Talk:Drowning/Archive 1

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Heading
Warm and dead: this is still taught within the first responder (FIRE/RESCUE/EMS/POLICE/etc) professions. For the lay person this means that a dead person who is the result of a suffocation like drowning or choking that the deceased should be worked on despite the long length of time dead. It has lots of common sense factors to this saying that is used like, the person should not have injuries incompatible with life and obviously shouldn't have been dead for days which is why the saying has hopefully only been used within the science used to teach professionals and not the general lay persons. Dead people are always cold or cool u less they are in an environment that keeps their body temp up. In short, if it doesn't make sense to you, you don't need to know. — Preceding unsigned comment added by 2600:1:F1A4:AC8:8144:D66B:D37B:BB54 (talk) 20:02, 22 April 2017 (UTC)

1
I new to this, so am not sure this is the right pklace to put put this. There are rare but documented cases of survivable submersion for extreme lengths of time. In one case a child named Michelle Funk survived drowning after being submerged in cold water for 70 minutes. In another, an 18 year old man survived 38 minutes under water. This is known as cold water drowning. I think this section could be improved by providing further details or references of these specfic cases. many people who survive prolonged sumersions are either children or small adults ie those witha large surface area to volume ratio who cool very quickly. More deatails on these cases would allow the reader to determine if these meet this theory.Luntie (talk) 07:04, 29 September 2010 (UTC)

Fresh water vs. Salt Water drowning
I added a small reference to fresh-water drowning, where death is not caused by asphyxia. Someone else may want to put together a section about it. Basically what happens is that water is osmotically drawn across the pulmonary epithelium very fast, resulting in hypotonic blood making the red blood cells burst (hemolysis). This changes the content of salts and when this changed blood reaches the heart it causes ventricular fibrillation. Perhaps I should list the source: Medical Physiology, 2nd edition, Rhoades & Tanner. Page 344.
 * This seems highly implausible although I haven't got access to Rhoades & Tanner. Although the mechanisms discussed are probably real it seems unlikely that there is time for these to act before the victim dies of just plain old hypoxia due to water in the lungs impeding oxygen uptake.  Unconsciousness from water inhalation can occur within thirty seconds of inhalation, there is just no time for thse other things, true though they may be, to start affecting the body.  Assimilating all that cold water sufficient to cool the blood (why is this different from hypothermia, which does not behave like this?) requires the patient to have waterlogged lungs for many minutes and still live.  If this does happen it must be exceedingly rare.  I suggest this section is deleted or relocated to effects of water inhalation, which would include Salt Water Aspiration Syndrome and doesn't live in Drowning.  I am left wondering if this item is intentionaly misleading.  Discussion is invited with a view to deletion.  Ex nihil (talk) 23:15, 1 May 2008 (UTC)


 * What about the cardiac response to excessive hypervolaemia in freshwater drowning? Affects cardiac decompensation with the acute increase in blood volume (Berguist et al Anesthesiology 1980;52:142-148) but this doesn't necessarily end immediately in cardiac arrest. The person can be conscious for UP TO 3 minutes (Pearn J 1985;142:586-588)and therefore it is highly unlikely for the subject to be in cardiac arrest. Involuntary respiratory movements also occur following unconsciousness, in which case osmotic changes, some form of cardiac output and therefore circulation are maintained, effectively allowing enough time for these processes to take place. Needless to say, the degree of hypoxic change whilst all this is going on keeps progressing until final cerebral anoxia.
 * This mechanism may have some validity under the heading secondary drowning. 1. The main problem is still the implausability of the statement "Although fresh-water drowning is often associated with aspiration of water into the lungs, the cause of death is not due to either hypoxia or pulmonary edema." Not having empirical data to hand I would imagine 99.9% of freshwater drownings are identical to salt water drownings, that is the victim is dead within minutes simply because the lungs are filled with water preventing gas exchange, ie hypoxia or anoxia.  Perhaps you could describe a realistic sequence of events by which the drowning victim died from hypervolaemia before simple hypoxia?  Perhaps the swimmer is immersed in choppy water for a very long time, breathing but continually inhaling water until eventually the body succumbs to biochemistry changes?  Maybe, but this can't be the norm, most victims are unconscious in seconds, dead in minutes - no time.  2. The cold water thing just does not appear credible, there may be cold water in the lungs, water in the lungs is an immediate problem at any temperature, but if the entire body is immersed in cold water, why is this different to simple hypothermia?  Hypothermia can kill but only if the victim is in air.  In the water the hypothermia will incapacitate the victim and when they cease to be able to swim they will simply inhale water and drown, by anoxia.  Please explain a practical mechanism. Ex nihil (talk) 04:44, 15 August 2008 (UTC)  Moved this to Secondary Drowning as ity seems to belong there. Ex nihil (talk) 23:17, 24 August 2008 (UTC)

I'm new to editing Wikpedia, so I'm not sure how to do this, but I just spotted an inconsistency: under the section Cardiac Arrest and Death there is the sentence "Sea water is much saltier than blood. Through osmosis water will leave the blood stream and enter the lungs thickening the blood". Later, under the section Secondary Drowning, there is the sentence "In contrast, salt-water drowning does not lead to uptake of inspired water into the vascular system because it is isotonic to blood." These two statements are a direct contradiction. I don't know which is the correct statement, and I'm not sure how to fix it, but I just thought I'd point it out for anyone who wants to look into it. Marsha, July 3, 2009


 * I have edited the section in question; it is indeed true that salt water, at least regular seawater from open oceans, is hypertonic rather than isotonic compared to blood. The conclusion is still valid, since all that will happen is that water will tend to exit the bloodstream rather than enter it, so erythrocytes do not swell and lyse but at worst shrink and stay intact. The section referred to "hydrolysis" which was probably a mistaken reference to hemolysis. As for the broader issue of whether freshwater drowning can cause death via hemolysis before common asphyxiation, I think this is more plausible than you might think. Blood goes from the lungs to the heart very fast, and thus freshwater in the lungs could potentially cause cardiac arrest within seconds. Sakkura (talk) 21:17, 3 August 2009 (UTC)

