Drowning

For other uses, see Drowning (disambiguation) and Drown (disambiguation).

Drowning

Vasily Perov: The Drowned, 1867 painting
Specialty| Critical care medicine
Symptoms| Event: Often occurs silently with a person found unconscious[1][2]
After rescue: Breathing problems, vomiting, confusion, unconscious[2][3]
Complications| Hypothermia, aspiration of vomit, acute respiratory distress syndrome[4]
Usual onset| Rapid[3]
Risk factors| Alcohol use, epilepsy, low socioeconomic status, access to water[5]
Diagnostic method| Based on symptoms[3]
Differential diagnosis| Suicide, seizure, hypoglycemia, heart arrhythmia[2]
Prevention| Fencing pools, teaching children to swim, safe boating practices[5][6]
Treatment| Rescue breathing, CPR, mechanical ventilation[7]
Medication| Oxygen therapy, intravenous fluids, vasopressors[7]
Frequency| 4.5 million (2015)[8]
Deaths| 324,000 (2015)[9]

Drowning is defined as respiratory impairment as a result of being in or under a liquid.[7][10] Drowning typically occurs silently, with only a few people able to wave their hands or call for help.[1] Symptoms following rescue may include breathing problems, vomiting, confusion, or unconsciousness.[2][3] Occasionally symptoms may not appear until up to six hours afterwards.[3] Drowning may be complicated by low body temperature, aspiration of vomit, or acute respiratory distress syndrome.[4][11]

Drowning is more common when the weather is warm and among those with frequent access to water.[4][5] Risk factors include alcohol use, epilepsy, and low socioeconomic status.[5] Common locations of drowning include swimming pools, bathtubs, natural bodies of water, and buckets.[3][7] Initially the person holds their breath, which is followed by laryngospasm, and then low oxygen levels.[4] Significant amounts of water usually only enter the lungs later in the process.[4] It may be classified into three types: drowning with death, drowning with ongoing health problems, and drowning with no ongoing health problems.[10]

Efforts to prevent drowning include teaching children to swim, safe boating practices, and limiting or removing access to water such as by fencing pools.[5][6] Treatment of those who are not breathing should begin with opening the airway and providing five breaths.[7] In those whose heart is not beating and who have been underwater for less than an hour CPR is recommended.[7] Survival rates are better among those with a shorter time under the water.[7] Among children who survive, poor outcomes occur in about 7.5% of cases.[7]

In 2015, there were an estimated 4.5 million cases of unintentional drowning worldwide.[8] That year, there were 324,000 drowning deaths, making it the third leading cause from unintentional injuries after falls and motor vehicle collisions.[9] Of these deaths, 56,000 occurred in children less than five years old.[9] Drowning accounts for 7% of all injury related deaths, with more than 90% of these deaths occurring in developing countries.[5][9] Drowning occurs more frequently in males and the young.[5]

## Contents

* 1 Signs and symptoms
* 2 Cause
* 2.1 Risk factors
* 2.2 Freediving
* 3 Pathophysiology
* 3.1 Oxygen deprivation
* 3.2 Water aspiration
* 3.3 Cold water immersion
* 4 Diagnosis
* 4.1 Forensics
* 5 Prevention
* 5.1 Water safety
* 6 Management
* 6.1 Rescue
* 6.2 First aid
* 6.3 Medical care
* 7 Prognosis
* 7.1 Children
* 8 Epidemiology
* 8.1 United States
* 9 Society and culture
* 9.1 Old terminology
* 9.1.1 Dry drowning
* 9.2 Capital punishment
* 10 References
* 11 External links

## Signs and symptoms[edit | edit source]

See also: Instinctive drowning response

Drowning is most often quick and unspectacular. Its media depictions as a loud, violent struggle have much more in common with distressed non-swimmers, who may well drown but have not yet begun to do so. In particular, an asphyxiating person is seldom able to call for help.[12] The instinctive drowning response covers many signs or behaviors associated with drowning or near-drowning:

* Head low in the water, mouth at water level
* Head tilted back with mouth open
* Eyes glassy and empty, unable to focus
* Eyes open, with fear evident on the face
* Hyperventilating or gasping
* Trying to swim in a particular direction but not making headway
* Trying to roll over on the back to float
* Uncontrollable movement of arms and legs, rarely out of the water.

Drowning begins at the point a person is unable to keep their mouth above water; inhalation of water takes place at a later stage.[13] Most people demonstrating the instinctive drowning response do not show obvious prior evidence of distress.[13]

A person drowning is generally unable to call for help, or seek attention, as they cannot obtain enough air. The instinctive drowning response is the final set of autonomic reactions in the 20–60 seconds before sinking underwater, and to the untrained eye can look similar to calm safe behavior.[12][14] Lifeguards and other persons trained in rescue learn to recognize drowning people by watching for these movements.[12]

## Cause[edit | edit source]

Children have drowned in buckets and toilets.

Drowning mainly happens due to the inability to swim in a circumstance: lack of skill, state of the waters, physical condition, loss of consciousness, and others. Anxiety can lead to exhaustion, precipitating the drowning.

Approximately 90% of drownings take place in freshwater (rivers, lakes and swimming pools) and 10% in seawater. Drownings in other fluids are rare, and often relate to industrial accidents.[citation needed] In New Zealand's early colonial history, so many settlers died while trying to cross rivers that drowning was known as "The New Zealand death".[15]

People have drowned in as little as 30 mm of water lying face down.[16] Children have drowned in baths, buckets and toilets; inebriates or those under the influence of drugs have died in puddles.

Drowning can also happen after the drowning incident itself, due to further complications. The inhaled fluid can act as an irritant inside the lungs. Physiological responses to even small quantities include the extrusion of liquid into the lungs (pulmonary edema) over the following hours, but this reduces the ability to exchange air and can lead to a person "drowning in their own body fluid". Certain poisonous vapors or gases (as for example in chemical warfare), or vomit can have a similar effect. The reaction can take place up to 72 hours after the drowning incident, and may lead to a serious condition or death.[citation needed]

### Risk factors[edit | edit source]

Many factors, behavioral and physical, are related to drowning:[17][18]

* Worldwide, drowning is the most common cause of death for persons with seizure disorders, largely in the bathtub (by unintentional injury). People with epilepsy are more likely to die due to accidents such as drowning. However, this risk is especially elevated in low- and middle-income countries compared to high-income countries.[19]
* The use of alcohol increases the risk for drowning across developed and developing nations. Alcohol is involved in approximately 50% of fatal drownings, and 35% of non-fatal drownings.[20] Among adolescents and adults, alcohol use is involved in almost a quarter of emergency department visits for drowning.[citation needed]
* Inability to swim: Participation in formal swimming lessons can reduce the risk of drowning. The optimal age to start the lessons is childhood, between 1 and 4 years old.
* Feeling too tired reduces the swimming performance. This exhaustion can appear because of the anxious movements motivated by fear during drowning. Otherwise, a bad calculation of the own physical capabilities can leave oneself exhausted before reaching the shore.
* Free access to water: Effective barriers prevent young children from gaining access to the water.
* Ineffective supervision: Drowning can occur anywhere there is water, and even in the presence of lifeguards.
* Risk can vary with location depending on age. Children between 1 and 4 usually drown in home swimming pools. Drownings in natural water settings increase with age. More than half of drownings among those 15 years and older occurred in natural water environments.
* Failure to wear life jackets or personal flotation devices was implicated in 88% of the boating related drownings in the US during 2010.

Population groups at risk in the US are:[17]

* Children and young adults: Drowning rates are highest for children under 5 years of age and persons 15–24 years of age.
* Males: Nearly 80% of people who die from drowning are male.
* Minorities: The fatal unintentional drowning rate for African Americans between 2005 and 2009 was significantly higher than that of whites across all ages. The fatal drowning rate of African American children of ages from 5 to 14 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 lack of basic swimming skills in some minority populations.

### Freediving[edit | edit source]

Some special causes of drowning can also happen during freediving activities:

* Ascent blackout, also called deep water blackout – caused by latent hypoxia during ascent from depth, where the partial pressure of oxygen in the lungs under pressure at the bottom of a deep freedive 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.[21]
* 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.[22] The body detects CO2 levels very accurately and relies on this to control breathing.[22] Hyperventilation reduces the carbon dioxide content of the blood but leaves the diver susceptible to 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.

## Pathophysiology[edit | edit source]

Drowning can be considered as going through four stages:[23]

1. Breath-hold under voluntary control until the urge to breathe due to hypercapnia becomes overwhelming
2. Fluid is aspirated into the airways and/or swallowed
3. Cerebral anoxia stops breathing and aspiration
4. Cerebral injury due to anoxia becomes irreversible

Generally, in the early stages of drowning a person holds their breath to prevent water from entering their lungs.[7] When this is no longer possible a small amount of water entering the trachea causes a muscular spasm that seals the airway and prevents further passage of water.[7] If the process is not interrupted, loss of consciousness due to hypoxia is followed rapidly by cardiac arrest.

### Oxygen deprivation[edit | edit source]

A conscious person will hold his or her breath (see Apnea) and will try to access air, often resulting in panic, including rapid body movement. This uses up more oxygen in the blood stream and reduces the time to unconsciousness. The person can voluntarily hold his or her breath for some time, but the breathing reflex will increase until the person tries to breathe, even when submerged.[24]

The breathing reflex in the human body is weakly related to the amount of oxygen in the blood but strongly related to the amount of carbon dioxide (see Hypercapnia). During apnea, the oxygen in the body is used by the cells, and excreted as carbon dioxide. Thus, the level of oxygen in the blood decreases, and the level of carbon dioxide increases. Increasing carbon dioxide levels lead to a stronger and stronger breathing reflex, up to the breath-hold breakpoint, at which the person can no longer voluntarily hold his or her breath. This typically occurs at an arterial partial pressure of carbon dioxide of 55 mm Hg, but may differ significantly between people.

The breath-hold break point can be suppressed or delayed either intentionally or unintentionally. Hyperventilation before any dive, deep or shallow, flushes out carbon dioxide in the blood resulting in a dive commencing with an abnormally low carbon dioxide level; a potentially dangerous condition known as hypocapnia. The level of carbon dioxide in the blood after hyperventilation may then be insufficient to trigger the breathing reflex later in the dive and a blackout may occur without warning and before the diver feels any urgent need to breathe. This can occur at any depth and is common in distance breath-hold divers in swimming pools. Hyperventilation is often used by both deep and distance free-divers to flush out carbon dioxide from the lungs to suppress the breathing reflex for longer. It is important not to mistake this for an attempt to increase the body's oxygen store. The body at rest is fully oxygenated by normal breathing and cannot take on any more. Breath holding in water should always be supervised by a second person, as by hyperventilating, one increases the risk of shallow water blackout because insufficient carbon dioxide levels in the blood fail to trigger the breathing reflex.[25][26]

A continued lack of oxygen in the brain, hypoxia, will quickly render a person unconscious usually around a blood partial pressure of oxygen of 25–30 mmHg.[26] An unconscious person rescued with an airway still sealed from laryngospasm stands a good chance of a full recovery. Artificial respiration is also much more effective without water in the lungs. At this point the person stands a good chance of recovery if attended to within minutes.[citation needed] More than 10% of drownings may involve laryngospasm, but the evidence suggests that it is not usually effective at preventing water from entering the trachea. The lack of water found in lungs during autopsy does not necessarily mean there was no water at the time of drowning, as small amounts of freshwater are readily absorbed into the bloodstream. Hypercarbia and hypoxia both contribute to laryngeal relaxation, after which the airway is effectively open through the trachea. There is also bronchospasm and mucous production in the bronchi associated with laryngospasm, and these may prevent water entry at terminal relaxation.[27]

The hypoxemia and acidosis caused by asphyxia in drowning affect various organs. There can be central nervous system damage, cardiac arhythmias, pulmonary injury, reperfusion injury, and multiple-organ secondary injury with prolonged tissue hypoxia.[28]

A lack of oxygen or chemical changes in the lungs may cause the heart to stop beating. This cardiac arrest stops the flow of blood and thus stops the transport of oxygen to the brain. Cardiac arrest used to be the traditional point of death but at this point there is still a chance of recovery. The brain cannot survive long without oxygen and the continued lack of oxygen in the blood combined with the cardiac arrest will lead to the deterioration of brain cells causing first brain damage and eventually brain death from which recovery is generally considered impossible. The brain will die after approximately six minutes without oxygen at normal body temperature, but hypothermia of the central nervous system may prolong this.[citation needed]

The extent of central nervous system injury to a large extent determines the survival and long term consequences of drowning, In the case of children, most survivors are found within 2 minutes of immersion, and most fatalities are found after 10 minutes or more.[28]

### Water aspiration[edit | edit source]

If water enters the airways of a conscious person, the person will try to cough up the water or swallow it, often inhaling more water involuntarily. When water enters the larynx or trachea, both conscious and unconscious persons experience laryngospasm, in which the vocal cords constrict, sealing the airway. This prevents water from entering the lungs. Because of this laryngospasm, in the initial phase of drowning, water generally enters the stomach and very little water enters the lungs. Though laryngospasm prevents water from entering the lungs, it also interferes with breathing. In most persons, the laryngospasm relaxes some time after unconsciousness and water can then enter the lungs causing a "wet drowning". However, about 7–10% of people maintain this seal until cardiac arrest.[24] This has been called "dry drowning", as no water enters the lungs. In forensic pathology, water in the lungs indicates that the person was still alive at the point of submersion. Absence of water in the lungs may be either a dry drowning or indicates a death before submersion.[29]

Aspirated water that reaches the alveoli destroys the pulmonary surfactant, which causes pulmonary oedema and decreased lung compliance which compromises oxygenation in affected parts of the lungs. This is associated with metabolic acidosis, and secondary fluid and electrolyte shifts. During alveolar fluid exchange, diatoms present in the water may pass through the alveolar wall into the capillaries to be carried to internal organs. Presence of these diatoms may be diagnostic of drowning.

