title: Mortality among drowning rescuers in China, 2013: a review of 225 rescue incidents from the press.
abstract: BACKGROUND
  Drowning is common worldwide. Rescue efforts attempted by untrained bystanders often lead to the death of the primary drowning victim (PDV), the rescuer or both. Our study aimed to inform prevention by identifying risk factors in rescuer drowning.
  
  
  METHODS
  Data on drowning rescue incidents reported online in mainland China, 2013, were reviewed. Information on the drowning incidents, PDVs and rescuers were retrieved for analysis.
  
  
  RESULTS
  A total of 225 rescue incidents were identified, of which 14 were victim-rescuer drowning incidents (VRDIs) (6.2%). A person-to-person rescue by swimming to PDVs was the most commonly used method (58.9%). Resuscitation was given immediately to 35.5% of PDVs after rescue. The mortality rate of the rescuers (13.3%) was similar to that of the PDVs (11.5%) (χ(2) = 0.5, p =0.49). Being an adult (OR = 0.2, 95% CI: 0.1-0.5) and other than the first rescuer (OR = 0.4, 95% CI: 0.2-0.9) decreased the risk of rescuers drowning.
  
  
  CONCLUSIONS
  Most of the currently employed life-saving methods are dangerous and even potentially life threatening. The idea of "rescuers' safety first" should be embraced, especially with teenage and child rescuers, who should never be encouraged to rescue others without first guaranteeing their own safety. Promotion of basic rescue skills should be implemented in the general public.
authors.affiliation: Institute of Non-Communicable Disease Control and Prevention, Ningbo Municipal Center for Disease Control and Prevention, No. 237, Yongfeng Road, Haishu District, Ningbo, Zhejiang Province, 315010, People's Republic of China. zhuyc@nbcdc.org.cn.
authors.forename: Yinchao
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Cardiovascular Epidemiology Unit, Institute of Environmental Medicine, Karolinska Institutet, Solna, 17172, Stockholm, Sweden. xia.jiang@ki.se.
authors.forename: Xia
authors.initials: X
authors.lastname: Jiang
authors.affiliation: Institute of Non-Communicable Disease Control and Prevention, Ningbo Municipal Center for Disease Control and Prevention, No. 237, Yongfeng Road, Haishu District, Ningbo, Zhejiang Province, 315010, People's Republic of China. lih@nbcdc.org.cn.
authors.forename: Hui
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Public Health Surveillance & Advisory Division, Zhejiang Province Center for Disease Control and Prevention, No.630, Xincheng Road, Binjiang District, Hangzhou, Zhejiang Province, 310051, People's Republic of China. fdli@cdc.zj.cn.
authors.forename: Fudong
authors.initials: F
authors.lastname: Li
authors.affiliation: Institute of Non-Communicable Disease Control and Prevention, Ningbo Municipal Center for Disease Control and Prevention, No. 237, Yongfeng Road, Haishu District, Ningbo, Zhejiang Province, 315010, People's Republic of China. chenjp@nbcdc.org.cn.
authors.forename: Jieping
authors.initials: J
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002648:Child; D002681:China / Q000453:epidemiology; D004332:Drowning / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D012307:Risk Factors; D017678:Sex Distribution; D013550:Swimming / Q000706:statistics & numerical data; D055815:Young Adult