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Important Websites www.aetsas.com www.alsg.org www.apola.asn.au/ www.blueflag.org www.cc.uoa.gr/health/socmed/hygien www.cdc.gov/injury www.childsafetyeurope.org/watersafety www.dlrg.de www.dnr.state.ak.us/parks/boating www.drenkeling.nl www.drowning.nl www.drowning-prevention.org www.ehbo.nl www.epsa.org.ar www.hss.state.ak.us/dph/chems/injury-prevention/kids_don’tfloat.htm www.hvrb.org www.ilsf.org www.imo.org www.intensive.org www.intensiv-innsbruck.at/education/ertrinken_hasibeder.htm www.iria.org www.itsasafety.org www.iws.ie www.keepwatch.com.au www.kidsalive.com.au www.kindveilig.nl www.knrm.nl www.marine-medic.com.au www.minvenw.nl www.nationalwatersafety.org.uk www.polmil.sp.gov.br/salvamarpaulista/ www.rcc-net.org www.reddingsbrigade.pagina.nl www.redcross.ca www.redned.nl www.resuscitationcouncil.nl www.rlss.org.au www.rnli.uk www.rospa.com 660 Important Websites www.royallifesaving.com.au www.safewaters.nsw.gov.au www.slsa.asn.au www.sobrasa.org www.socorrismo.com www.sossegovia.com www.sshk.nl www.surflifesaving.com.au www.swimandsurvive.com.au www.szpilman.com www.thelifeguardstore.com www.uscg.mil www.uscg.mil/d17/d17rbs/d17rbs.htm www.usla.org www.vaic.org.au www.watersafe.org.nz www.watersafety.com.au www.watersafety.gr www.watersafety.vic.gov.au www.who/int www.who.int/violence_injury_prevention/ www.who.int/violence_injury_prevention/publications/other_injury/en/ drowning_factsheet.pdf Final Recommendations of the World Congress on Drowning Amsterdam 26 – 28 June 2002 The World Congress on Drowning is an initiative of de Maatschappij tot Redding van Drenkelingen Established in Amsterdam in 1767 As a result of an interactive process that was initiated in 1998 by nine task forces, including some 80 experts, and finalized during plenary sessions, expert meet- ings and research meetings in 2002 at the World Congress on Drowning, recom- mendations were made in the field of drowning prevention, rescue and treat- ment. This was the first time that many of these subjects were addressed in a global forum. The congress was attended by more than 500 persons. Although not every participant was directly involved in the development of each recommendation, these recommendations can be considered to be the most authoritative recom- mendations on the issue of drowning prevention, rescue and treatment at this moment. Many of the foremost authorities have been involved in the preparations dur- ing the four years prior to the congress and have been actively involved during the congress. The draft version of the 13 final recommendations was presented at the plenary closing ceremony of the congress. That preliminary version of the recommendations was distributed by e-mail and adapted as a result of the com- ments received. An additional series of detailed recommendations in the areas of rescue and diving (breath hold, scuba and hose diving) were agreed upon within the nominated task forces. This final version of the recommendations was then agreed upon by the members of the scientific steering group and the chairs of the nine task forces (epidemiology, prevention, rescue, resuscitation, hospital treatment, brain and spinal protection, immersion hypothermia, diving and drowning and water-re- lated disasters). All recommendations, together with the preparatory documents as consensus papers, reports of expert and research meetings, will be published in 2005 in the Handbook on Drowning. A list of names of the members of the scientific steering group, task forces and attendees of the World Congress on Drowning is included. 662 Recommendations 1. A new, more appropriate, world-wide uniform definition of drowning must be adopted A uniform definition of drowning is important for purposes of registration, di- agnosis and research. The following definition was accepted: “Drowning is the process of experi- encing respiratory impairment from submersion/immersion in liquid.” All organisations involved in epidemiological research and vital statisti- cal data collection as well as rescue organisations and the medical community should consider and preferably accept this new definition as a basis for useful communication and include it in their glossary. Further consultation of drown- ing experts is needed to uniformly classify morbidity and mortality due to drowning. 2. There is a great need of adequate and reliable international registrations of drowning incidents International and national registration procedures of the number of drowning victims, immersion hypothermia victims, rescues, and hospital data are needed to better appreciate the world-wide burden of drowning. Also clinical data, for example on resuscitations and rewarming techniques, are needed to improve treatment. International organisations, such as The World Health Organisation (WHO), the International Red Cross and Red Crescent organisations (IRCRC), the Inter- national Life Saving Federation (ILS), the International Life Boat Institute (ILF) and Diver’s Alert Network (DAN), as well as national organisations, institutions and medical research consortiums are advised to set up and coordinate data- collection. 