Of people who have survived drowning, almost one third will experience complications such as acute lung injury (ALI) or acute respiratory distress syndrome (ARDS).[30] ALI/ARDS can be triggered by pneumonia, sepsis and water aspiration and are life-threatening disorders that can result in death if not treated promptly.[30] During drowning, aspirated water enters the lung tissues, causes a reduction in alveolar surfactant, obstructs ventilation and triggers a release of inflammatory mediators which ultimately results in hypoxia.[30] Specifically, upon reaching the alveoli, hypotonic liquid found in fresh water dilutes pulmonary surfactant, destroying the substance.[31] Comparatively, aspiration of hypertonic seawater draws liquid from the plasma into the alveoli and similarly causes damage to surfactant by disrupting the alveolar-capillary membrane.[31] Still, there is no clinical difference between salt and freshwater drowning. Once someone has reached definitive care, supportive care strategies such as mechanical ventilation can help to reduce the complications of ALI/ARDS.[30]

Whether a person drowns in fresh water versus salt water makes no difference in the respiratory management or the outcome of the person.[32] People who drown in fresh water may experience worse hypoxemia early in their treatment, however, this initial difference is short-lived and the management of both fresh water and salt water drowning is essentially the same.[32]

### Cold water immersion[edit | edit source]

Submerging the face in water cooler than about 21 °C (70 °F) triggers the diving reflex, common to air-breathing vertebrates, especially marine mammals such as whales and seals. This reflex protects the body by putting it into energy saving mode to maximize the time it can stay under water. The strength of this reflex is greater in colder water and has three principal effects:[citation needed]

* Bradycardia, a slowing of the heart rate by up to 50% in humans.
* Peripheral vasoconstriction, the restriction of the blood flow to the extremities to increase the blood and oxygen supply to the vital organs, especially the brain.
* Blood Shift, the shifting of blood to the thoracic cavity, the region of the chest between the diaphragm and the neck, to avoid the collapse of the lungs under higher pressure during deeper dives.

The reflex action is automatic and allows both a conscious and an unconscious person to survive longer without oxygen under water than in a comparable situation on dry land. The exact mechanism for this effect has been debated and may be a result of brain cooling similar to the protective effects seen in people who are treated with deep hypothermia.[33][34]

The actual cause of death in cold or very cold water is usually lethal bodily reactions to increased heat loss and to freezing water, rather than any loss of core body temperature. Of those who die after plunging into freezing seas, around 20% die within 2 minutes from cold shock (uncontrolled rapid breathing and gasping causing water inhalation, massive increase in blood pressure and cardiac strain leading to cardiac arrest, and panic), another 50% die within 15 – 30 minutes from cold incapacitation (loss of use and control of limbs and hands for swimming or gripping, as the body 'protectively' shuts down the peripheral muscles of the limbs to protect its core),[35] and exhaustion and unconsciousness cause drowning, claiming the rest within a similar time.[36] A notable example of this occurred during the sinking of the Titanic, in which most people who entered the −2 °C (28 °F) water died within 15–30 minutes.[37]

> [S]omething that almost no one in the maritime industry understands. That includes mariners [and] even many (most) rescue professionals: It is impossible to die from hypothermia in cold water unless you are wearing flotation, because without flotation – you won’t live long enough to become hypothermic.

> — Mario Vittone, lecturer and author in water rescue and survival[35]

Submersion into cold water can induce cardiac arrhythmias (abnormal heart rates) in healthy people, sometimes causing strong swimmers to drown.[38] The physiological effects caused by the diving reflex conflict with the body's cold shock response, which includes a gasp and uncontrollable hyperventilation leading to aspiration of water.[39] While breath-holding triggers a slower heart rate, cold shock activates tachycardia, an increase in heart rate.[38] It is thought that this conflict of these nervous system responses may account for the arrhythmias of cold water submersion.[38]

Heat transfers very well into water, and body heat is therefore lost extremely quickly in water compared to air,[40] even in merely 'cool' swimming waters around 70F (~20C).[36] A water temperature of 10 °C (50 °F) can lead to death in as little as one hour, and water temperatures hovering at freezing can lead to death in as little as 15 minutes.[36] This is because cold water can have other lethal effects on the body, so hypothermia is not usually a reason for drowning or the clinical cause of death for those who drown in cold water.

Upon submersion into cold water, remaining calm and preventing loss of body heat is paramount.[41] While awaiting rescue, swimming or treading water should be limited to conserve energy and the person should attempt to remove as much of the body from the water as possible; attaching oneself to a buoyant object can improve the chance of survival should unconsciousness occur.[41]

Hypothermia (and also cardiac arrest) present a risk for survivors of immersion, as for survivors of exposure; in particular the risk increases if the survivor, feeling well again, tries to get up and move, not realizing their core body temperature is still very low and will take a long time to recover.[citation needed]

Most people who experience cold-water drowning do not develop hypothermia quickly enough to decrease cerebral metabolism before ischemia and irreversible hypoxia occur. The neuroprotective effects appear to require water temperatures below about 5 °C.[42]

## Diagnosis[edit | edit source]

The World Health Organization in 2005 defined drowning as "the process of experiencing respiratory impairment from submersion/immersion in liquid".[10] This definition does not imply death, or even the necessity for medical treatment after removal of the cause, nor that any fluid enters the lungs. The WHO further recommended that outcomes should be classified as: death, morbidity, and no morbidity.[10] There was also consensus that the terms wet, dry, active, passive, silent, and secondary drowning should no longer be used.[10]

Experts differentiate between distress and drowning.

* Distress – people in trouble, but who still have the ability to keep afloat, signal for help and take actions.
* Drowning – people suffocating and in imminent danger of death within seconds.

### Forensics[edit | edit source]

Forensic diagnosis of drowning is considered one of the most difficult in forensic medicine. External examination and autopsy findings are often non-specific, and the available laboratory tests are often inconclusive or controversial. The purpose of investigation is generally to distinguish whether the death was due to immersion, or whether the body was immersed post mortem. The mechanism in acute drowning is hypoxemia and irreversible cerebral anoxia due to submersion in liquid.[citation needed]

Drowning would be considered as a possible cause of death when the body was recovered from a body of water, or in close proximity to a fluid which could plausibly have caused drowning, or when found with the head immersed in a fluid. A medical diagnosis of death by drowning is generally made after other possible causes of death have been excluded by means of a complete autopsy and toxicology tests. Indications of drowning are seldom completely unambiguous, and may include bloody froth in the airway, water in the stomach, cerebral oedema and petrous or mastoid haemorrhage. Some evidence of immersion may be unrelated to the cause of death, and lacerations and abrasions may have occurred before or after immersion or death.[23]

Diatoms should normally never be present in human tissue unless water was aspirated, and their presence in tissues such as bone marrow suggests drowning, however, they are present in soil and the atmosphere and samples may easily be contaminated. An absence of diatoms does not rule out drowning, as they are not always present in water.[23] A match of diatom shells to those found in the water may provide supporting evidence of the place of death.[citation needed] Drowning in salt water can leave significantly different concentrations of sodium and chloride ions in the left and right chambers of the heart, but this will dissipate if the person survived for some time after the aspiration, or if CPR was attempted,[23] and have been described in other causes of death.[citation needed]

Most autopsy findings relate to asphyxia and are not specific to drowning. The signs of drowning are degraded by decomposition. Large amounts of froth will be present around the mouth and nostrils and in the upper and lower airways in freshly drowned bodies. The volume of froth is generally much greater in drowning than from other origins. Lung density may be higher than normal but normal weights are possible after cardiac arrest reflex or vaso-vagal reflex. The lungs may be over inflated and waterlogged, filling the thoracic cavity, and the surface may have a marbled appearance, with darker areas associated with collapsed alveoli interspersed with paler aerated areas. Fluid trapped in the lower airways may block the passive collapse that is normal after death. Haemorrhagic bullae of emphysema may be found. These are related to rupture of alveolar walls. These signs, while suggestive of drowning, are not conclusive.[citation needed]

## Prevention[edit | edit source]

Drowning prevention campaign in Ghana

It is estimated that more than 85% of drownings could be prevented by supervision, training in water skills, normatives, technology, and public education.[43][44]

* Surveillance of the swimmers: Watching the swimmers is a basic task, especially in the case of children. More than 500 children die from drowning each day. Young children must be supervised, regardless of if they can already swim. The danger increases when they are alone. A baby can drown in the bathtub, in the toilet, and even in a small bucket filled with less than an inch of water. It only takes around 2 minutes underwater for an adult to lose consciousness, and only between 30 seconds and 2 minutes for a small child to die. Choosing supervised swimming places is safer. Many pools and bathing areas either have lifeguards or a pool safety camera system for local or remote monitoring. Some others have a computer-aided drowning detection. However, normal bystanders can also play an important role in drowning detection, and in performing an intervention or notification to lifeguards or any other authority by any method (phone, alarm, etc.) Lifeguards may be unaware of a drowning due to "the intrusion of non-lifeguard duties upon lifeguards' primary task: preventive lifeguarding" and because of "the distraction from surveillance duties".[45] For example, they could be diverted by using the mobile phone for leisure purposes upon the watching operations. About the alarms in pools, evidence shows that they are poor for any utility.[46] The World Health Organization recommends to analyze what are the most crowded hours in the swimming zones, to increase the number of lifeguards at those moments (the more people is swimming, the more work is distributed to each lifeguard.)
* Learning to swim: Being able to swim is one of the best defenses against drowning. The studies recommend that children learn to swim when they are between 1 and 4 years old, but in a safe environment and being supervised. Learning to swim is also possible in adults, equally taking the classes in a safe environment and under supervision. After being able to swim, it's still possible to drown (because of the state of the water and other circumstances), so it is recommended to choose swimming places that are safe and kept under surveillance.
* Additional education: The WHO recommends to train the general public in first-aid for the drowned, cardiopulmonar resuscitation (CPR), and to behave in a safe manner when being in the water. In addition, it is convenient to give some advices to the minors so they avoid drowning. If they can not swim, it is recommended to teach them to keep themselves away from deep waters.
* Fencing the pools: Every swimming pool, private or public, should be fenced and enclosed, on every side, so no child nor any other person can access inside.[47] The "Raffarin law", applied in France in 2003, that forced to fence any pool, reduced the drowning of children by 75%. It is also convenient to check that there are no objects left on the surface of the pools, so children don't approach attracted by them.

Drain hole in a pool.

* Absorbed by pool drains: Swimming pools usually have drainage systems to absorb and beam the water. If they work badly, they can drain to the swimmers themselves, causing injuries or even trapping their hair or any extremity, which could lead to immobilize and drown them. To avoid it, drainage holes and sumps are covered with grates and lids (according to the case), and, besides, they must suction with not too much strength. This require to make a good installation of the pool, and to check it, and to review it periodically. It is also recommended that the pool has many drainage holes, small and spaced, instead of only a big one, but the most important factor is that the system work well.
* Caution in problematic diseases: Some illnesses require prudence when water is near. Epilepsy and all seizure disorders are problematic to swim, dive and bathe because of the possibility of drowning during a convulsion. Moreover, drowning is the most common cause of unintentional death for the people which suffers from that sort of diseases. For the epileptics, it is recommended to take showers rather than using a bath tub for bathing.
* Alcohol or drugs: Alcohol and drugs increase the probability of drowning. This danger is greater in the bars located near the water, in the parties of boat-clubs, etc.

Lifejacket (model without rear part). To jump with it into the water, fasten the strap around the body and grab the front neck area with both hands.