Dr Raymond A. Schep: we may theorize which is worse, salt water or fresh water aspiration, but actual experimentation pretty much settles the issue. AW Conn, et al, Crit Care Med 1995 p2095 in experiments on dogs found aspiration of fresh water into to lungs to be much more harmful than salt water. 16% water absorption occurred with fresh water as opposed to 6% with salt water. This means treatment with diuretics is more critical in the case of near drownings in fresh water, whereas treatment for hypernatria and hyperchloria (Water dilution!!!) is in order for near drownings in salt water. —Preceding unsigned comment added by 66.251.102.206 (talk) 23:32, 29 September 2009 (UTC)


 * Freshwater Drowning occurs when a person inspires fresh water. The inspired water inhibits the function of the lungs to cause hypoxia. Freshwater drowning is further complicated by the change in blood ph, chemistry and pressure which can lead to irregular heart rhythm and ventricular fibrilation.
 * Secondary Drowning is a side effect often found in near-drowning victims who have inspired fresh water. Once the water has been removed from the lungs, the haemodiluted blood comes out from the capillaries back into the alveoli.
 * Saltwater Drowning occurs when a person inspires salt water. The inspiration of salt water has the opposite effect to freshwater and causes haemoconcentration and a decrease in blood pressure, however the blood chemistry is not changed drastically.
 * Dry Drowning. Dry drowning occurs in both fresh and salt water. It is a reaction of the human body, when panicked in a drowning situation, to close the larynx in order to prevent water entering the lungs. This will lead to hypoxia and subsequent unconsciousness however no water will enter the lungs. This is generally the case in near-drowning. —Preceding unsigned comment added by Frozen-core (talk • contribs) 01:55, 14 December 2009 (UTC)

Statistics
I am rather dubious about many of the statistics here and all of the surveys suggest items. I haven't done the research but there must be a good authoritative source, RSLSI? Could someone find the real rate of drownings per country? The real rates of drownings atrributed to causes? The evidence for males and age relatedness? Perhaps in a table? The stats need to be widened beyond the US experience if they are to have any real relevance beyond the US, the stats vary enormously between countries, I am Australian, we drown heaps, I bet Sweden doesn't. The article also needs some sources cited. I took out the 145,000 worldwide, I haven't got anything to refute this but it seems far too low given the world population in billions, I can think of individual events, ferry sinkings, dam collapses, floods, cyclones, tsunamis accounting for hundreds at a time. 145,000 looks like recreational drowning deaths.

The section under: Well-known mechanisms by which a person drowns can be categorized as follows: needs some verification, it suffers from category confusion, does this relate to dangerous situations, the condition of the victim, the process of drowning? It looks as if it has been cut and paste from somewhere, where is that somewhere? Ex nihil 01:05, 29 June 2006 (UTC)

The annual drownings attributed to SCUBA diving needs to be investigated. An internet search will show U.S. SCUBA related statistics are said to average about 90 deaths per year from all causes, drowning being one of them. The article claims 10% of all U.S. drownings are related to SCUBA (600+ total deaths)  Driftwood87 (talk) 20:05, 10 May 2009 (UTC)

I noticed the same problem with attributing so many deaths to scuba diving. I looked for similar statistics but could not find any, so I replaced those which are obviously incorrect, with accurate, though less interesting statistics from the cdc, that just list drowning by body of water, but not by activity (which would have been preferable)

Re: near-drowning in sea versus freshwater.

Blood and seawater are NOT isotonic as stated, seawater is <~3.5%, blood/plasma ~0.9% w/w NaCl. Thus, in freshwater aspiration, osmosis leads to absorbtion of water into blood/plasma, with the attenant problems as described, but in saltwater aspiration, plasma is drawn into lung void, with increased tendency to pulmonary oedeama, suffacant flushing and a positive feedback loop of secondary drowning. As such, saltwater aspiration is estimated to be ~2x as dangerous as freshwater aspiration. "Essentials of Sea Survival", Golden F. & Tipton M., Human Kinetics Europe Ltd (May 2002)ISBN-10: 0736002154 is an authoratitive work on the subject.The section as it stands is only partially correct, misleading and potentially dangerous in the interpretations it may lead to. —Preceding unsigned comment added by 88.73.66.212 (talk) 16:12, 21 May 2009 (UTC)

Grotesque Images
I for one am getting a bit tired of the images of corpses and other unnecessary imagery on Wikipedia. Can we please remove this one? It serves no purpose in the article, it is simply a corpse. I'm starting to think Wikipedia editors have an unhealthy fixation with images of death. Just think what would happen if a young grade school student researching something else came upon this. Remember Wikipedia is for everyone and not just adults.

General stuff
I am not happy with this: ''Drowning following car accidents is the second most likely cause of injury and death for children up to 14 years. Males are much more likely to drown than females.'' The leading causes of death may be very different in different parts of the world (I guess neither drowning nor car accidents play a major role in Mauritania), so specific figures should be quoted. And where does the information about male/female risk come from? Kosebamse 07:14, 12 Apr 2004 (UTC)


 * The numbers are based on an american statistic, so you are right, they probably do not apply worldwide. The same statistic also showed that more men drown than women. This, however can quite likely be the same worldwide, as men are more likely to take risks (and hence to fail the odds) than females. I will see if i can find a reference. -- chris_73 07:21, 12 Apr 2004 (UTC)

Thanks for the prompt reply! I have rephrased that sentence a little to be less specific, but references would be fine. By the way, in causes of drowning there seems to be nothing about inability to swim. Do you know if there are any figures about how many people drown because they have not learnt swimming? Kosebamse 07:25, 12 Apr 2004 (UTC)


 * Got the reference with "more males", and "high risk below 14": Water-Related Injuries. It has also some info about drowning due to the inability to swim. However, I think (but dont have the exact data yet), most people drown for other reasons (drunk, unconscious, trapped, exhaustion, cold, currents ...). Also, a normal person will naturally float in the water, and can happily breathe with the nose and mouth above the water almost indefinitely. They drown if they panik or get exhausted. I will check . -- chris_73 07:30, 12 Apr 2004 (UTC)


 * Couldnt find a reference about how many people drown because they cant swim. Found one ref, but this was misquoting another study, and just attributed all causes to "cannot swim". It seems, one problem is to distinguish the different causes, sort of "Was it the cold water, the waves, being drunk or being a bad swimmer?". There are many statistics about the location, if you need that. BTW thanks for improving the article! -- chris_73 07:48, 12 Apr 2004 (UTC)

--

"Even after brain death some cells of the body will continue to live, and for example hair may grow."