3. More data must be collected and knowledge gained about drowning in low-income countries and societies According to repeated WHO reports, over 80% of all drownings occur in low-in- come countries or in low-income groups in high income countries. Nevertheless only few epidemiological data about these risk groups are available. The WHO, IRCRC, ILS, ILF and the European Consumer Safety Institute (ECOSA) are en- couraged to expand the research on drowning risk factors in these low-income groups because this is expected to have a major impact in reducing the risk of drowning. 4. Preventive strategies and collaboration are needed The vast majority of drownings can be prevented and prevention (rather than rescue or resuscitation) is the most important method by which to reduce the number of drownings. The circumstances and events in drowning differ across many different situations and in different countries world wide. Considerable differences exist in the locations of drowning and among different cultures. Recommendations 663 Therefore, all agencies concerned with drowning prevention – legislative bodies, consumer groups, research institutions, local authorities and designers, manu- facturers and retailers - must collaborate to set up national and local prevention initiatives. These will depend on good intelligence and insightful research, and must include environmental design and equipment designs as a first route, in conjunction with education, training programs and policies which address spe- cific groups at risk, such as children. The programs must be evaluated and the results of the evaluations must be published. 5. All individuals, and particularly police officers and fire fighters, must learn to swim Knowing how to swim is a major skill to prevent drowning for individuals at risk. International organisations such as WHO, IRCF and ILS, and their national branches must emphasize the importance of swimming lessons and drowning survival skills at all levels for as many persons as possible. The relationships between swimming lessons, swimming ability and drowning in children needs to be studied. In addition, certain public officials who frequently come in close contact with persons at risk for drowning, such as police officers and fire fight- ers, must be able to swim for their own safety and for the safety of the public. 6. Rescue techniques must be investigated Most of the current rescue techniques have evolved by trial and error, with little scientific investigation. Rescue organisations such as the ILS, ILF, IRCRC but also the International Maritime Organization (IMO) must be encouraged to evaluate the self-rescue and rescue techniques in their training programs in ac- cordance with current scientific data on the effectiveness and efficiency. Based on the data, the best rescue techniques must be selected for education and train- ing programs. 7. Basic resuscitation skills must be learned by all volunteer and professional rescuers as well as lay persons who frequent aquatic areas or supervise others in water environment The instant institution of optimal first aid and resuscitation techniques is the most important factor to survive after drowning has occurred. Resuscitation or- ganisations, such as organisations, in particular those related to International Liaison Committee on Resuscitation (ILCOR), as well as professional rescue or- ganisations and other groups who frequent aquatic areas, must promote training programs in first aid and Basic Life Support for anyone who frequently visits or is assigned to work in the aquatic or other water environment. 664 Recommendations 8. Uniform glossary of definitions and a uniform reporting of drowning resuscitation must be developed and used To increase the understanding of the dying process and the resuscitation poten- tial in drowning, a uniform reporting system must be developed and used for the registration of resuscitation of drowning. International resuscitation organisations, such as ILCOR-related organisa- tions and medical groups, must establish a uniform reporting system, facilitate its use, be involved in the analysis of the data and support of recommendations based on the studies. 9. Hospital treatment of the severe drowning victim must be concentrated The optimal treatment of drowning victims includes dealing with specific severe complications such as the Acute Respiratory Distress Syndrome, pneumonia, hypoxic
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