* Use of lifejacket: The children that can not swim, the disabled, and other people in risk of drowning, would have to wear a fastened lifejacket when they are in the water, and even near the water. There exist some other floating devices (inflatable inner tubes, arm floaties -water wings-, foam tubes, etc.) which can be more or less useful (depending of how is each one of them); however they are not considered safety instruments by the institutions, but "toys".[48] The instrument that is considered safe to float on water is the lifejacket, when it is homologated and well fastened around the body. Besides, there are some other flotation instruments that are considered safe: the professional circle-shaped lifebuoy (hoop-buoy, ring-buoy, life-ring, life-donut, lifesaver or lifepreserver), which is mainly designed to be thrown, and some other professional variants that are designed to be used by lifeguards in their rescues.
* Keeping calm in water: This is to avoid getting tired, because it difficults swimming. Exhaustion can appear because of the anxious movements motivated by fear during drowning. In other sense, a bad calculation of the own physical capabilities can leave oneself exhausted before reaching the water's edge. Lowering the rhythm helps to reduce exhaustion. In case of suffering a tug, cramp or contracture (muscle spasm), it is useful to keep calm and swimming towards the shore, asking for help if necessary. If oneself is stung by a jellyfish, it is possible to get out of the water without major problems even with some itching or pain. When a problem makes swimming more difficult, it is possible to float by laying on the own back (in a completely horizontal position face up), because that position allows to float without effort.
* Not to jump into water before knowing the depth: It is convenient to know if there are, or could be, rocks that stand out too much. Headfirst jumps cause more than 70% of all spinal injuries related to sports and recreational activities. A fall from a great height on shallow water (in a swimming pool or in the sea) can cause a serious impact against the bottom. This could kill the person immediately, or later, in case of suffering a brain or body injury followed by drowning. If the person does not die, the injury could cause a permanent paralysis.
* Avoid dangerous waters: Avoid swimming in turbulent waters, with very large waves, with dangerous animals, and in those that are too cold. Also avoid dragging currents. These currents may have any characteristic that allows to recognize them, such as being more turbulent, more foamy, dragging things or debris, etc. In case of being caught by one of these currents, swim out from it (it is possible to move out gradually, in a diagonal direction until arriving to the shore).

Hoop-buoy in a boat.

* Navigating safely: Many people who die by drowning die in navigation accidents. A safe navigation includes being informed of the state of the sea, and equipping the boat with regulatory instruments to keep people afloat. These instruments are lifejackets (see above) and professional lifebuoys with the shape of a circle (ring-buoy, hoop-buoy, life-ring, life-donut, lifesaver or lifepreserver).
* Use the "buddy system": It consists in not to swim alone, but near a buddy, who can help in case of any problem.
* Paying heed to rules: Most people who drown did not follow the safety normatives. It is important to pay attention to the banners, the flags that indicate if swimming is possible and the indications of the authorities (lifeguards, coastguards, etc.).

### Water safety[edit | edit source]

The concept of water safety involves the procedures and policies that are directed to prevent people from drowning or injuring in water.[49]

## Management[edit | edit source]

See also: PPO:Drowning

### Rescue[edit | edit source]

Water rescue (simulation). The rescuer has already controlled the position of an anxious person, and then begins the towing to shore in backstroke style. The person's nose and mouth are kept above the water.

Many people who are drowning manage to save themselves, or are assisted by bystanders or professional rescuers. Less than 6% of people rescued by lifeguards need medical attention, and only 0.5% need CPR. The statistics are not as good for rescue by bystanders, but even there, a minority require CPR.

When a drowning occurs, or a swimmer becomes missing, bystanders should immediately call for help. A lifeguard should be called, if present. If not, emergency medical services and paramedics should be contacted as soon as possible. Rescue, and where necessary, resuscitation, should be started as early as possible. So the person should be taken out of the water as soon as possible.

Rescuers should avoid endangering themselves unnecessarily and, when possible, should assist from a safe position[50] (such as a boat or the shore). This assistance usually consists in throwing with precision a flotation instrument (as a hoop-shaped lifebuoy). In other cases, the manner to help could be by holding out an object (as a rope or pole, even the own arm. etc.) towards the person, but, doing this, the rescuer's body should be laying down, well secured to the ground, to avoid falling to the water too.

In a direct swimming rescue, the initial grasp is important and must be well managed by the rescuer. If something goes wrong, it could happen that an anxious drowning person clings to the rescuer to stand out of the water, submerging the rescuer in the process. To avoid this, it is recommended that the rescuer approaches to the panicking person with a buoyant object, or offering one hand, or even from behind and bending the person's arm against the back to restrict movement. Anyway, if the person pushes the rescuer towards below the water, the rescuer can usually escape diving downwards (because people who are unable to swim tend to move up, searching the water surface). After escaping in that manner, it is possible to come back and try a new approach to the drowning person. When the rescuer accomplishes a successful approach, the negatively buoyant objects (used in diving, such the weight belt) should be removed. Next, the priority is to transport the person to the water's edge using a tow maneuver. The rescuer usually approaches to the drowning person from behind, and then the person's body is turned face up, and grasped with a secure grip. There are many grips that can be used, but it is common that they grasp the person around the jaw area. The person's mouth and nose must be kept above the water surface. If the person is cooperative, the towing may be in a similar fashion held at the armpits. Unconscious people may be pulled in another similar fashion held at the chin and cheeks, and ensuring that the mouth and nose are well kept above the water.[citation needed] Special care has to be taken for people with suspected spinal injuries, they can require a more specific grip, and a back board (spinal board) may be needed for their rescue.[51]

In unconscious people, an in-water resuscitation could increase the chances of survival by a factor of about three, but this procedure require both medical and swimming skills, and only the breaths of the rescue ventilation are practicable in the water. Chest compressions require a suitable platform, so in-water assessment of circulation is pointless. If the person does not respond after a few breaths, cardiac arrest may be assumed, and getting them out of the water becomes the priority.[50]

### First aid[edit | edit source]

See also: Expired air resuscitation, Cardio-pulmonary resuscitation, Basic life support, and First aid

Rescue breaths

Chest compressions

The checks for responsiveness and breathing are carried out with the person horizontally supine. If unconscious but breathing, the recovery position is appropriate.

If not breathing, rescue ventilation is necessary. Drowning can produce a gasping pattern of apnea while the heart is still beating, and ventilation alone may be sufficient. The airway-breathing-circulation (ABC) sequence should be followed, rather than starting with compressions as is typical in cardiac arrest,[52] because the basic problem is lack of oxygen.

Five initial breaths are recommended, as the initial ventilation may be difficult because of water in the airways which can interfere with effective alveolar inflation. Thereafter a continual sequence of 2 breaths and 30 chest compressions is recommended. This alternance is repeated until vital signs are re-established, the rescuers are unable to continue, or advanced life support is available.[50] For babies, the procedure is slightly modified. In the rescue breaths, the rescuer's mouth covers the baby's mouth and nose at the same time. Besides, the chest compressions are applied pressing with only with two fingers on the chest bone (approximately on the lower part).

Attempts to actively expel water from the airway by abdominal thrusts, Heimlich maneuver or positioning head downwards should be avoided as there is no obstruction by solids, and they delay the start of ventilation and increase the risk of vomiting, with an increased risk of death, as aspiration of stomach contents is a common complication of resuscitation efforts.[50][53]

Treatment for hypothermia may also be necessary. Because of the diving reflex, people submerged in cold water and apparently drowned may revive after a relatively long period of immersion.[54] Rescuers retrieving a child from water significantly below body temperature should attempt resuscitation even after protracted immersion.[54]

### Medical care[edit | edit source]

People with a near-drowning experience who have normal oxygen levels and no respiratory symptoms should be observed in a hospital for a period of time to ensure there are no delayed complications.[55] The target of ventilation is to achieve 92% to 96% arterial saturation and adequate chest rise. Positive end-expiratory pressure will generally improve oxygenation. Drug administration via peripheral veins is preferred over endotracheal administration. Hypotension remaining after oxygenation may be treated by rapid crystalloid infusion.[50] Cardiac arrest in drowning usually presents as asystole or pulseless electrical activity. Ventricular fibrillation is more likely to be associated with complications of pre-existing coronary artery disease, severe hypothermia, or the use of epinephrine or norepinephrine.[50]

While surfactant may be used, no high quality evidence exist that looks at this practice.[3] Extracorporeal membrane oxygenation may be used in those who cannot be oxygenated otherwise.[3] Steroids are not recommended.[3]

## Prognosis[edit | edit source]

Duration of submersion  | Risk of death or poor outcomes[50]

|

0–5 min  | 10%
6–10 min  | 56%
11–25 min  | 88%
>25 min  | nearly 100%
Signs of brain-stem injury predict death or severe neurological consequences

Disability-adjusted life year for drowning per 100,000 inhabitants in 2004.[56]

no data

< 100

100–150

150–200

200–250

250–300

300–350

350–400

400–450

450–500

500–600

600–700

> 700

People who have drowned who arrive at a hospital with spontaneous circulation and breathing usually recover with good outcomes.[54] Early provision of basic and advanced life support improve probability of positive outcome.[50]

Longer duration of submersion is associated with lower probability of survival and higher probability of permanent neurological damage.[54]

Contaminants in the water can cause bronchospasm and impaired gas exchange, and can cause secondary infection with delayed severe respiratory compromise.[54]

Low water temperature can cause ventricular fibrillation, but hypothermia during immersion can also slow the metabolism, allowing a longer hypoxia before severe damage occurs.[54] Hypothermia which reduces brain temperature significantly can improve outcome. A reduction of brain temperature by 10 °C decreases ATP consumption by approximately 50%, which can double the time that the brain can survive.[50]

The younger the person, the better the chances of survival.[54] In one case, a child submerged in cold (37 °F (3 °C)) water for 66 minutes was resuscitated without apparent neurological damage.[54] However, over the long term significant deficits were noted, including a range of cognitive difficulties, particularly general memory impairment, although recent magnetic resonance imaging (MRI) and magnetoencephalography (MEG) were within normal range.[57]

### Children[edit | edit source]

Drowning is a major worldwide cause of death and injury in children. Long term neurological outcomes of drowning cannot be predicted accurately during the early stages of treatment and although survival after long submersion times, mostly by young children, has been reported, many survivors will remain severely and permanently neurologically compromised after much shorter submersion times. Factors affecting probability of long term recovery with mild deficits or full function in young children include the duration of submersion, whether advanced life support was needed at the accident site, the duration of cardiopulmonary resuscitation, and whether spontaneous breathing and circulation are present on arrival at the emergency room.[58]

Data on long-term outcome are scarce and unreliable. Neurological examination at the time of discharge from hospital does not accurately predict long term outcomes. Some people with severe brain injury and were transferred to other institutions died months or years after the drowning and are recorded as survivors. Non-fatal drownings have been estimated as two to four times more frequent than fatal drownings.[58]

## Epidemiology[edit | edit source]

In 2013, drowning was estimated to have resulted in 368,000 deaths, down from 545,000 deaths in 1990.[59] There are more than 20 times that many non-fatal incidents.[60] It is the third leading cause of death from unintentional trauma after traffic injuries and falls.[61]

In many countries, drowning is one of the main causes of preventable death for children under 12 years old. In the United States in 2006, 1100 people under 20 years of age died from drowning.[62] The United Kingdom has 450 drownings per year, or 1 per 150,000, whereas in the United States, there are about 6,500 drownings yearly, around 1 per 50,000. In Asia suffocation and drowning were the leading causes of preventable death for children under five years of age;[63][64] a 2008 report by the organization found that in Bangladesh, for instance, 46 children drown each day.[65]

Males, due to a generally increased likelihood for risk taking, are 4 times more likely to have submersion injuries.[60]

In the fishing industry, the largest group of drownings is associated with vessel disasters in bad weather, followed by man-overboard incidents and boarding accidents at night; either in foreign ports, or under the influence of alcohol.[60] Scuba diving deaths are estimated at 700 to 800 per year, associated with inadequate training and experience, exhaustion, panic, carelessness and barotrauma.[60]

### United States[edit | edit source]

In the United States, drowning is the second leading cause of death (after motor vehicle accidents) in children 12 and younger.[66]

People who drown are more likely to be male, young, or adolescent.[66] Surveys indicate that 10% of children under 5 have experienced a situation with a high risk of drowning. Worldwide, about 175,000 children die through drowning every year.[67] The causes of drowning cases in the US from 1999 to 2006 were as follows:[68]