Myth - see http://www.snopes.com/science/nailgrow.htm (and since the cause of apparent shrinkage is *dehydration* of tissue, unlikely to occur in drowning). --Calair 03:59, 6 Sep 2004 (UTC)


 * The instances where people survived under water for extended periods of time, however, is not a myth. This is known as cold water drowning -- Chris 73 Talk 06:41, Sep 6, 2004 (UTC)


 * It's not a myth. It is, however, in the article twice - under "Cardiac Arrest and Death" and again at the end of "Rescue and Treatment" - which is why I removed one and only one of those appearances. That's what the 'duplicate' in the edit summary was for. --Calair 06:49, 6 Sep 2004 (UTC)
 * OK, my mistake, I missed that. -- Chris 73 Talk 12:20, Sep 6, 2004 (UTC)
 * No problem. I think I did a better job of it second time around, anyway; shouldn't have removed it from the first-aid section but from the other. --Calair 22:56, 6 Sep 2004 (UTC)

I did a tremendous amount of gramatical revision to this page and fixed some of the above concerns. In the process, several lines struck me. "Near drowning incidents are estimated to be 2 to 500 times the number of drowning incidents."

As an engineer I think it's silly to report such uncertain data.

"If the victim is physically much stronger than the rescuer, there may be cases where it is advisable for the rescuer to wait until the victim passes out so that the victim does not accidentally drown the rescuer."

Though I am not a trained EMS responder, this seems ludicrous and potentially dangerous to include in Wikipedia. If you have either the credentials or sources to back it up, please put it back in.

--Casito 23:37, 5 Jan 2005 (UTC)


 * Thanks for your great work in fixing Grammar. About the "wait till victim passes out": I have a number of lifesaving licenses in Germany and the US (but no EMS), and this point was definitely taught in the German classes, and I think also in the US classes. A panicking victim can drown a weaker rescuer, and it is always advised to approach a panicking victim in the water from behind, using a special grip to secure and immobilize the victim. If the panicking victim is stronger than the rescuer, the victim can drown the rescuer. In this case it is better to wait until the victim calms down (i.e. passes out). In the worst case, this would mean one person dead (victim) instead of two (victim and rescuer). However, I agree that ethically and also legally, this topic is difficult. Hope this answered your question. -- Chris 73 Talk 00:56, Jan 6, 2005 (UTC)


 * Ex nihil 01:36, 7 February 2006 (UTC) I have added a brief discussion of latent hypoxia and hypocapnia under Initial Oxygen Starvation. These are the two basic self induced hypoxic mechanisms for blackout on ascent from depth and blackout without depth after hyperventilation.  Unfortunately there is some confusion about the terms shallow water blackout and deep water blackout because the term SWB is often used in US scuba Open Water curricula to refer to latent hypoxia leaving nothing to cover the shallow water hypocapnic blackout.  Also some scuba divers use DWB as technical shorthand slang to refer to one aspect of nitrogen narcosis.  Both mechanisms kill a lot of swimmers and need some clarification.  I would rely on the articles shallow water blackout and deep water blackout to provide any more detail.  I think this section could do with a bit of a rewrite for the sake of lucidity.  I might attempt it is this last edit settles.

More about what to do if someone tries to drown you
Cant you add a bit on how to defend yourself if someone tries to drown you under Prevention?Ollie the Magic Skater 20:13, 18 March 2006 (UTC)
 * Do you mean someone trying to drown you intentionally, or a panicking victim pushing you under water. My (layman) advice, in a loose order of preference:


 * try to get away
 * try to get out of reach (behind the attacker/panicked person)
 * try to use a arresting grip/police grip
 * for panicked person: dive under water to get out of sight (out of mind)
 * for intentional drowning: use self defense techniques, due to the nature of the water kicks probably won't work very well, probably better to poke the eye or hit the throat area.
 * -- Chris 73 | Talk 21:44, 18 March 2006 (UTC)

"Last thoughts of Near-Drowning Victims Before Unconsiousness", Vandalism?
Near drowning victims often report that their last thought before unconsciousness was imagining other people's reaction to their drownings, and feeling embarrassed and ashamed for being stupid enough to drown, believing that smart people would be able to prevent their own drownings (For a list of causes see swimming).

This sounds a lot like vandalism, which was why I initially deleted it. Is this true, because to me it seems like hear say at best, and mean-spiritedness toward drowning victims at worst. If someone is going to make this bold and touchy a claim in this article, they should atleast provide a cite. To me, strolling in to this article, it just seems too unbelievable. I would think other people seeing the article would feel the same way to.--64.60.64.146 15:26, 4 May 2006 (UTC)
 * I added this when i expanded the article quite some time ago. The source is a book about crabfishing in Alaska. (it was either Working on the Edge : Surviving In the World's Most Dangerous Profession: King Crab Fishing on Alaska's HighSeas or Nights of Ice : True Stories of Disaster and Survival on Alaska's High Seas, don't remember which one exactly, since i read both). The book was not a novel, but non-fiction. As for mean spirited: these is the short form of comments from near drowning survivors, not really nice, but true, and the goal of Wikipedia is not to be nice, but stick to facts. The exact formulation of the text can of course be adjusted, and maybe formulated in a nicer way, but I strongly believe this should stay, as it gives great insight into the drowning process. If you want to adjust the text, please go ahead and improve the article, just don't remove it. Hope this helps. -- Chris 73 | Talk 15:36, 4 May 2006 (UTC)


