Prevention of needless deaths from drowning.
OBJECTIVE
To determine whether faulty pool maintenance and substandard lifeguard performance critically delayed retrieval and resuscitation of a significant number of pool drowning victims.


METHODS
One hundred and eighty drowning incidents that resulted in litigation from 1998 to 2008 were studied to determine whether faulty pool maintenance and/or substandard lifeguard performance delayed retrieval and thereby contributed to the death of these persons. A total of 180 swimming pools-commercial and private-were included. Ninety-seven of these pools were manned by lifeguards. Subjects who underwent the drowning process and suffered severe brain injury or death were reviewed to determine the rescue and resuscitation attempts by lifeguards or bystanders at the pool.


RESULTS
One hundred and seventy-seven of the 180 persons who underwent the drowning process died. Cases were analyzed as to whether faulty pool maintenance and/or substandard lifeguard performance contributed to their demise. At fault were cloudy or dirty water; drain pipes that created underwater suction to trap victims; inadequate fencing around pools through which small children gained access; permitting small children to be at the pool without adult supervision; permitting dangerous exercises such as hyperventilation while underwater swimming, resulting in shallow water blackout; lifeguards not being attentive, being distracted by other persons, performing nonrelated chores, leaving their positions without proper relief, while failure to enter the water when told persons were submerged.


CONCLUSIONS
Faculty pool maintenance and substandard lifeguard performance critically delayed retrieval and resuscitation of a significant number of pool drowning victims.
Modell
Jerome H
JH
Department of Anesthesiology, University of Florida College of Medicine, Gainesville, FL 32610-0254, USA. jmodell@anest.ufl.edu
D016887:Cardiopulmonary Resuscitation; D002648:Child; D002675:Child, Preschool; D004332:Drowning / Q000401:mortality / Q000517:prevention & control*; D006801:Humans; D007223:Infant; D012449:Safety / Q000592:standards; D013551:Swimming Pools / Q000592:standards*; D014481:United States / Q000453:epidemiology