31.0% | Drowning and submersion while in natural water

|

27.9% | Unspecified drowning and submersion
14.5% | Drowning and submersion while in swimming pool
9.4% | Drowning and submersion while in bathtub
7.2% | Drowning and submersion following fall into natural water
6.3% | Other specified drowning and submersion
2.9% | Drowning and submersion following fall into swimming pool
0.9% | Drowning and submersion following fall into bathtub

According to the US National Safety Council, 353 people ages 5 to 24 drowned in 2017.[69]

## Society and culture[edit | edit source]

### Old terminology[edit | edit source]

The word "drowning"—like "electrocution"—was previously used to describe fatal events only, and occasionally that usage is still insisted upon, though the consensus of the medical community supports the definition used in this article. Several terms related to drowning which have been used in the past are also no longer recommended.[7] These include:

Active drowning: People, such as non-swimmers and the exhausted or hypothermic at the surface, who are unable to hold their mouth above water and are suffocating due to lack of air. Instinctively, people in such cases perform well-known behaviors in the last 20–60 seconds before being submerged, representing the body's last efforts to obtain air.[10][50] Notably, such people are unable to call for help, talk, reach for rescue equipment, or alert swimmers even feet away, and they may drown quickly and silently close to other swimmers or safety.[12]

* Dry drowning: Drowning in which no water enters the lungs.[10][50]

* Near drowning: Drowning which is not fatal.[10][50]

* Wet drowning: Drowning in which water enters the lungs.[10][50]

* Passive drowning: People who suddenly sink or have sunk due to a change in their circumstances. Examples include people who drown in an accident, or due to sudden loss of consciousness or sudden medical condition.[50]

* Secondary drowning: Physiological response to foreign matter in the lungs due to drowning causing extrusion of liquid into the lungs (pulmonary edema) which adversely affects breathing.[10][50]

* Silent drowning: Drowning without a noticeable external display of distress.[10][70]

#### Dry drowning[edit | edit source]

Dry drowning is a term that has never had an accepted definition, and is currently medically discredited.[71][72] Following the 2002 World Congress on Drowning in Amsterdam, a consensus definition of drowning was established. Based on this definition, drowning is the "process of experiencing respiratory impairment from submersion/immersion in liquid."[73] This definition resulted in only three legitimate drowning subsets: fatal drowning, non-fatal drowning with illness/injury, and non-fatal drowning without illness/injury.[74] In response, major medical consensus organizations have adopted this definition worldwide and have officially discouraged any medical or publication use of the term "dry drowning".[71] Such organizations include the International Liaison Committee on Resuscitation,[75] the Wilderness Medical Society,[41] the American Heart Association,[76] the Utstein Style system,[75] the International Lifesaving Federation,[77] the International Conference on Drowning,[73] Starfish Aquatics Institute,[78] the American Red Cross,[79] the Centers for Disease Control and Prevention (CDC),[80][81][82] the World Health Organization [83] and the American College of Emergency Physicians.[84]

Drowning experts have recognized that the end result pathophysiology of hypoxemia, acidemia, and eventual death is the same whether water entered the lung or not. As this distinction does not change management or prognosis, but causes significant confusion due to alternate definitions and misunderstandings, it is generally established that pathophysiological discussions of "dry" versus "wet" drowning are not relevant to drowning care.[85]

"Dry drowning" is frequently cited in the news with a wide variety of definitions.[86] and is often confused with the equally inappropriate and discredited term "secondary drowning" or "delayed drowning".[87] Various conditions including spontaneous pneumothorax, chemical pneumonitis, bacterial or viral pneumonia, head injury, asthma, heart attack, and chest trauma have been misattributed to the erroneous terms "delayed drowning", "secondary drowning", and "dry drowning". Currently, there has never been a case identified in the medical literature where a person was observed to be without symptoms and who died hours or days later as a direct result of drowning alone.[71]

### Capital punishment[edit | edit source]

Main article: Execution by drowning

In Europe, drowning was used as capital punishment. During the Middle Ages, a sentence of death was read using the words "cum fossa et furca", or "with pit and gallows".[88]

Drowning survived as a method of execution in Europe until the 17th and 18th centuries.[89] England had abolished the practice by 1623, Scotland by 1685, Switzerland in 1652, Austria in 1776, Iceland in 1777, and Russia by the beginning of the 1800s. France revived the practice during the French Revolution (1789–1799) and it was carried out by Jean-Baptiste Carrier at Nantes.[90]