 * I just wanted a cite. Without your cite it looks like vandalism using made up information to troll.  Now that I know it's actual fact, I agree, it should be kept.  Though, I really think it would be best to add the cite to warn people that this is actual reported fact and not fiction.--24.130.125.164 01:09, 5 May 2006 (UTC)

As a near-drowning victim myself, I support the vandalism claim. My last thoughts were focused on trying to survive and what my situation was as I was losing that fight. The closest I had to idle thought was wondering if I could breath water. I have had other accidents, like falling from a three story rooftop, where there was time to contemplate. Drowning is different from that. It is more similar to receiving a powerful electric shock. Drowning is an event which seizes your complete attention all the way through to the end. —Preceding unsigned comment added by 76.115.41.188 (talk) 02:20, 14 August 2010 (UTC)


 * First of all, did you lose consciousness? If not, then that may be part of the reason your experience was different. If you had come closer to losing consciousness, perhaps you would have had the same thoughts. But of course, maybe you did lose consciousness, in which case my first point is moot. Second of all, you are one person. The experiences of one person do not represent the experiences of the whole. Chris 73 has a reference to the claims of multiple people; all you have is, for want of a better word, original research, on the claim of only one person. If you can find a reference where as many people contradict what Chris 73's reference says, well, then you'll have a pretty good argument. But at this point...not so much. NoriMori (ノリモリ) 23:40, 2 October 2010 (UTC)

Heimlich
I was looking at the following paragraph:

"The Heimlich maneuver is needed only for obstructed airways, not for water in the airways. Performing the Heimlich maneuver on drowning victims not only delays ventilation, it may induce vomiting - the vomit may then be aspirated, leading to serious injury or death. Furthermore, news articles have raised concerns that the entire concept is not only useless, but that Dr. Henry Heimlich used fabricated case reports to promote the idea:" [And it has a link here]

The first part, specifically,

"The Heimlich maneuver is needed only for obstructed airways, not for water in the airways. Performing the Heimlich maneuver on drowning victims not only delays ventilation, it may induce vomiting - the vomit may then be aspirated, leading to serious injury or death,"

seems fine. It is informative and all that good stuff. But it's the last portion that I'm concerned about:

"Furthermore, news articles have raised concerns that the entire concept is not only useless, but that Dr. Henry Heimlich used fabricated case reports to promote the idea . . . ."

It seems out of place, and almost takes a biased standpoint. It's out of place because this is an article about drowning, not about the Heimlich maneuvre, whether or not the Heimlich can be used on a drowning victim. And it seems biased because, while it has a link to a site (which, from my opinion, feels a bit amateur-ish to be a substantiated news source), because it seems to disregard any chance that the maneuvre is viable; it is a one-sided argument.

Anyways, I'm just bringing this up because I was curious what others thought about it. I am new here, and I don't want to go changing this if it shouldn't be changed, therefore I leave it up to someone a bit more experienced on this to make the decision.

Ex nihil 04:20, 15 June 2006 (UTC) I think you are right, I have adjusted that section. See what you think.

Much better, thank you.

Image:SWB3 temp.jpg
Hi. This is a very well written article. I liked the language. Just curious.. is that picture of the drowning lady real? Sorry i dont have a login. Once again, its a wonderful article.
 * Thanks for the compliments. The image is staged, I believe (but I cant't find where). I'll ask the uploader. -- Chris 73 | Talk 10:57, 18 July 2006 (UTC)
 * Yes the image is staged. Ex nihil 08:29, 19 July 2006 (UTC)


 * What was the goal of this picture? It seems quite macabre. It's certainly understandable that you may want to put up a picture of your daughter, but it's just hard to see how it fits in with the educational value of the article. --Groovyk 07:39, 6 August 2006 (UTC)


 * The image was actually made for Shallow water blackout, not drowning, someone borrowed it but that's OK. My daughter and I have an interest in educating people in this area.  The pool that hosted this picture experienced a real shallow water blackout and this was exactly how the victim was found.  The intent was to illustrate that people drown silently and unnoticed as opposed to the drama attached to the traditional splashing, waving and shouting you see in the movies.  This picture is entirely applicable to drowning 'though; the first you are likely to be aware that someone is in trouble in your pool is seeing something like this.  I hope that the picture changes people's idea of what a drowning might look like.  If you were shocked it's been successful.  Ex nihil 10:28, 7 August 2006 (UTC)
 * The picture is very appropriate to illustrate the article I think. It's quite a good picture, looks realistic, and I am very glad it is just staged. -- Chris 73 | Talk 11:01, 7 August 2006 (UTC)

How-to reduction
The introduction to the how-to list was a good addition. Currently there are no established guidelines to the reduction of how-to content, but any ideas and discussion would be welcome here, and also on the how-to category talk page. Santtus 12:11, 22 July 2006 (UTC)

Not sure when a 'how to' becomes fact but the way the Prevention para is rewritten now I believe could be taken as objective information on relevant, related practice rather than instruction on prevention. Drowning and its prevention go hand in hand so something should be placed here. How do people feel about removing the tag? Ex nihil 02:37, 28 August 2006 (UTC)

Old wives tales?
Me and my friend are having an argument about whether "don't eat before swimming" is old wive's tales or sound advice. In our counry (Greece) it is part of the swimming guidelines published by the authorities every summer. On the other hand "don't take a lot of fast, deep breaths before diving" is not.

There is nothing about it in the article, but we noticed one of the editors has lifeguard training. Would they (or someone else) have something to say on the matter?

If it's true that you shouldn't swim after eating it should be added to the article too.


