is important because once you step into the tub, the water level will rise. If you fill water to the top of the tub, bath water can get spilled over the sides, creating a spillage and then water could go everywhere.
Remember, water and electricity don’t mix. Use a towel to wipe your body and prevent the water from coming in contact with anything that can be a source of an electric shock. Also, unplug small electrical appliances such as hairdryers, electric razors, etc beforehand, when not in use to avoid a shock or fire. Dry your hands completely before using even the smallest of electrical appliances.
Never leave an electrical appliance near a bathtub, shower or sink.
Children and infants should never be left in the bathtub alone, even for a few seconds, and the caregiver should not be distracted by other tasks or chores.
Following these simple safety tips in the bathroom can help prevent an electrical fire or tragic events. Stay safe!

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