## References[edit | edit source]

1. ↑ 1.0 1.1 "Drowning". CDC. 15 September 2017. Archived from the original on 3 February 2017. Retrieved 9 August 2018.
2. ↑ 2.0 2.1 2.2 2.3 Ferri, Fred F. (2017). Ferri's Clinical Advisor 2018 E-Book: 5 Books in 1. Elsevier Health Sciences. p. 404\. ISBN 9780323529570. Archived from the original on 30 July 2020. Retrieved 4 August 2020.
3. ↑ 3.0 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 "Drowning - Injuries; Poisoning - Merck Manuals Professional Edition". Merck Manuals Professional Edition. September 2017. Archived from the original on 9 August 2018. Retrieved 9 August 2018.
4. ↑ 4.0 4.1 4.2 4.3 4.4 Handley, AJ (16 April 2014). "Drowning". BMJ (Clinical Research Ed.). 348: g1734. doi:10.1136/bmj.g1734. PMID 24740929.
5. ↑ 5.0 5.1 5.2 5.3 5.4 5.5 5.6 "Drowning". World Health Organization. 15 January 2018. Archived from the original on 23 August 2018. Retrieved 9 August 2018.
6. ↑ 6.0 6.1 Preventing drowning: an implementation guide (PDF). WHO. 2015. p. 2\. ISBN 978-92-4-151193-3. Archived (PDF) from the original on 28 July 2018. Retrieved 9 August 2018.
7. ↑ 7.00 7.01 7.02 7.03 7.04 7.05 7.06 7.07 7.08 7.09 7.10 Mott, TF; Latimer, KM (1 April 2016). "Prevention and Treatment of Drowning". American Family Physician. 93 (7): 576–82. PMID 27035042.
8. ↑ 8.0 8.1 GBD 2015 Disease and Injury Incidence and Prevalence, Collaborators. (8 October 2016). "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1545–1602. doi:10.1016/S0140-6736(16)31678-6. PMC 5055577. PMID 27733282.
9. ↑ 9.0 9.1 9.2 9.3 GBD 2015 Mortality and Causes of Death, Collaborators. (8 October 2016). "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1459–1544. doi:10.1016/s0140-6736(16)31012-1. PMC 5388903. PMID 27733281.
10. ↑ 10.00 10.01 10.02 10.03 10.04 10.05 10.06 10.07 10.08 10.09 10.10 van Beeck, EF; Branche, CM; Szpilman, D; Modell, JH; Bierens, JJ (November 2005). "A new definition of drowning: towards documentation and prevention of a global public health problem". Bulletin of the World Health Organization. 83 (11): 853–6. PMC 2626470. PMID 16302042.
11. ↑ Wall, Ron (2017). Rosen's Emergency Medicine: Concepts and Clinical Practice (9 ed.). Elsevier. p. 1802\. ISBN 978-0323354790.
12. ↑ 12.0 12.1 12.2 12.3 Vittone, Mario; Pia, Francesco (Fall 2006). "'It Doesn't Look Like They're Drowning': How To Recognize the Instinctive Drowning Response" (PDF). On Scene: The Journal of U.S. Coast Guard Search and Rescue: 14. Archived (PDF) from the original on 3 January 2011. Retrieved 29 December 2010.
13. ↑ 13.0 13.1 Pia, Frank (1999). "Chapter 14: Reflections on Lifeguard surveillance programs". In Fletemeyer, John R.; Freas, Samuel J. (eds.). Drowning: New Perspectives on Intervention and Prevention. p. 234\. ISBN 978-1-57444-223-6.
14. ↑ O'Connell, Claire (3 August 2010). "What stops people shouting and waving when drowning?". Irish Times. Archived from the original on 22 October 2012. Retrieved 29 December 2010.
15. ↑ Young, David (13 July 2012). "Rivers - The impact of European settlement". Te Ara: The Encyclopedia of New Zealand. Archived from the original on 2 June 2015. Retrieved 7 January 2015.
16. ↑ Gulli, Benjamin; Ciatolla, Joseph A.; Barnes, Leaugeay (2011). Emergency Care and Transportation of the Sick and Injured. Sudbury, Massachusetts: Jones and Bartlett. p. 1157\. ISBN 9780763778286. Archived from the original on 25 November 2017.
17. ↑ 17.0 17.1 Staff (23 September 2014). "Drowning". CDC Tip sheets. Atlanta. Georgia: Centers for Disease Control and Prevention. Archived from the original on 3 February 2017. Retrieved 2 February 2017.
18. ↑ Staff (28 April 2016). "Unintentional Drowning: Get the Facts". Home and Recreational Safety. Atlanta, Georgia: Centers for Disease Control and Prevention. Archived from the original on 2 February 2017. Retrieved 2 February 2017.
19. ↑ Watila, Musa M.; Balarabe, Salisu A.; Ojo, Olubamiwo; Keezer, Mark R.; Sander, Josemir W. (October 2018). "Overall and cause-specific premature mortality in epilepsy: A systematic review" (PDF). Epilepsy & Behavior. 87: 213–225. doi:10.1016/j.yebeh.2018.07.017. ISSN 1525-5050. PMID 30154056.
20. ↑ Hamilton, Kyra; Keech, Jacob J.; Peden, Amy E.; Hagger, Martin S. (2018-06-03). "Alcohol use, aquatic injury, and unintentional drowning: A systematic literature review". Drug and Alcohol Review. 37 (6): 752–773. doi:10.1111/dar.12817. ISSN 0959-5236. PMID 29862582. Archived from the original on 14 March 2021. Retrieved 4 August 2020.
21. ↑ Campbell, Ernest (1996). "Free Diving and Shallow Water Blackout". Diving Medicine Online. scuba-doc.com. Archived from the original on 18 September 2016. Retrieved 24 January 2017.
22. ↑ 22.0 22.1 Lindholm, P; Lundgren, C. E. (2006). "Alveolar gas composition before and after maximal breath-holds in competitive divers". Undersea & Hyperbaric Medicine. 33 (6): 463–7. PMID 17274316. Archived from the original on 24 March 2011. Retrieved 30 December 2010.
23. ↑ 23.0 23.1 23.2 23.3 Harle, Lindsey (August 2012). "Drowning". Forensic pathology: Types of injuries. PathologyOutlines.com. Archived from the original on 7 February 2017. Retrieved 3 February 2017.
24. ↑ 24.0 24.1 Gorman, Mark (2008). Jose Biller (ed.). Interface of Neurology and Internal Medicine. Lippincott Williams & Wilkins. pp. 702–706. ISBN 978-0-7817-7906-7. Archived from the original on 19 June 2013. Retrieved 9 May 2013.
25. ↑ Lane, Jordan D. (2017). "Drowning Deaths From Unsupervised Breath Holding: Separating Necessary Training From Unwarranted Risk". Military Medicine. 182 (January/February): 1471–1473. doi:10.7205/MILMED-D-16-00246. PMID 28051962.[permanent dead link]
26. ↑ 26.0 26.1 Lindholm, Peter (2006). Lindholm, P.; Pollock, N. W.; Lundgren, C. E. G. (eds.). Physiological mechanisms involved in the risk of loss of consciousness during breath-hold diving (PDF). Breath-hold diving. Proceedings of the Undersea and Hyperbaric Medical Society/Divers Alert Network 2006 June 20–21 Workshop. Durham, NC: Divers Alert Network. p. 26\. ISBN 978-1-930536-36-4. Archived (PDF) from the original on 19 May 2016. Retrieved 24 January 2017.
27. ↑ North, Robert (December 2002). "The pathophysiology of drowning" (PDF). South Pacific Underwater Medicine Society Journal. 32 (4). Archived from the original (PDF) on 11 February 2017. Retrieved 9 February 2017.
28. ↑ 28.0 28.1 Cantwell, G Patricia (5 July 2016). "Drowning: Pathophysiology". Drugs & Diseases - Emergency Medicine. Medscape. Archived from the original on 4 February 2017. Retrieved 3 February 2017.
29. ↑ DiMaio, Dominick; DiMaio, Vincent J.M. (28 June 2001). Forensic Pathology (2nd ed.). Taylor & Francis. pp. 405–. ISBN 978-0-8493-0072-1. Archived from the original on 19 June 2013. Retrieved 9 May 2013.
30. ↑ 30.0 30.1 30.2 30.3 Jin, Faguang; Li, Congcong (2017-04-05). "Seawater-drowning-induced acute lung injury: From molecular mechanisms to potential treatments". Experimental and Therapeutic Medicine. 13 (6): 2591–2598. doi:10.3892/etm.2017.4302. ISSN 1792-0981. PMC 5450642. PMID 28587319.
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32. ↑ 32.0 32.1 Michelet, Pierre; Dusart, Marion; Boiron, Laurence; Marmin, Julien; Mokni, Tarak; Loundou, Anderson; Coulange, Mathieu; Markarian, Thibaut (2018-08-03). "Drowning in fresh or salt water". European Journal of Emergency Medicine. Publish Ahead of Print (5): 340–344. doi:10.1097/mej.0000000000000564. ISSN 0969-9546. PMID 30080702.
33. ↑ Lundgren, Claus E. G.; Ferrigno, Massimo, eds. (1985). Physiology of Breath-hold Diving. 31st Undersea and Hyperbaric Medical Society Workshop. Vol. UHMS Publication Number 72(WS-BH)4-15-87. Undersea and Hyperbaric Medical Society. Archived from the original on 2 June 2009. Retrieved 24 April 2009.
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36. ↑ 36.0 36.1 36.2 "Hypothermia safety". United States Power Squadrons. 23 January 2007. Archived from the original on 8 December 2008. Retrieved 19 February 2008.
37. ↑ Butler, Daniel Allen (1998). Unsinkable: The Full Story of RMS Titanic. Mechanicsburg, PA: Stackpole Books. ISBN 978-0-8117-1814-1.
38. ↑ 38.0 38.1 38.2 Shattock, Michael J.; Tipton, Michael J. (2012-06-14). "'Autonomic conflict': a different way to die during cold water immersion?". The Journal of Physiology. 590 (14): 3219–3230. doi:10.1113/jphysiol.2012.229864. ISSN 0022-3751. PMC 3459038. PMID 22547634.
39. ↑ Tipton, M. J.; Collier, N.; Massey, H.; Corbett, J.; Harper, M. (2017-09-21). "Cold water immersion: kill or cure?". Experimental Physiology. 102 (11): 1335–1355. doi:10.1113/ep086283. ISSN 0958-0670. PMID 28833689. Archived from the original on 30 July 2020. Retrieved 4 August 2020.
40. ↑ Sterba, J. A. (1990). "Field Management of Accidental Hypothermia during Diving". US Navy Experimental Diving Unit Technical Report. NEDU-1-90. Archived from the original on 27 July 2011. Retrieved 11 June 2008.
41. ↑ 41.0 41.1 41.2 Schmidt, AC; Sempsrott JR; Hawkins SC (2016). "Wilderness Medical Society Practice Guidelines for the Prevention and Treatment of Drowning". Wilderness & Environmental Medicine. 27 (2): 236–51. doi:10.1016/j.wem.2015.12.019. PMID 27061040. Retrieved August 25, 2017.
42. ↑ Cantwell, G Patricia (5 July 2016). "Drowning: Prognosis". Drugs & Diseases - Emergency Medicine. Medscape. Archived from the original on 4 February 2017. Retrieved 3 February 2017.
43. ↑ Centers for Disease Control and Prevention. "Water-Related Injuries". Archived from the original on 14 February 2020.
44. ↑ Szpilman, David; Bierens, Joost J.L.M.; Handley, Anthony J.; Orlowski, James P. (4 October 2012). "Drowning". The New England Journal of Medicine. 366 (22): 2102–2110. doi:10.1056/NEJMra1013317. PMID 22646632.
45. ↑ Pia, Frank (June 1984). "The RID factor as a cause of drowning". Parks & Recreation. Archived from the original on 5 March 2016. Retrieved 1 October 2012 - via pia-enterprises.com.
46. ↑ Mott, TF; Latimer, KM (1 April 2016). "Prevention and Treatment of Drowning". American Family Physician. 93 (7): 576–82. PMID 27035042.
47. ↑ Thompson, D. C.; Rivara, F. P. (2000). "Pool fencing for preventing drowning in children". The Cochrane Database of Systematic Reviews (2): CD001047. doi:10.1002/14651858.CD001047. ISSN 1469-493X. PMID 10796742.
48. ↑ Centers for Disease Control and Prevention. "Water-Related Injuries". Archived from the original on 14 February 2020.
49. ↑ "Water safety - RoSPA". rospa.com. Archived from the original on 21 December 2019. Retrieved 2020-02-14.
50. ↑ 50.00 50.01 50.02 50.03 50.04 50.05 50.06 50.07 50.08 50.09 50.10 50.11 50.12 50.13 50.14 Szpilman, David; Bierens, Joost J.L.M.; Handley, Anthony J.; Orlowski, James P. (4 October 2012). "Drowning". The New England Journal of Medicine. 366 (22): 2102–2110. doi:10.1056/NEJMra1013317. PMID 22646632.
51. ↑ "2005 ILCOR resuscitation guidelines" (PDF). Circulation. 112 (22 supplement). 29 November 2005. doi:10.1161/CIRCULATIONAHA.105.166480 (inactive 25 January 2020). Archived (PDF) from the original on 27 February 2008. Retrieved 17 February 2008. "There is insufficient evidence to recommend for or against the use of oxygen by the first aid provider."`{{cite journal}}`: CS1 maint: DOI inactive as of January 2020 (link)
52. ↑ Hazinski, Mary Fran, ed. (2010). Guidelines for CPR and ECC (PDF). Highlights of the 2010 American Heart Association (Report). American Heart Association. p. 2\. Archived (PDF) from the original on 6 January 2017. Retrieved 2 January 2017.
53. ↑ MedlinePlus Encyclopedia: Near drowning
54. ↑ 54.0 54.1 54.2 54.3 54.4 54.5 54.6 54.7 McKenna, Kim D. (2011). Mosby's paramedic textbook. Jones & Bartlett Publishers. pp. 1262–1266. ISBN 978-0-323-07275-5. Archived from the original on 19 June 2013. Retrieved 9 May 2013.
55. ↑ "Drowning - Symptoms, diagnosis and treatment". BMJ Best Practice. Archived from the original on 3 December 2018. Retrieved 2018-12-03.
56. ↑ "WHO Disease and injury country estimates". World Health Organization. 2009. Archived from the original on 11 November 2009. Retrieved 11 November 2009.
57. ↑ Hughes, S. K.; Nilsson, D. E.; Boyer, R. S.; Bolte, R. G.; Hoffman, R. O.; Lewine, J. D.; Bigler, E. D. (2002). "Neurodevelopmental outcome for extended cold water drowning: A longitudinal case study". Journal of the International Neuropsychological Society. 8 (4): 588–596. doi:10.1017/s1355617702814370. PMID 12030312.
58. ↑ 58.0 58.1 Suominen, Pertti K.; Vähätalo, Raisa (15 August 2012). "Neurologic long term outcome after drowning in children". Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 20 (55): 55. doi:10.1186/1757-7241-20-55. ISSN 1757-7241. PMC 3493332. PMID 22894549.
59. ↑ GBD 2013 Mortality and Causes of Death, Collaborators (17 December 2014). "Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013". Lancet. 385 (9963): 117–71. doi:10.1016/S0140-6736(14)61682-2. PMC 4340604. PMID 25530442.
60. ↑ 60.0 60.1 60.2 60.3 Cantwell, G Patricia (5 July 2016). "Drowning: Epidemiology". Drugs & Diseases - Emergency Medicine. Medscape. Archived from the original on 4 February 2017. Retrieved 3 February 2017.
61. ↑ Lozano, R; Naghavi, M.; Foreman, K.; Lim, S.; Shibuya, K.; Aboyans, V.; Abraham, J.; Adair, T.; Aggarwal, R.; Ahn, S. Y.; Alvarado, M.; Anderson, H. R.; Anderson, L. M.; Andrews, K. G.; Atkinson, C.; Baddour, L. M.; Barker-Collo, S.; Bartels, D. H.; Bell, M. L.; Benjamin, E. J.; Bennett, D.; Bhalla, K.; Bikbov, B.; Bin Abdulhak, A.; Birbeck, G.; Blyth, F.; Bolliger, I.; Boufous, S.; Bucello, C.; et al. (15 Dec 2012). "Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010". Lancet. 380 (9859): 2095–128. doi:10.1016/S0140-6736(12)61728-0. hdl:10536/DRO/DU:30050819. PMID 23245604.
62. ↑ Committee on injury, violence, and poison prevention (2010). "Policy Statement—Prevention of Drowning". Pediatrics. 126 (1): 178–185. doi:10.1542/peds.2010-1264. PMID 20498166. Archived from the original on 9 June 2010.`{{cite journal}}`: CS1 maint: multiple names: authors list (link)
63. ↑ "Drowning, Homicide and Suicide Leading Killers for Children in Asia". The Salem News. 11 March 2008. Archived from the original on 11 September 2011. Retrieved 5 October 2010.
64. ↑ "UNICEF Says Injuries A Fatal Problem For Asian Children". All Headline News. 13 March 2008. Archived from the original on 18 January 2012. Retrieved 5 October 2010.
65. ↑ "Children Drowning, Drowning Children" (PDF). The Alliance for Safe Children. Archived from the original (PDF) on 28 July 2011. Retrieved 6 October 2010.
66. ↑ 66.0 66.1 "Drowning". Centers for Disease Control and Prevention. 23 September 2014. Archived from the original on 10 May 2016. Retrieved 26 June 2016.
67. ↑ "Traffic Accidents Top Cause Of Fatal Child Injuries". Science. National Public Radio. 10 December 2008. Archived from the original on 12 December 2016. Retrieved 2 February 2017.
68. ↑ "Archived copy". Archived from the original on 27 September 2017. Retrieved 9 September 2017.`{{cite web}}`: CS1 maint: archived copy as title (link)[not specific enough to verify]
69. ↑ "Drowning: It Can Happen in an Instant". US National Safety Council. 2019. Archived from the original on 14 June 2019. Retrieved 2019-05-31.
70. ↑ Breining, Greg (29 May 2015). "Silent Drowning: How to Spot the Signs and Save a Life". Outdoors. Safe Bee. Archived from the original on 3 February 2017. Retrieved 2 February 2017.
71. ↑ 71.0 71.1 71.2 Hawkins, SC; Sempsrott, J.; Schmidt, A. (16 June 2017). "Drowning in a Sea of Misinformation: Dry Drowning and Secondary Drowning". Emergency Medicine News. Archived from the original on 7 August 2017.
72. ↑ Szpilman, D; Bierens JL; Handley A; Orlowski JP (2012). "Drowning". New England Journal of Medicine. 10 (2): 2102–2110. doi:10.1056/nejmra1013317. PMID 22646632.
73. ↑ 73.0 73.1 van Beeck, EF (2006). "Definition of Drowning". In Handbook on Drowning: Prevention, Rescue, Treatment. Berlin: Springer.
74. ↑ Van Beeck, EF; Branche, CM (2005). "A new definition of drowning: towards documentation and prevention of a global public health program". Bull World Health Organ. 83: 853–856.
75. ↑ 75.0 75.1 Idris, AH (2003). "Recommended Guidelines for Uniform Reporting of Data from Drowning". Circulation. 108 (20): 2565–2574. doi:10.1161/01.cir.0000099581.70012.68. PMID 14623794.
76. ↑ "2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 112 (24): IV–133–IV–135. 2005. doi:10.1161/CIRCULATIONAHA.105.166565. Archived from the original on 26 August 2017. Retrieved 25 August 2017.
77. ↑ "Lifesaving Position Statement LPS 17: Definition of Drowning". International Life Saving Federation. 9 March 2016. Archived from the original on 1 July 2017. Retrieved 25 August 2017.
78. ↑ "Defining Drowning". www.starfishaquaticsinstitute.blogspot.com. Starfish Aquatics Institute. 7 April 2015. Archived from the original on 25 August 2017. Retrieved 25 August 2017.
79. ↑ Tobin, JM; Rossano JW; Wernicki PG (2017). "Dry Drowning: A Distinction without a Difference". Resuscitation. 118: e5–e6. doi:10.1016/j.resuscitation.2017.06.023. PMID 28655623. Retrieved August 25, 2017.[permanent dead link]
80. ↑ Gilchrist, A (2004). "Nonfatal and Fatal Drownings in Recreational Water Settings-United States 2001-2002". Morbidity and Mortality Weekly Report. 53: 447–452.
81. ↑ "Dry Drowning". Snopes. June 8, 2017. Retrieved August 25, 2017.
82. ↑ "Water-Related Injuries". US Centers for Disease Control and Prevention. Jun 12, 2008. Archived from the original on July 19, 2008. Retrieved August 25, 2017.`{{cite web}}`: CS1 maint: bot: original URL status unknown (link)
83. ↑ van Beek, EF (2005). "A new definition of drowning: towards documentation and prevention of a global public health problem". Bulletin of the World Health Organization. 83: 801–880.
84. ↑ American College of Emergency Physicians Press Release (11 July 2017). "Death After Swimming Is Extremely Rare and is NOT Dry Drowning". www.acep.org. American College of Emergency Physicians. Archived from the original on 7 August 2017. Retrieved 25 August 2017.
85. ↑ Sempsrott, J; Schmidt, AC; Hawkins, SC (2017). "Drowning and Submersion Injuries". In Auerbach's Wilderness Medicine 7th edition. Philadelphia: Elsevier.
86. ↑ "Death After Swimming is Extremely Rare – And is NOT "Dry Drowning"". American College of Emergency Physicians. Archived from the original on 21 October 2017. Retrieved 20 October 2017.
87. ↑ Sempsrott, J. "Wet and Wild: Drowning & Water Injuries: Dry Drowning and Secondary Drowning". Wilderness Medicine Magazine. Archived from the original on 7 August 2017.
88. ↑ Halkerston, Peter (1829). A Translation and Explanation of the principal technical Terms and Phrases used in Mr. Erskine's Institute of the Law of Scotland ... With an index materiarum and the Latin maxims in law and equity most in use (2nd ed.). Edinborough: Peter Halkerston. p. 29\. Archived from the original on 25 November 2017. Retrieved 2 February 2017.
89. ↑ Norton, Rictor (17 November 2011). "Newspaper Reports: The Dutch Purge of Homosexuals, 1730". Homosexuality in Eighteenth-Century England: A Sourcebook. Archived from the original on 18 May 2012.
90. ↑ "Drowning and Life Saving" . Encyclopædia Britannica. Vol. 08 (11th ed.). 1911.