 * That used to be taught in the UK up to the 1980's on the basis that it caused cramps. My understanding now is that this is discredited, certainly it seems absent from swimming, diving and LS curricula.  Someone in authority in current teaching practice out there?? Ex nihil 06:09, 6 August 2006 (UTC)

Drowning pictures
I have temporarily removed the SWB image from this article on behalf of the girl who staged it. I have added the comment below to the Talk page of FoxSports Radio by way of explanation: ''FoxSportsRadio, I note the copyright issues on the pictures you have added and this will resolve sometime over the next week. However, even if it is resolved in favour of retaining the pictures my feeling is that they do not improve the article and should be removed anyway. The SWB image was staged for the didactic purpose of showing how a victim can expect to be found, it is accurate and the article only needs one. The additions are very repetitive and probably inaccurate anyway, the victim can float but will assume a foetal position, not that high out of the water and generally will sink in fresh water. The picture of the decomposed body may have a genuine function on another article dealing with decomposition but seems gratuitous here, this is not the condition of somebody who has just drowned or is in the process of drowning. Unfortunately, the subject of the SWB picture, who was supportive of staging the picture to illustrate shallow water blackout is upset about the association with these additions and therefore I have removed that picture on her behalf until the matter is resolved.'' Ex nihil 03:51, 14 August 2006 (UTC)

Torture and execution???
As drowning is linked from http://en.wikipedia.org/wiki/Torture, either this should be elaborated on here, or removed from the torture page. —The preceding unsigned comment was added by 71.197.131.165 (talk) 03:48, 10 December 2006 (UTC).

Drowning images
Those images show the effects while drowning (the girl in the red suit) and the permanent damage after drowning (the dead girl in the blue tank). Catherine Woods 13:51, 29 January 2007 (UTC)

Images again
Is it really necessary to show images of presumed dead people? I seems a bit childish to me. We all know what happens if you drown and don't get help in time. No educational value of these images. Seems they were put up just for show. If you really must know what a dead person looks like go to http://www.rotten.com.

Mentat78 14:21, 30 January 2007 (UTC)

I couldn't agree more with Catherine and Mentat78. The pictures of corpses add nothing to the article. If the photo of the girl in the pool is staged, it should be clearly stated as such. Other articles I've seen involving causes of death don't show a corpse of a victim. I have no problem with photos demonstrating key points, and even encourage them, however these seem to be added for 'shock' value. This is clearly not appropriate for this article in my opinion.

--Gclinkscales 10:27, 31 January 2007 (UTC)


 * None of the people shown in photos is dead. I removed a bunch of images with questionable licenses. The one image with a suitable license should stay, of course labeled as staged. -- Chris 73 | Talk 17:13, 31 January 2007 (UTC)


 * Chris, you are wrong. Both the people featured in these pictures are dead. They drowned. Catherine Woods 20:44, 31 January 2007 (UTC)
 * Fair use images are not allowed if there is a free image alternative available. Besides, these images are staged. -- Chris 73 | Talk 21:29, 31 January 2007 (UTC)
 * I staged the picture myself to illustrate an important characteristic of shallow water blackout. I agree that if it is just a picture purporting to be a dead body it does not contribute. The purpose was to illustrate that people tend to drown very quietly and unnoticed on the bottom rather than in the classic yelling and waving on surface and that what they should be looking for is what you see in the picture.  That would be useful information to convey and is in keeping with TV ads and website images used by at least two national lifesaving organisations in France and Australia.  In that context alone it is a useful picture but perhaps it should be clearly connected to some text to that effect.   Ex nihil 01:05, 1 February 2007 (UTC)


 * Fair use images are not allowed if there is a free image alternative available. I know. But, these images are not staged. These pictures show two dead girls. They have drowned. So don't drop the bomb that they're staged, I've met with their parents, they've said that they're daughters drowned. THEY ARE DEAD. THEY ARE NOT STAGED. THERE. Catherine Woods 00:52, 1 February 2007 (UTC)
 * As per Fair use, i have deleted the fair use images since there is a alternative image with a free license available. Please do not upload these images again. -- Chris 73 | Talk 07:49, 1 February 2007 (UTC)

Could someone please post the links to these images? I can't really understand the one about the 'dead girl in a tank' if I can't see it.

The pathophysiology of drowning
The subchapter The pathophysiology of drowning contradicts Both describe as first phase a cold shock with increased pulmonary ventilation, i.e. severe hyperventilation, and a massive increase in heart rate and blood pressure. -- Xypron 00:10, 31 January 2007 (UTC)
 * Canadian Red Cross: Drowning Research: Drownings in Canada, 10 Years of Research Module 2 - Ice & Cold Water Immersion, 2006
 * Transport Canada Survival in Cold Waters, 2003


 * Cold shock is the same thing as Mammalian diving reflex. Blood pressure increases due to peripheral vasoconstriction and blood shift. Respiration changes aren't mentioned. Therefore, there is no contradiction with your sources. Perhaps something should be included regarding changes in respiration, but those aren't part of the mammalian dive reflex. -Mike.lifeguard 03:22, 2 July 2007 (UTC)

Adding a link
I work for the America's Most Wanted Safety Center, a new department of America's Most Wanted getting away from the capturing of criminals, and branching out to all aspects of safety. I feel a link to our post about pool safety would be appropriate and mutually beneficial, because it encapsulates a lot of the safety ideas here, but in an entertaining video. The link is http://www.amw.com/safety/?p=62 please consider it. Jrosenfe 15:39, 22 June 2007 (UTC)

Common presentation of DNS
This text came directly after the description of the Instinctive Drowning Response (although not termed as such): These presentations, however, are not the most common. In my experience, the IDR is the most common presentation of a DNS. And if not, then what is it? If that sentence is to be included, then the most common presentation surely needs to be explained. -Mike.lifeguard 01:59, 2 July 2007 (UTC)

Rescue and Treatment section
This section is a giant how-to. And it's not even a good one. It needs to be rewritten (and shortened). Perhaps a link to water rescue or some other article is in order? -Mike.lifeguard 02:06, 2 July 2007 (UTC)

Transwiki to Wikibooks
This article was transwiki'd to Wikibooks today. Thanks for all the how-tos!  – Mike.lifeguard  | talk 01:49, 10 July 2007 (UTC)

Solid Drowning
The article should contain information about cases of solid drowning such as grain suffocation.

Inaccuracies
Mammalian diving reflex does not agree with this article - it says "Bradycardia, a reduction in the heart rate (of about 20% in humans)." while this article says it is 50%

Caption
The caption for the first sign shown says:

"A sign with 83 tally marks warns hikers on the trail to Hanakapiai Beach, Hawaii."

