Drowning, near-drowning, and ice-water drowning

Drowning has become an accident of affluence. As pointed out in the article by O'Carroll et AL 1 in this issue ofTHE JOURNAL, close to 50% of all drowning accidents in Los Angeles County occur in swimming pools. Drowning is now the second leading cause of accidental death in children and the second leading cause of years of potential life lost. For all causes of death in children, drowning is exceeded only by motor vehicle accidents and cancer. 2 As impressive as these figures are, mortality data fail to reflect the large toll in morbidity from anoxic brain damage caused by near-drowning accidents. It is estimated that one third of all survivors are moderately to severely neurologically damaged. 3 Hospitalization for near-drowning occurs five times more frequently than for drownings, and near-drowning accidents are estimated to be 500 to 600 times more common than their fatal counterpart. The vast