## External links[edit | edit source]

* Canadian Red Cross: Drowning Research: Drownings in Canada, 10 Years of Research Module 2 – Ice & Cold Water Immersion

Classification|

* ICD-10: T75.1
* ICD-9-CM: 994.1
* DiseasesDB: 3957

|

External resources|

* MedlinePlus: 000046
* eMedicine: emerg/744

* v
* t
* e

Consequences of external causes

Temperature|

| Elevated|

Hyperthermia
Heat syncope

|

Reduced|

Hypothermia
Immersion foot syndromes

Trench foot
Tropical immersion foot
Warm water immersion foot
Chilblains
Frostbite
Aerosol burn
Cold intolerance
Acrocyanosis
Erythrocyanosis crurum

Radiation|

Radiation poisoning
Radiation burn
Chronic radiation keratosis
Eosinophilic, polymorphic, and pruritic eruption associated with radiotherapy
Radiation acne
Radiation-induced cancer
Radiation recall reaction
Radiation-induced erythema multiforme
Radiation-induced hypertrophic scar
Radiation-induced keloid
Radiation-induced morphea

Air|

* Hypoxia/Asphyxia
* Barotrauma
* Aerosinusitis
* Decompression sickness
* High altitude
* Altitude sickness
* Chronic mountain sickness
* Death zone
* HAPE
* HACE

Food|

* Starvation

Maltreatment|

* Physical abuse
* Sexual abuse
* Psychological abuse

Travel|

* Motion sickness
* Seasickness
* Airsickness
* Space adaptation syndrome

Adverse effect|

* Hypersensitivity
* Anaphylaxis
* Angioedema
* Allergy
* Arthus reaction

* Adverse drug reaction

Other|

* Electrical injury
* Drowning
* Lightning injuries

Ungrouped
skin conditions
resulting from
physical factors|

* Dermatosis neglecta
* Pinch mark
* Pseudoverrucous papules and nodules
* Sclerosing lymphangitis
* Tropical anhidrotic asthenia
* UV-sensitive syndrome

environmental skin conditions
Electrical burn
frictional/traumatic/sports

Black heel and palm
Equestrian perniosis
Jogger's nipple
Pulling boat hands
Runner's rump
Surfer's knots
Tennis toe
Vibration white finger
Weathering nodule of ear
Wrestler's ear
Coral cut
Painful fat herniation
Uranium dermatosis

iv use

Skin pop scar
Skin track
Slap mark
Pseudoacanthosis nigricans
Narcotic dermopathy

* v
* t
* e

Underwater diving

* Diving modes
* Atmospheric pressure diving
* Freediving
* Saturation diving
* Scuba diving
* Snorkeling
* Surface oriented diving
* Surface-supplied diving
* Unmanned diving

Diving equipment

* Cleaning and disinfection of personal diving equipment
* Human factors in diving equipment design

| Basic equipment|

* Diving mask
* Snorkel
* Swimfin

|

Breathing gas|

* Bailout gas
* Bottom gas
* Breathing air
* Decompression gas
* Emergency gas supply
* Heliox
* Nitrox
* Oxygen
* Travel gas
* Trimix

Buoyancy and
trim equipment|

* Buoyancy compensator
* Power inflator
* Dump valve
* Diving weighting system
* Ankle weights
* Integrated weights
* Trim weights
* Weight belt

Decompression
equipment|

* Decompression buoy
* Decompression cylinder
* Decompression trapeze
* Dive computer
* Diving shot
* Jersey upline
* Jonline

Diving suit|

* Atmospheric diving suit
* Dry suit
* Sladen suit
* Standard diving suit
* Rash vest
* Wetsuit
* Dive skins
* Hot-water suit

Helmets
and masks|

* Anti-fog
* Diving helmet
* Free-flow helmet
* Lightweight demand helmet
* Orinasal mask
* Reclaim helmet
* Shallow water helmet
* Standard diving helmet
* Diving mask
* Band mask
* Full-face mask
* Half mask

Instrumentation|

* Bottom timer
* Depth gauge
* Dive computer
* Dive timer
* Diving watch
* Helium release valve
* Pneumofathometer
* Submersible pressure gauge

Mobility
equipment|

* Diving bell
* Closed bell
* Wet bell
* Diving stage
* Swimfin
* Monofin
* PowerSwim
* Towboard

| Diver
propulsion
vehicle|

* Advanced SEAL Delivery System
* Cosmos CE2F series
* Dry Combat Submersible
* Human torpedo
* Motorised Submersible Canoe
* Necker Nymph
* R-2 Mala-class swimmer delivery vehicle
* SEAL Delivery Vehicle
* Shallow Water Combat Submersible
* Siluro San Bartolomeo
* Wet Nellie
* Wet sub

|

Safety
equipment|

* Alternative air source
* Octopus regulator
* Pony bottle
* Bolt snap
* Buddy line
* Dive light
* Diver's cutting tool
* Diver's knife
* Diver's telephone
* Through-water communications
* Diving bell
* Diving safety harness
* Emergency gas supply
* Bailout block
* Bailout bottle
* Lifeline
* Screw gate carabiner
* Emergency locator beacon
* Rescue tether
* Safety helmet
* Shark-proof cage
* Snoopy loop
* Navigation equipment
* Distance line
* Diving compass
* Dive reel
* Line marker
* Surface marker buoy
* Silt screw

Underwater
breathing
apparatus|

* Atmospheric diving suit
* Diving cylinder
* Burst disc
* Diving cylinder valve
* Diving helmet
* Reclaim helmet
* Diving regulator
* Mechanism of diving regulators
* Regulator malfunction
* Regulator freeze
* Single-hose regulator
* Twin-hose regulator
* Full face diving mask

| Open-circuit
scuba|

* Scuba set
* Bailout bottle
* Decompression cylinder
* Independent doubles
* Manifolded twin set
* Scuba manifold
* Pony bottle
* Scuba configuration
* Sidemount
* Sling cylinder

|

Diving
rebreathers|

* Carbon dioxide scrubber
* Carleton CDBA
* CDLSE
* Cryogenic rebreather
* CUMA
* DSEA
* Dolphin
* Electro-galvanic oxygen sensor
* FROGS
* Halcyon PVR-BASC
* Halcyon RB80
* IDA71
* Interspiro DCSC
* KISS
* LAR-5
* LAR-6
* LAR-V
* LARU
* Porpoise
* Ray
* Siebe Gorman CDBA
* Siva
* Viper

Surface-supplied
diving equipment|

* Air line
* Diver's umbilical
* Diving air compressor
* Gas panel
* Hookah
* Scuba replacement
* Sea Trek
* Snuba
* Standard diving dress

Escape set|

* Davis Submerged Escape Apparatus
* Momsen lung
* Steinke hood
* Submarine Escape Immersion Equipment

Diving
equipment
manufacturers|

* AP Diving
* Apeks
* Aqua Lung America
* Aqua Lung/La Spirotechnique
* Beuchat
* René Cavalero
* Cis-Lunar
* Cressi-Sub
* Dacor
* DESCO
* Dive Xtras
* Divex
* Diving Unlimited International
* Drägerwerk
* Fenzy
* Maurice Fernez
* Technisub
* Oscar Gugen
* Heinke
* HeinrichsWeikamp
* Johnson Outdoors
* Mares
* Morse Diving
* Nemrod
* Oceanic Worldwide
* Porpoise
* Sub Sea Systems
* Shearwater Research
* Siebe Gorman
* Submarine Products
* Suunto

Diving support equipment

| Access equipment|

* Boarding stirrup
* Diver lift
* Diving bell
* Diving ladder
* Diving platform (scuba)
* Diving stage
* Downline
* Jackstay
* Launch and recovery system
* Messenger line
* Moon pool

|

Breathing gas
handling|

* Air filtration
* Activated carbon
* Hopcalite
* Molecular sieve
* Silica gel
* Booster pump
* Carbon dioxide scrubber
* Cascade filling system
* Diver's pump
* Diving air compressor
* Diving air filter
* Water separator
* High pressure breathing air compressor
* Low pressure breathing air compressor
* Gas blending
* Gas blending for scuba diving
* Gas panel
* Gas reclaim system
* Gas storage bank
* Gas storage quad
* Gas storage tube
* Helium analyzer
* Nitrox production
* Membrane gas separation
* Pressure swing adsorption
* Oxygen analyser
* Oxygen compatibility

Decompression
equipment|

* Built-in breathing system
* Decompression tables
* Diving bell
* Bell cursor
* Closed bell
* Clump weight
* Launch and recovery system
* Wet bell
* Diving chamber
* Diving stage
* Recreational Dive Planner
* Saturation system

Platforms|

* Dive boat
* Canoe and kayak diving
* Combat Rubber Raiding Craft
* Liveaboard
* Subskimmer
* Diving support vessel
* HMS Challenger (K07)

| Underwater
habitat|

* Aquarius Reef Base
* Continental Shelf Station Two
* Helgoland Habitat
* Jules' Undersea Lodge
* Scott Carpenter Space Analog Station
* SEALAB
* Tektite habitat

|

Remotely operated
underwater vehicles|

* 8A4-class ROUV
* ABISMO
* Atlantis ROV Team
* CURV
* Deep Drone
* Épaulard
* Global Explorer ROV
* Goldfish-class ROUV
* Kaikō ROV
* Kaşif ROUV
* Long-Term Mine Reconnaissance System
* Mini Rover ROV
* OpenROV
* ROV KIEL 6000
* ROV PHOCA
* Scorpio ROV
* Sea Dragon-class ROV
* Seabed tractor
* Seafox drone
* Seahorse ROUV
* SeaPerch
* SJT-class ROUV
* T1200 Trenching Unit
* VideoRay UROVs

Safety equipment|

* Diver down flag
* Diving shot
* Hyperbaric lifeboat
* Hyperbaric stretcher
* Jackstay
* Jonline
* Reserve gas supply

General|

* Diving spread
* Air spread
* Saturation spread
* Hot water system
* Sonar
* Underwater acoustic positioning system
* Underwater acoustic communication

Freediving

| Activities|

* Aquathlon
* Apnoea finswimming
* Freediving
* Haenyeo
* Pearl hunting
* Ama
* Snorkeling
* Spearfishing
* Underwater football
* Underwater hockey
* Underwater ice hockey
* Underwater rugby
* Underwater target shooting

|

Competitions|

* Nordic Deep
* Vertical Blue
* Disciplines
* Constant weight (CWT)
* Constant weight without fins (CNF)
* Dynamic apnea (DYN)
* Dynamic apnea without fins (DNF)
* Free immersion (FIM)
* No-limits apnea (NLT)
* Static apnea (STA)
* Skandalopetra diving
* Variable weight apnea (VWT)
* Variable weight apnea without fins

Equipment|

* Diving mask
* Diving suit
* Hawaiian sling
* Polespear
* Snorkel (swimming)
* Speargun
* Swimfins
* Monofin
* Water polo cap

