Suitability of existing definitions for drowning to meet the new definition: a scoping review

Past studies have shown a lack of consensus on the definition and terminology of drowning among experts in the field and relevant organizations. There is a need for a new look at the definition of drowning to improve the understanding of drowning events.

A literature search of seven electronic databases, including PubMed, EMBASE, CINHAL, MEDLINE, Sport Discus, and Social Sciences from 1960 to 2020 was conducted using the MESH search terms "drowning", "near-drowning", "submersion", and "immersion". Cochrane databases were also searched for systematic reviews The items were searched in all fields of publication, including title, abstract, and keyword.

The search identified approximately 2500 articles, 230 of which were reviewed. The inclusion criteria were applied to the full text of 230 articles, and 25 articles addressing the different definitions of drowning were assessed. They were reviewed critically by authors using a standard review form. The search identified that there were at least 20 different outcome measures for drowning incidents reported. Definitions of drowning in the literature were found for the following terms: dry versus wet drowning, secondary drowning, drowned and near-drowned, drowning without aspiration and drowning with aspiration, near drowning without aspiration or with aspiration, active drowning, passive drowning, silent drowning, witnessed and unwitnessed, immersion, submersion, death certificate records drowning, unintentional submersion, road traffic injury leading to passenger vehicle drowning, drowning, near drowning, salt or freshwater drowning, and cold water drowning.

In the literature, a lack of consensus was observed but the following terms should not be abandoned; "Non-fatal drowning" which is used to describe death following rescue and life with at least 24 hours of in-hospital survival and the development of one or more complications and "Fatal drowning" which implies death occurring at the scene or 24 h of a submersion incident.