Forgive me if I'm wrong, but...aren't there only 82 tallies on that sign?


 * Yes; fixed now. TJRC (talk) 21:27, 30 January 2009 (UTC)
 * Yes; fixed now. TJRC (talk) 21:27, 30 January 2009 (UTC)

Males more likely to drown than females
I'm not doubting the truth of this claim, but I don't think "common conditions and risk factors that may lead to drowning" is the right place to include it. No one drowns because they made the mistake of being a male; rather, I imagine, males are statistically more likely to engage in the other risk-taking behaviors that can lead to drowning (swimming without a flotation device, drinking, swimming in places where the water conditions or temperature are more than they can handle, etc.). I.e., the higher incidence of drowning among males reflects correlation with other factors, it doesn't reflect that being male is a "risk condition" for drowning. r ʨ anaɢ talk/contribs 22:41, 30 April 2009 (UTC)

New 2002 Drowning Definition
The basic definition of drowning in this article is incorrect, or at least 8 years out of date. The currently accepted definition “drowning is the process of experiencing respiratory impairment from submersion/immersion in liquid,” was adopted in 2002 World Congress on Drowning. http://www.cslsa.org/events/ArchiveAttachments/Spr03Minutes/AttachmentG2.pdf and subsequently by the World Health Organization http://www.who.int/bulletin/volumes/83/11/vanbeeck1105abstract/en/index.html. —Preceding unsigned comment added by 209.47.92.134 (talk) 19:24, 25 February 2010 (UTC)
 * Exactly what I came here to address. It is my understanding that "drowning" refers to the lungs filling with water, and does not have to be fatal. Am I wrong here? Joefromrandb (talk) 15:40, 12 March 2011 (UTC)
 * Time to change this article then? Mattlore (talk) 23:42, 18 July 2012 (UTC)
 * Where in the new definition does it specify that the lungs must be filled with water (or any other liquid for that matter)? Respiratory impairment from submersion/immersion in a liquid does not imply that any of the liquid necessarily enters the lungs. Respiratory impairment does not imply a fatal result. As this could be critically important to the whole article, I think we need the full text of the definition, Peter (Southwood) (talk): 08:20, 19 July 2012 (UTC)
 * OK, definition is exactly as quoted above. I have prepared a short text to add to the article as follows: Peter (Southwood) (talk): 09:32, 19 July 2012 (UTC)

The following definition was accepted by the World Congress on Drowning in 2002 and subsequently by the World Health Organisation in 2005: "Drowning is the process of experiencing respiratory impairment from submersion/immersion in liquid."

This definition does not imply fatality, or even the necessity for medical treatment after removal of the cause, nor that any fluid necessarily enters the lungs.

The WHO further recommended "Drowning outcomes should be classified as: death, morbidity, and no morbidity. There was also consensus that the terms wet, dry, active, passive, silent, and secondary drowning should no longer be used."
 * I like your changes, but in the section immediately after the new definition, there are references to 'active' and 'passive'. Shouldn't these be removed as they are no longer appropriate??
 * WesT (talk) 23:14, 25 October 2012 (UTC)

"Warm and dead" ??
The "Management" section of this article contains the interesting phrase

"The rule 'no patient should be pronounced dead until warm   and dead' applies."

I had never personally encountered this "rule" before, and have no idea what it means. Google searches on the phrase all lead either back to the Wiki article on drowning, or to sites quoting directly from the Wiki article.

It seems to me that there should be either: 1) an explanation of the phrase in the article or a footnote, or 2) a citation and link to a suorce which explains the phrase/rule, or 3) The phrase should be removed and replaced with something more universally understood.

Any one of these would be an improvement. —Preceding unsigned comment added by 74.92.174.105 (talk) 21:40, 15 April 2010 (UTC)

I am not the author of the original text, however the meaning is pretty clear to me. "warm and dead" means that all of the usual signs indicating mortality continue after the body has been restored to room temperature. Before that, persons taken from very cold water may appear dead (particularly applying observations common in a first aid situation) but in fact not be so.

djb3500 —Preceding unsigned comment added by 60.226.37.42 (talk) 12:41, 10 July 2010 (UTC)

I think Red Cross CPR instructions are (and I paraphrase) "once you have started CPR it should not be stopped unless there is "recovery" OR it is physically impossible to continue (exhaustion, flooding etc) OR a suitably medically qualified person pronounces death. The "warm and dead" specification is information for an inexperienced suitably medically qualified person. Ecstatist (talk) 04:45, 13 September 2011 (UTC)

US-centric how-to
I've just tagged the management section as being US-centric, and providing how-to type guidance. I've not time to clean it up immediately, but I'll do so at a later date if I get chance.

The reason for tagging as how-to should be fairly obvious. The reason for tagging as US-centric is that the Heimlich manoeuvre is taught (under a different name) as part of standard first-aid training in the UK, which directly contradicts article text, and implies that much of the remainder may be US-specific guidelines as well.

--me_and (talk) 10:44, 20 July 2010 (UTC)


 * The management section is about how to treat drowning. No location specific. Doc James (talk · contribs · email) 15:34, 9 January 2011 (UTC)

Various edits and sourcing
I've had a go at some basic improvement to the article, but it needs a lot done to it and I'm not sure enough of my expertize for all of this. I've tried to make a start on fixing some of these. Needs a lot of attention. FT2 (Talk 17:15, 30 December 2010 (UTC)
 * 1) The intro didn't summarize the article, I think I've fixed and sourced this now. Some excess detail moved to "Epidemiology".
 * 2) No section on basic terms, classifications, and overview. It didn't differentiate "distress" and "drowning" which is a critical differentiator in all modern credible papers and books.
 * 3) Handling of less common forms was mixed. Deep water blackout was included in one section, shallow water omitted, secondary drowning had a section to itself (with a tag from 2008).
 * 4) Drowning behaviors were mixed in with other information.
 * 5) Clinical physiological information was mixed in with "signs and symptoms".