Freedivers|

* Deborah Andollo
* Peppo Biscarini
* Sara Campbell
* Derya Can Göçen
* Goran Čolak
* Carlos Coste
* Robert Croft
* Mandy-Rae Cruickshank
* Yasemin Dalkılıç
* Leonardo D'Imporzano
* Flavia Eberhard
* Şahika Ercümen
* Emma Farrell
* Francisco Ferreras
* Pierre Frolla
* Flavia Eberhard
* Mehgan Heaney-Grier
* Elisabeth Kristoffersen
* Loïc Leferme
* Enzo Maiorca
* Jacques Mayol
* Audrey Mestre
* Karol Meyer
* Stéphane Mifsud
* Alexey Molchanov
* Natalia Molchanova
* Dave Mullins
* Patrick Musimu
* Guillaume Néry
* Herbert Nitsch
* Umberto Pelizzari
* Annelie Pompe
* Michal Risian
* Stig Severinsen
* Tom Sietas
* Aharon Solomons
* Martin Štěpánek
* Walter Steyn
* Tanya Streeter
* William Trubridge
* Devrim Cenk Ulusoy
* Danai Varveri
* Alessia Zecchini
* Nataliia Zharkova

Hazards|

* Barotrauma
* Drowning
* Freediving blackout
* Deep-water blackout
* Shallow-water blackout
* Hypercapnia
* Hypothermia

Historical|

* Ama
* Octopus wrestling
* Swimming at the 1900 Summer Olympics – Men's underwater swimming

Organisations|

* AIDA International
* Scuba Schools International
* Australian Underwater Federation
* British Freediving Association
* Confédération Mondiale des Activités Subaquatiques
* Fédération Française d'Études et de Sports Sous-Marins
* Performance Freediving International

Professional diving

| Occupations|

* Ama
* Commercial diver
* Commercial offshore diver
* Hazmat diver
* Divemaster
* Diving instructor
* Diving safety officer
* Diving superintendent
* Diving supervisor
* Haenyeo
* Media diver
* Police diver
* Public safety diver
* Scientific diver
* Underwater archaeologist

| Military diving|

* Army engineer diver
* Clearance diver
* Frogman
* List of military diving units
* Royal Navy ships diver
* Special Boat Service
* United States military divers
* U.S. Navy diver
* U.S.Navy master diver
* United States Navy SEALs
* Underwater Demolition Team

|

Underwater work|

* Commercial offshore diving
* Dive leader
* Diver training
* Recreational diver training
* Hyperbaric welding
* Media diving
* Nondestructive testing
* Pearl hunting
* Police diving
* Potable water diving
* Public safety diving
* Scientific diving
* Ships husbandry
* Sponge diving
* Submarine pipeline
* Underwater archaeology
* Archaeology of shipwrecks
* Underwater construction
* Offshore construction
* Underwater demolition
* Underwater photography
* Underwater search and recovery
* Underwater videography

| Salvage diving|

* SS Egypt
* Kronan
* La Belle
* SS Laurentic
* RMS Lusitania
* Mars
* Mary Rose
* USS Monitor
* HMS Royal George
* Vasa

|

Diving contractors|

* COMEX
* Helix Energy Solutions Group

Tools & equipment|

* Abrasive waterjet
* Airlift
* Baited remote underwater video
* In-water surface cleaning
* Brush cart
* Cavitation cleaning
* Pressure washing
* Pigging
* Lifting bag
* Remotely operated underwater vehicle
* Thermal lance
* Tremie
* Water jetting

Underwater
weapons|

* Limpet mine
* Speargun
* Hawaiian sling
* Polespear

| Underwater
firearm|

* Gyrojet
* Mk 1 Underwater Defense Gun
* Powerhead
* Underwater pistols
* Heckler & Koch P11
* SPP-1 underwater pistol
* Underwater revolvers
* AAI underwater revolver
* Underwater rifles
* ADS amphibious rifle
* APS underwater rifle
* ASM-DT amphibious rifle

|

Recreational diving

| Specialties|

* Altitude diving
* Cave diving
* Deep diving
* Ice diving
* Muck diving
* Open-water diving
* Rebreather diving
* Sidemount diving
* Solo diving
* Technical diving
* Underwater photography
* Wreck diving

|

Diver
organisations|

* British Sub-Aqua Club (BSAC)
* Cave Divers Association of Australia (CDAA)
* Cave Diving Group (CDG)
* Comhairle Fo-Thuinn (CFT)
* Confédération Mondiale des Activités Subaquatiques (CMAS)
* Federación Española de Actividades Subacuáticas (FEDAS)
* Fédération Française d'Études et de Sports Sous-Marins (FFESSM)
* International Association for Handicapped Divers (IAHD)
* National Association for Cave Diving (NACD)
* Woodville Karst Plain Project (WKPP)

Diving tourism
industry|

* Dive center
* Environmental impact of recreational diving
* Scuba diving tourism
* Shark tourism
* Sinking ships for wreck diving sites

Diving events
and festivals|

* Diversnight
* Underwater Bike Race

Recreational
dive sites|

| Reef diving
regions|

* Aliwal Shoal Marine Protected Area
* Arrecifes de Cozumel National Park
* Edmonds Underwater Park
* Great Barrier Reef
* iSimangaliso Marine Protected Area
* Poor Knights Islands
* Table Mountain National Park Marine Protected Area

|

Reef dive
sites|

* Artificial reef
* Gibraltar Artificial Reef
* Shark River Reef
* Osborne Reef
* Fanadir
* Gamul Kebir
* Palancar Reef
* Underwater artworks
* Cancún Underwater Museum
* Christ of the Abyss
* Molinere Underwater Sculpture Park

Wreck diving
regions|

* Chuuk Lagoon
* Edmonds Underwater Park
* Finger Lakes Underwater Preserve Association
* Maritime Heritage Trail – Battle of Saipan
* Michigan Underwater Preserves
* Robben Island Marine Protected Area
* Table Mountain National Park Marine Protected Area
* Tulagi
* Tulamben
* Whitefish Point Underwater Preserve
* Wreck Alley, San Diego

Wreck dive
sites|

* HMS A1
* HMS A3
* USS Aaron Ward
* Abessinia
* Aeolian Sky
* Albert C. Field
* Andrea Doria
* Antilla
* Antilles
* Aquila
* USS Arkansas
* Bianca C.
* SS Binnendijk
* HMS Boadicea
* Booya
* HMSAS Bloemfontein
* Breda
* HMAS Brisbane
* HMHS Britannic
* Bungsberg
* HMAS Canberra
* Carl D. Bradley
* Carnatic
* SMS Dresden
* Dunraven
* Eastfield
* HMT Elk
* Ellengowan
* RMS Empress of Ireland
* HMS Falmouth
* Fifi
* SS Francisco Morazan
* Fujikawa Maru
* Fumizuki
* SATS General Botha
* USNS General Hoyt S. Vandenberg
* HMS Ghurka
* Glen Strathallan
* SAS Good Hope
* Gothenburg
* Herzogin Cecilie
* Hilma Hooker
* Hispania
* HMS Hood
* HMAS Hobart
* Igara
* James Eagan Layne
* Captain Keith Tibbetts
* King Cruiser
* SMS Kronprinz
* Kyarra
* HMS Laforey
* USAT Liberty
* Louis Sheid
* USS LST-507
* SMS Markgraf
* Mikhail Lermontov
* HMS M2
* Maine
* Maloja
* HMS Maori
* Marguerite
* SS Mauna Loa
* USAT Meigs
* Mendi
* USCGC Mohawk
* Mohegan
* RMS Moldavia
* HMS Montagu
* MV RMS Mulheim
* Nagato
* Oceana
* USS Oriskany
* Oslofjord
* P29
* P31
* Pedernales
* Persier
* HMAS Perth
* SAS Pietermaritzburg
* Piłsudski
* Pool Fisher
* HMS Port Napier
* Preußen
* President Coolidge
* PS Queen Victoria
* Radaas
* Rainbow Warrior
* RMS Rhone
* Rondo
* Rosehill
* Rotorua
* Royal Adelaide
* Royal Charter
* Rozi
* HMS Safari
* Salem Express
* USS Saratoga
* USS Scuffle
* HMS Scylla
* HMS Sidon
* USS Spiegel Grove
* Stanegarth
* Stanwood
* Stella
* HMAS Swan
* USS Tarpon
* Thesis
* Thistlegorm
* Toa Maru
* Torrey Canyon
* SAS Transvaal
* U-40
* U-352
* U-1195
* Um El Faroud
* Varvassi
* Walter L M Russ
* Washingtonian (1913)
* HMNZS Wellington
* USS Yancey
* Yongala
* Zenobia
* Zealandia
* Zingara

Cave diving
sites|

* Blauhöhle
* Chinhoyi Caves
* Devil's Throat at Punta Sur
* Engelbrecht Cave
* Fossil Cave
* Jordbrugrotta
* Piccaninnie Ponds
* Pluragrotta
* Pollatoomary
* Sistema Ox Bel Ha
* Sistema Sac Actun
* Sistema Dos Ojos
* Sistema Nohoch Nah Chich

Freshwater
dives|

* Dutch Springs
* Ewens Ponds
* Little Blue Lake

Training sites|

* Capernwray Dive Centre
* Deepspot
* National Diving and Activity Centre
* Stoney Cove

Open ocean
diving|

* Blue-water diving
* Black-water diving

Diving safety

* Human factors in diving equipment design
* Human factors in diving safety
* Life-support system
* Safety-critical system
* Scuba diving fatalities

| Diving
hazards|

* List of diving hazards and precautions
* Environmental
* Current
* Delta-P
* Entanglement hazard
* Overhead
* Silt out
* Wave action
* Equipment
* Freeflow
* Use of breathing equipment in an underwater environment
* Failure of diving equipment other than breathing apparatus
* Single point of failure
* Physiological
* Cold shock response
* Decompression
* Nitrogen narcosis
* Oxygen toxicity
* Seasickness
* Uncontrolled decompression
* Diver behaviour and competence
* Lack of competence
* Overconfidence effect
* Panic
* Task loading
* Trait anxiety
* Willful violation

| Consequences|

* Barotrauma
* Decompression sickness
* Drowning
* Hypothermia
* Hypoxia
* Hypercapnia
* Hyperthermia

|

Diving
procedures|

* Ascending and descending
* Emergency ascent
* Boat diving
* Canoe and kayak diving
* Buddy diving
* buddy check
* Decompression
* Decompression practice
* Pyle stop
* Ratio decompression
* Dive briefing
* Dive log
* Dive planning
* Scuba gas planning
* Diver communications
* Diving hand signals
* Diving line signals
* Diver voice communications
* Diver rescue
* Diver training
* Doing It Right
* Drift diving
* Gas blending for scuba diving
* Night diving
* Solo diving
* Water safety

Risk
management|

* Checklist
* Hazard identification and risk assessment
* Hazard analysis
* Job safety analysis
* Risk assessment
* Risk control
* Hierarchy of hazard controls
* Incident pit
* Lockout–tagout
* Permit To Work
* Redundancy
* Safety data sheet
* Situation awareness

| Diving team|

* Bellman
* Chamber operator
* Diver medical technician
* Diver's attendant
* Diving supervisor
* Diving systems technician
* Gas man
* Life support technician
* Stand-by diver

|

Equipment
safety|

* Breathing gas quality
* Testing and inspection of diving cylinders
* Hydrostatic test
* Sustained load cracking
* Diving regulator
* Breathing performance of regulators

Occupational
safety and
health|

* Approaches to safety
* Job safety analysis
* Risk assessment
* Toolbox talk
* Housekeeping
* Association of Diving Contractors International
* Code of practice
* Contingency plan
* Diving regulations
* Emergency procedure
* Emergency response plan
* Evacuation plan
* Hazardous Materials Identification System
* Hierarchy of hazard controls
* Administrative controls
* Engineering controls
* Hazard elimination
* Hazard substitution
* Personal protective equipment
* International Marine Contractors Association
* Occupational hazard
* Biological hazard
* Chemical hazard
* Physical hazard
* Psychosocial hazard
* Occupational hygiene
* Exposure assessment
* Occupational exposure limit
* Workplace health surveillance
* Safety culture
* Code of practice
* Diving safety officer
* Diving superintendent
* Health and safety representative
* Operations manual
* Safety meeting
* Standard operating procedure

Diving medicine

| Diving
disorders|

* List of signs and symptoms of diving disorders
* Cramp
* Motion sickness
* Surfer's ear

| Pressure
related|

* Alternobaric vertigo
* Barostriction
* Barotrauma
* Air embolism
* Aerosinusitis
* Barodontalgia
* Dental barotrauma
* Pulmonary barotrauma
* Compression arthralgia
* Decompression illness
* Dysbarism

| Oxygen|

* Freediving blackout
* Hyperoxia
* Hypoxia
* Oxygen toxicity

|

Inert gases|

* Avascular necrosis
* Decompression sickness
* Isobaric counterdiffusion
* Taravana
* Dysbaric osteonecrosis
* High-pressure nervous syndrome
* Hydrogen narcosis
* Nitrogen narcosis

