title: Vehicle submersion: a review of the problem, associated risks, and survival information.
abstract: BACKGROUND
  Of all drownings, 3 to 11% occur in submersed vehicles, yet scientific study of this topic seems limited.
  
  
  METHODS
  A search was made of digital medical, drowning, transportation, and rescue databases regarding vehicle submersion drownings.
  
  
  RESULTS
  The major risk factors include driving on ice or roadways near water, flooding of roadways or bridges, slippery roads, curved roads, and darkness. A new definition of a Flotation Phase (from water impact until water rises to the bottom of side windows) defines a period when escape is easiest. Since survival probability is highest during this period (generally the first minute)--and then decreases rapidly--cell phones should not be used to call for help because this will only squander the optimal window for survival. It is virtually impossible to open a door until the vehicle is almost completely full of water. Since there is little or no trapped air, this period provides a very low chance of survival. Before exit, children should be released from their restraints. Breaking windows is difficult without a center punch or rescue hammer, which should be visibly mounted within reach of the driver.
  
  
  CONCLUSIONS
  Prevention includes installing adequate guardrails, barriers, warning signs, and road markings, or placing roadways at a greater distance from water. Areas at high risk for flooding should have signs and public warning systems for flash flooding should be improved. Public education should also focus on the dangers of driving on flooded roads or bridges, and on ice roads.
authors.affiliation: Laboratory for Exercise and Environmental Medicine, Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, Canada.
authors.forename: Gerren K
authors.initials: GK
authors.lastname: McDonald
authors.forename: Gordon G
authors.initials: GG
authors.lastname: Giesbrecht
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality* / Q000517:prevention & control; D001336:Automobiles; D004332:Drowning / Q000401:mortality* / Q000517:prevention & control; D055868:Floods; D006801:Humans; D007053:Ice; D007101:Immersion; D060106:Lakes; D012106:Research; D012307:Risk Factors; D045483:Rivers; D013997:Time Factors
chemical_list: D007053:Ice