"A person drowning is unable to shout or call for help" This line perhaps should have the emphasis changed which would add to the awareness of "rescuers" of drowning people. I suggest - "A person who is able to shout or call for help is not drowning" and this would make a rescuer realize that he need not approach too closely (or too hurriedly) and incur unnecessary risks. Ecstatist (talk) 21:00, 11 September 2011 (UTC)
 * I think your proposed revision makes it sound like a person who is shouting or calling for help can be safely ignored, because they're not at risk. I'm no expert, but if your concern is encouraging safety, it seems more important to emphasize vigilance ("A drowning person won't be able to call for help, so you need to watch carefully") than restraint ("If someone's calling for help, they're not actually drowning at that moment, so you can take your time responding to them"). Theoldsparkle (talk) 15:04, 12 September 2011 (UTC)

In the classification paragraph, drowning and distress are differentiated clearly. Many drownings are unnecessary double victim drownings when an ignorant, incapable, exhausted, panicking though well meaning rescuer is drowned by the original distressed and panicking (but not necessarily at great risk) swimmer. In some cases they drown each other where no drowning would have occurred. Rule one: Do not attempt a rescue unless you are confident of your safety. Dead heroes can not help anyone anymore. In any water rescue scenario you should STOP, LOOK, THINK, PLAN, ACT. Usually, these few extra seconds save more lives than they lose.Ecstatist (talk) 03:45, 13 September 2011 (UTC) In Management paragraph "Thus it is advised that the rescuer approach with a buoyant object" AND KEEP IT BETWEEN HIMSELF AND THE VICTIM WHILE OFFERING IT TO THE VICTIM. The capitalized section is my crude edit suggestion. Someone else may refine and add it.Ecstatist (talk) 04:03, 13 September 2011 (UTC)


 * Having looked at the context of your first suggestion, I'll withdraw my objection. Feel free to edit the article. Theoldsparkle (talk) 14:17, 13 September 2011 (UTC)

New review in NEJM 2012
Doc James (talk · contribs · email) 23:33, 2 June 2012 (UTC) Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:51, 27 February 2013 (UTC)

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gCaptain
I was cleaning up and attempted to format the reference for the quotation from:



to:

But the gCaptain site is blacklisted, and the original format appears to be an attempt to bypass the blacklist. This makes the quotation in "Cold water immersion" rather suspect. --  Gadget850talk 11:37, 28 February 2015 (UTC)


 * That would depend on why the site was blacklisted. It may be for copyright infringement, in which case it passes no judgement on the quality of information. &bull; &bull; &bull; Peter (Southwood) (talk): 20:48, 31 January 2017 (UTC)

Treatment
As drowning is not always fatal, surely there should be a section on treatment? First aid in the field, transportation and definitive treatment can all be described.• • • Peter (Southwood) (talk): 20:44, 31 January 2017 (UTC)
 * Busy working on it. Thanks for good source posted above. &bull; &bull; &bull; Peter (Southwood) (talk): 15:33, 1 February 2017 (UTC)

Reference section
I intend to sort out references, and this is easier for me if they are all together, so unless anyone objects, I will be moving the definitions out of the text into a list in the references section, and converting them to CS1 template citations in those few cases which are not already CS1. • • • Peter (Southwood) (talk): 16:05, 1 February 2017 (UTC)

B-class review

 * Looks up to B-class for WPSCUBA, so promoting. &bull; &bull; &bull; Peter (Southwood) (talk): 05:37, 3 February 2017 (UTC)

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Merger proposal
Proposed merger with redirect from Dry drowning, which is no longer officially a thing, so a mention/explanation of that here would be better than a separate article explaining that it is not accepted as a separate thing any more. • • • Peter (Southwood) (talk): 20:49, 25 August 2017 (UTC)

Discussion: From a reader POV, I suspect that a short article on Dry drowning, whose main points are (a) it's almost certainly not happening to your kid, and (b) this is just an old name for what happens when drowning produces hours or days of symptoms before killing you, rather than the minutes that you see in Hollywood movies, would probably be helpful. WhatamIdoing (talk) 18:20, 26 August 2017 (UTC)
 * Support. The term is really a misnomer, so could be included as a subsection to adequately dismiss it as "drowning" and provide MEDRS-quality source(s) where experts have defined it. Among the various authoritative groups discussed in the lede for Dry drowning, this position from the American College of Emergency Physicians is dated July 2017, succinctly on point, and clarifies the misunderstanding of "dry drowning". --Zefr (talk) 20:59, 25 August 2017 (UTC)
 * Unsure No strong feeling either way. Either as a subsection of the main article or as a summary with a separate article. Doc James  (talk · contribs · email) 21:07, 25 August 2017 (UTC)
 * Support as a subsection of the main article--Ozzie10aaaa (talk) 02:31, 26 August 2017 (UTC)
 * Unsure, but leaning against the merge. I see that some sources say that it doesn't exist, and the SNOMED-CT medical event code for when the non-existent thing happens in the real world is 242014006.  Some sources say that having a drink "go down the wrong pipe" is a mild (but real) case of drowning, and MeSH says that it's only drowning if you die.  On the basis of these significant contradictions, I don't think that we can say "by definition" it's this or that, because it seems to be the case that we can only make a claim of "by the definition that I happen to prefer, but not by the definition that you happen to prefer".
 * , Do you think the amount of reliable information available for an independent article justifies having one?
 * Support as a subsection. Best place to sort this out for the reader is here. It may be discredited as a medical definition but it certainly persists as a popular idea and users need that advice. Also, insufficient content to warrant a separate article. E x nihil (talk) 23:01, 3 September 2017 (UTC)

