<unk>  is a type of suffocation induced by the submersion or immersion of the mouth and nose in a liquid. Most instances of fatal<unk>  occur alone or in situations where others present are either unaware of the victim's situation or unable to offer assistance. After successful resuscitation,<unk>  victims may experience breathing problems, vomiting, confusion, or unconsciousness. Occasionally, victims may not begin experiencing these symptoms for several hours after they are rescued. An incident of<unk>  can also cause further complications for victims due to low body temperature, aspiration of vomit, or acute respiratory distress syndrome (respiratory failure from lung inflammation).<unk>  is more likely to happen when spending extended periods of time near large bodies of water. Risk factors for<unk>  include a lack of training or attention to children, alcohol or drug use, epilepsy, and lack of higher education, which is often accompanied by diminished or non-existent swimming skills. Common<unk>  locations include natural and man-made bodies of water, bathtubs, swimming pools, and even buckets and toilets.<unk>  occurs when an individual spends too much time with their nose and mouth submerged in a liquid to the point of being unable to breathe. If this is not followed by an exit to the surface, low oxygen levels and excess carbon dioxide in the blood trigger a neurological state of breathing emergency, which results in increased physical distress and occasional contractions of the vocal folds. Significant amounts of water usually only enter the lungs later in the process. While the word<unk> " is commonly associated with fatal results,<unk>  may be classified into three different types:<unk>  with death,<unk>  with ongoing health problems, and<unk>  with no ongoing health problems. Sometimes the term "near-drowning" is used in the latter cases. Among children who survive, poor outcomes occur in about 7.5% of cases. Steps to prevent<unk>  include: teaching children and adults to swim and to recognise unsafe water conditions; never swimming alone, use of personal flotation devices on boats and when swimming in unfavourable conditions; limiting or removing access to water, such as with fencing of swimming pools; and exercising appropriate supervision. Treatment of victims who are not breathing should begin with opening the airway and providing five breaths of mouth-to-mouth resuscitation. Cardiopulmonary resuscitation (CPR) is recommended for a person whose heart has stopped beating and has been underwater for less than an hour. Causes Children have drowned in buckets and toilets. A major contributor to<unk>  is the inability to swim. Other contributing factors include the state of the water itself, distance from a solid footing, physical impairment, or prior loss of consciousness. Anxiety brought on by fear of<unk>  or water itself can lead to exhaustion, thus increasing the chances of<unk> . Approximately 90% of<unk> s take place in freshwater (rivers, lakes, and a relatively small number of swimming pools); the remaining 10% take place in seawater.<unk> s in other fluids are rare, and often related to industrial accidents. In New Zealand's early colonial history, so many settlers died while trying to cross the rivers that<unk>  was called "the New Zealand death." People have drowned in as little as of water while lying face down. Children have drowned in baths, buckets, and toilets. People who are inebriated or otherwise intoxicated can drown in puddles. Death can occur due to complications following an initial<unk> . Inhaled fluid can act as an irritant inside the lungs. Even small quantities can cause the extrusion of liquid into the lungs (pulmonary edema) over the following hours; this reduces the ability to exchange the air and can lead to a person<unk>  in their own body fluid." Vomit and certain poisonous vapors or gases (as in chemical warfare) can have a similar effect. The reaction can take place up to 72 hours after the initial incident and may lead to a serious injury or death. Risk factors Many behavioral and physical factors are related to<unk> :<unk>  is the most common cause of death for persons with seizure disorders, largely in bathtubs. Epileptics are more likely to die due to accidents such as<unk> . However, this risk is especially elevated in low- and middle-income countries compared to high-income countries. *The use of alcohol increases the risk of<unk>  across developed and developing nations. Alcohol is involved in approximately 50% of fatal<unk> s, and 35% of non-fatal<unk> s. * Inability to swim can lead to<unk> . Participation in formal swimming lessons can reduce this risk. The optimal age to start the lessons is childhood, between one and four years of age. *Feeling overly tired reduces swimming performance. This exhaustion can be rapidly aggravated by anxious movements motivated by fear during or in anticipation of<unk> . An overconfident appraisal of one's own physical capabilities can lead to "swimming out too far" and exhaustion before returning to solid footing. * Free access to water can be hazardous, especially to young children. Barriers can prevent young children from gaining access to the water. * Ineffective supervision.<unk>  can occur anywhere there is water, even in the presence of lifeguards. * Risk can vary with location depending on age. Children between one and four more commonly drown in home swimming pools than elsewhere.<unk> s in natural water settings increase with age. More than half of<unk> s occur among those fifteen years and older and occurred in natural water environments. Population groups at risk in the US are generally the old and young. *Youth:<unk>  rates are highest for children under five years of age and persons fifteen to twenty-four years of age. *Males: nearly 80% of<unk>  victims are male. *Minorities: the fatal unintentional<unk>  rate for African Americans above the age of 29 between 1999 and 2010 was significantly higher than that of whites above the age of 29. The fatal<unk>  rate of African American children of ages from five to fourteen is almost three times that of white children in the same age range, and 5.5 times higher in swimming pools. These disparities might be associated with a lack of basic swimming skills in some minority populations. Free-diving Some additional causes of<unk>  can also happen during freediving activities: * Ascent blackout, also called deep water blackout – caused by hypoxia during ascent from depth. The partial pressure of oxygen in the lungs under pressure at the bottom of a deep free dive is adequate to support consciousness but drops below the blackout threshold as the water pressure decreases on the ascent. It usually strikes upon arriving near the surface as the pressure approaches normal atmospheric pressure. * Shallow water blackout – caused by hyperventilation prior to swimming or diving. The primary urge to breathe is triggered by rising carbon dioxide (CO2) levels in the bloodstream. The body detects CO2 levels very accurately and relies on this to control breathing. Hyperventilation reduces the carbon dioxide content of the blood but leaves the diver susceptible to a sudden loss of consciousness without warning from hypoxia. There is no bodily sensation that warns a diver of an impending blackout, and people (often capable swimmers swimming under the surface in shallow water) become unconscious and drown quietly without alerting anyone to the fact that there is a problem; they are typically found on the bottom.
Drowning
Arrhythmia
Heat stroke
Hypoglycemia
Sudden wealth syndrome
Murder
Heat exhaustion
Seizure