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The Perfect Storm
I recently added a quote from Junger's The Perfect Storm to help explain the reasons your brain attempts to breathe underwater. It seems to have been deleted. This was my first wiki addition - I'd just like to know why someone removed it. — Preceding unsigned comment added by Mr. Amylon (talk • contribs) 15:01, 22 March 2018 (UTC)
 * , Taking into account the user who reverted your edit, I would guess that he did not consider your reference a medically reliable source, but I could be mistaken., perhaps you could clarify? Cheers, &middot; &middot; &middot; Peter (Southwood) (talk): 15:08, 22 March 2018 (UTC)
 * I would endorse the deletion because the quote was a lay person (Sebastion Junger's) speculative opinion with no necessary scientific basis. Don't be discouraged, and please keep editing, but expect a fairly merciless and speedy revert to anything that isn't backed up by a proper citation. Welcome to Wikipedia. E x nihil (talk) : Ex nihil (talk) 16:37, 22 March 2018 (UTC)
 * So referencing the book itself is a primary source. If there is a good secondary source that comments on this person's description and verifies that it is accurate and notable than we would be good. Doc James  (talk · contribs · email) 03:43, 23 March 2018 (UTC)
 * Alright, so I think where my misunderstanding came in here is that we teach The Perfect Storm as a work of journalism - Junger conducted countless interviews and compiled established information in order to tell this story to the world. So my logic was that the interviews he conducted, the weather records/forecasts, the established science on drowning and death, etc, were the primary sources.  His book would be a secondary source.  After reading some more on the Wiki guidelines, is TPS considered a secondary source because of that, or is it "original research" and thus banned?  I guess my first interpretation of "original research" was basically a prohibition on self-promotion, but I get the sense that you would argue that it is larger than that?  (I'm not arguing - I truly appreciate the discussion.  I'm trying to learn as much as I can about this process before I start having my students edit pages as part of future assignments). --Mr. Amylon (talk) 16:01, 25 March 2018 (UTC)

Bad internal Link
Dry drowning is cycled--DRobert (talk) 19:00, 11 June 2018 (UTC)

Definition
The article says,
 * Drowning is defined as respiratory impairment as a result of being in or under a liquid.

That's just wrong. Drowning is death as a result of respiratory impairment etc etc. If you didn't die, you didn't drown. That's the common understanding in the English language.

Now, OK, so this "World Congress on Drowning" adopted a different definition. That they can do, but it doesn't change the meaning in English, not by itself. The article should, at the very least, acknowledge the conflict and explain that a not-fully-accepted recent definition is being used, and it should do so early and prominently. --Trovatore (talk) 02:57, 14 September 2018 (UTC)


 * Isn't it also true that a person can drown from fluid in the lungs without being "in or under a liquid?" If so, then the definition is doubly incorrect.—Anita5192 (talk) 03:15, 14 September 2018 (UTC)
 * Yes, that seems true as well, though it's less startlingly at variance with common usage. --Trovatore (talk) 03:37, 14 September 2018 (UTC)
 * Agree. I would have thought that drowning is generally understood to be death as a result of having fluid IN the lungs, not by being in or under water as a scuba diver or swimmer is and having fluid AROUND the lungs. And if you don't die then it was a 'near-drowning' not a drowning, or there would be people around telling folk that they drowned yesterday. I suggest that if that definition remains then it is clearly labelled as the determination of a specific meeting and not in common use. E x nihil (talk) : Ex nihil (talk) 13:14, 14 September 2018 (UTC)
 * Wikipedia is based on references. References are provided for the current definition which is correct.
 * This current definition is more than 10 years old. Doc James  (talk · contribs · email) 04:04, 15 September 2018 (UTC)
 * Ten years old??? That's nothing.  Language changes ten years old are still neologisms.  It's not at all clear that the language has changed, except in certain specialized usages.
 * Just the same, I don't really object to the definition used by specialists as being the basis for the article, if it is really used by the experts in the field, as opposed to some self-appointed "Congress". What I object to is failing to acknowledge that this specialized usage is at variance with the still-valid common meaning of the word.  That point should be explicitly called out and explained, early and prominently.  Then the rest of the article can use the novel definition, again assuming that it is genuinely accepted by the expert community, a point on which I am not qualified to comment. --Trovatore (talk) 05:19, 16 September 2018 (UTC)

Having read both citations and looked up the WHO website, this (rather uncommon usage) definition does actually seem to be the thing now. However, despite feeling personally uncomfortable with it, I changed it so that it reads better now with the actual words used (although I just couldn't stand the rather illiterate '/' and felt compelled to replace it with an 'or') and I added the WHO source in the text to soften readers' WTF reactions. E x nihil (talk) : Ex nihil (talk) 12:41, 17 September 2018 (UTC)
 * That is the common definition. We have a section on old definition here Drowning
 * It is not just used by WHO but many many others (all lifeguards and medical professionals for example).
 * If you wish to add details that other definitions are still in common use please find high quality recent secondary sources that discuss the issue.
 * Also we generally paraphrase rather than quote. Doc James  (talk · contribs · email) 17:19, 17 September 2018 (UTC)
 * I've expanded that section slightly, though I didn't add any new references. The "dry drowning" section covers much of the overall terminology debate (and includes references), but I feel like this specific issue should be at the head of the section. I wasn't sure whether it was appropriate to move the material from "dry drowning" up, and I didn't want to duplicate references (or to remove references from that section). I'm not sure it will be easy or even possible to find recent sources that insist on this usage (at least not easily; I found one from 2006, but that doesn't seem recent enough), but it's obvious that there are still some who insist on the old usage—especially non-professionals, who are very likely unaware of the effort to standardize definitions within the field. Would dictionary definitions work? Some of the ones I find online very specifically define "drown[ing]" as fatal and exclude anything resembling the definition that has become standard among health care providers.


 * https://www.thefreedictionary.com/drown
 * https://www.dictionary.com/browse/drown?s=t
 * http://www.learnersdictionary.com/definition/drown
 * https://dictionary.cambridge.org/us/dictionary/english/drown
 * https://en.oxforddictionaries.com/definition/drown


 * A notable exception is Merriam-Webster, which defines "drowning" merely as "suffocating by submersion" (though the "Learner's Dictionary" above is also by Merriam-Webster):


 * https://www.merriam-webster.com/dictionary/drown


 * 108.34.148.110 (talk) 23:40, 2 October 2018 (UTC)
 * Happy to have it listed under "old terminology" Doc James  (talk · contribs · email) 17:48, 3 October 2018 (UTC)