Carbon dioxide|

* Hypercapnia
* Hypocapnia

Breathing gas
contaminants|

* Carbon monoxide poisoning

Immersion
related|

* Asphyxia
* Drowning
* Hypothermia
* Immersion diuresis
* Instinctive drowning response
* Laryngospasm
* Salt water aspiration syndrome
* Swimming-induced pulmonary edema

Treatment|

* Demand valve oxygen therapy
* First aid
* Hyperbaric medicine
* Hyperbaric treatment schedules
* In-water recompression
* Oxygen therapy
* Therapeutic recompression

Personnel|

* Diving Medical Examiner
* Diving Medical Practitioner
* Diving Medical Technician
* Hyperbaric nursing

Screening|

* Atrial septal defect
* Effects of drugs on fitness to dive
* Fitness to dive
* Psychological fitness to dive

Research|

| Researchers in
diving physiology
and medicine|

* Arthur J. Bachrach
* Albert R. Behnke
* Paul Bert
* George F. Bond
* Robert Boyle
* Albert A. Bühlmann
* John R. Clarke
* Guybon Chesney Castell Damant
* Kenneth William Donald
* William Paul Fife
* John Scott Haldane
* Robert William Hamilton Jr.
* Leonard Erskine Hill
* Brian Andrew Hills
* Felix Hoppe-Seyler
* Christian J. Lambertsen
* Simon Mitchell
* Charles Momsen
* John Rawlins R.N.
* Charles Wesley Shilling
* Edward D. Thalmann
* Jacques Triger

|

Diving medical
research
organisations|

* Aerospace Medical Association
* Divers Alert Network (DAN)
* Diving Diseases Research Centre (DDRC)
* Diving Medical Advisory Council (DMAC)
* European Diving Technology Committee (EDTC)
* European Underwater and Baromedical Society (EUBS)
* National Board of Diving and Hyperbaric Medical Technology
* Naval Submarine Medical Research Laboratory
* Royal Australian Navy School of Underwater Medicine
* Rubicon Foundation
* South Pacific Underwater Medicine Society (SPUMS)
* Southern African Underwater and Hyperbaric Medical Association (SAUHMA)
* Undersea and Hyperbaric Medical Society (UHMS)
* United States Navy Experimental Diving Unit (NEDU)

Law

* Civil liability in recreational diving
* Diving regulations
* Duty of care
* List of legislation regulating underwater diving
* Investigation of diving accidents
* UNESCO Convention on the Protection of the Underwater Cultural Heritage

History of underwater diving

* History of decompression research and development
* History of scuba diving
* List of researchers in underwater diving
* Timeline of diving technology
* Underwater diving in popular culture

| Archeological
sites|

* SS Commodore
* USS Monitor
* Queen Anne's Revenge
* Whydah Gally

|

Underwater art
and artists|

* The Diver
* Jason deCaires Taylor

Engineers
and inventors|

* William Beebe
* Georges Beuchat
* John R. Clarke
* Jacques Cousteau
* Charles Anthony Deane
* John Deane
* Ted Eldred
* Henry Fleuss
* Émile Gagnan
* Joseph-Martin Cabirol
* Christian J. Lambertsen
* Yves Le Prieur
* John Lethbridge
* Ernest William Moir
* Joseph Salim Peress
* Auguste Piccard
* Willard Franklyn Searle
* Augustus Siebe
* Jacques Triger

Equipment|

* Aqua-Lung
* RV Calypso
* SP-350 Denise
* Nikonos
* Porpoise regulator
* Standard diving dress
* Vintage scuba

Military and
covert operations|

* Raid on Alexandria (1941)
* Sinking of the Rainbow Warrior

Scientific projects|

* 1992 cageless shark-diving expedition
* Mission 31

Incidents|

| Dive boat incidents|

* Sinking of MV Conception
* Fire on MV Red Sea Aggressor

|

Diver rescues|

* Alpazat cave rescue
* Tham Luang cave rescue

Early diving|

* John Day (carpenter)
* Charles Spalding
* Ebenezer Watson

Freediving fatalities|

* Loïc Leferme
* Audrey Mestre
* Nicholas Mevoli
* Natalia Molchanova

Offshore
diving incidents|

* Byford Dolphin diving bell accident
* Drill Master diving accident
* Star Canopus diving accident
* Stena Seaspread diving accident
* Venture One diving accident
* Waage Drill II diving accident
* Wildrake diving accident

Professional
diving fatalities|

* Roger Baldwin
* John Bennett
* Victor F. Guiel Jr.
* Craig M. Hoffman
* Peter Henry Michael Holmes
* Johnson Sea Link accident
* Edwin Clayton Link
* Gerard Anthony Prangley
* Pier Skipness
* Robert John Smyth
* Albert D. Stover
* Richard A. Walker
* Lothar Michael Ward
* Joachim Wendler
* Bradley Westell
* Arne Zetterström

Scuba diving
fatalities|

* Ricardo Armbruster
* Allan Bridge
* David Bright
* Berry L. Cannon
* Cotton Coulson
* Cláudio Coutinho
* E. Yale Dawson
* Deon Dreyer
* Milan Dufek
* Sheck Exley
* Maurice Fargues
* Fernando Garfella Palmer
* Guy Garman
* Steve Irwin
* Jim Jones
* Henry Way Kendall
* Artur Kozłowski
* Chris and Chrissy Rouse
* Kirsty MacColl
* Agnes Milowka
* François de Roubaix
* Dave Shaw
* Wesley C. Skiles
* Dewey Smith
* Rob Stewart
* Esbjörn Svensson
* Josef Velek

Publications

| Manuals|

* NOAA Diving Manual
* U.S. Navy Diving Manual
* Basic Cave Diving: A Blueprint for Survival
* Underwater Handbook
* Bennett and Elliott's physiology and medicine of diving
* Encyclopedia of Recreational Diving
* The new science of skin and scuba diving
* Professional Diver's Handbook
* Basic Scuba

|

Standards and
Codes of Practice|

* Code of Practice for Scientific Diving (UNESCO)
* DIN 7876
* IMCA Code of Practice for Offshore Diving
* ISO 24801 Recreational diving services — Requirements for the training of recreational scuba divers

General non-fiction|

* The Darkness Beckons
* Goldfinder
* The Last Dive
* Shadow Divers
* The Silent World: A Story of Undersea Discovery and Adventure

Research|

* List of Divers Alert Network publications

Dive guides|

Training and registration

| Diver
training|

* Competence and assessment
* Competency-based learning
* Refresher training
* Skill assessment
* Diver training standard
* Diving instructor
* Diving school
* Occupational diver training
* Commercial diver training
* Military diver training
* Public safety diver training
* Scientific diver training
* Recreational diver training
* Introductory diving
* Teaching method
* Muscle memory
* Overlearning
* Stress exposure training

| Skills|

* Combat sidestroke
* Diver navigation
* Diver trim
* Ear clearing
* Frenzel maneuver
* Valsalva maneuver
* Finning techniques
* Scuba skills
* Buddy breathing
* Low impact diving
* Diamond Reef System
* Surface-supplied diving skills
* Underwater searches

|

Recreational
scuba
certification
levels|

| Core diving skills|

* Advanced Open Water Diver
* Autonomous diver
* CMAS* scuba diver
* CMAS** scuba diver
* Introductory diving
* Low Impact Diver
* Master Scuba Diver
* Open Water Diver
* Supervised diver

|

Leadership skills|

* Dive leader
* Divemaster
* Diving instructor
* Master Instructor

Specialist skills|

* Rescue Diver
* Solo diver

Diver training
certification
and registration
organisations|

* European Underwater Federation (EUF)
* International Diving Regulators and Certifiers Forum (IDRCF)
* International Diving Schools Association (IDSA)
* International Marine Contractors Association (IMCA)
* List of diver certification organizations
* National Oceanic and Atmospheric Administration (NOAA)
* Nautical Archaeology Society
* Universal Referral Program
* World Recreational Scuba Training Council (WRSTC)

| Commercial diver
certification
authorities|

* Australian Diver Accreditation Scheme (ADAS)
* Commercial diver registration in South Africa
* Divers Institute of Technology
* Health and Safety Executive (HSE)
* Department of Employment and Labour

|

Commercial diving
schools|

* Divers Academy International
* Norwegian diver school

Free-diving
certification
agencies|

* AIDA International (AIDA)
* Confédération Mondiale des Activités Subaquatiques (CMAS)
* Performance Freediving International (PI)
* Scuba Schools International (SSI)

Recreational scuba
certification
agencies|

* American Canadian Underwater Certifications (ACUC)
* American Nitrox Divers International (ANDI)
* Association nationale des moniteurs de plongée (ANMP)
* British Sub-Aqua Club (BSAC)
* Comhairle Fo-Thuinn (CFT)
* Confédération Mondiale des Activités Subaquatiques (CMAS)
* Federación Española de Actividades Subacuáticas (FEDAS)
* Fédération Française d'Études et de Sports Sous-Marins (FFESSM)
* Federazione Italiana Attività Subacquee (FIAS)
* Global Underwater Explorers (GUE)
* International Association for Handicapped Divers (IAHD)
* International Association of Nitrox and Technical Divers (IANTD)
* International Diving Educators Association (IDEA)
* Israeli Diving Federation (TIDF)
* National Academy of Scuba Educators (NASE)
* National Association of Underwater Instructors (NAUI)
* Nederlandse Onderwatersport Bond (NOB)
* Professional Association of Diving Instructors (PADI)
* Professional Diving Instructors Corporation (PDIC)
* Sub-Aqua Association (SAA)
* Scuba Diving International (SDI)
* Scuba Educators International (SEI)
* Scottish Sub Aqua Club (ScotSAC)
* Scuba Schools International (SSI)
* Türkiye Sualtı Sporları Federasyonu (TSSF)
* United Diving Instructors (UDI)
* YMCA SCUBA Program

Scientific diver
certification
authorities|

* American Academy of Underwater Sciences (AAUS)
* CMAS Scientific Committee

Technical
certification
agencies|

* American Nitrox Divers International (ANDI)
* British Sub-Aqua Club (BSAC)
* Confédération Mondiale des Activités Subaquatiques (CMAS)
* Diving Science and Technology (DSAT)
* Federazione Italiana Attività Subacquee (FIAS)
* International Association of Nitrox and Technical Divers (IANTD)
* Professional Association of Diving Instructors (PADI)
* Professional Diving Instructors Corporation (PDIC)
* Trimix Scuba Association (TSA)
* Technical Extended Range (TXR)

| Cave
diving|

* Cave Divers Association of Australia (CDAA)
* Cave Diving Group (CDG)
* Global Underwater Explorers (GUE)
* National Association for Cave Diving (NACD)
* National Speleological Society#Cave Diving Group (CDG)
* National Association of Underwater Instructors (NAUI)
* Technical Diving International (TDI)

|

Underwater sports

| Surface snorkeling|

* Finswimming

|

Snorkeling/breath-hold|

* Spearfishing
* Underwater football
* Underwater hockey
* Australia
* Turkey
* Underwater rugby
* Colombia
* United States
* Underwater target shooting

Breath-hold|

* Aquathlon
* Apnoea finswimming
* Freediving
* Underwater ice hockey

Open Circuit Scuba|

* Immersion finswimming
* Sport diving
* Underwater cycling
* Underwater orienteering
* Underwater photography

Rebreather|

* Underwater photography

Sports governing
organisations
and federations|

* International
* AIDA International
* Confédération Mondiale des Activités Subaquatiques)
* National
* AIDA Hellas
* Australian Underwater Federation
* British Freediving Association
* British Octopush Association
* British Underwater Sports Association
* Comhairle Fo-Thuinn
* Federación Española de Actividades Subacuáticas
* Fédération Française d'Études et de Sports Sous-Marins
* South African Underwater Sports Federation
* Türkiye Sualtı Sporları Federasyonu
* Underwater Society of America)

Competitions|

* 14th CMAS Underwater Photography World Championship

Underwater divers

| Pioneers
of diving|

* Eduard Admetlla i Lázaro
* Aquanaut
* James F. Cahill
* Jacques Cousteau
* Billy Deans
* Dottie Frazier
* Hans Hass
* Dick Rutkowski
* Teseo Tesei
* Arne Zetterström

|

Underwater
scientists
archaeologists and
environmentalists|

* Michael Arbuthnot
* Robert Ballard
* George Bass
* Mensun Bound
* Louis Boutan
* Hugh Bradner
* Cathy Church
* Eugenie Clark
* James P. Delgado
* Sylvia Earle
* John Christopher Fine
* George R. Fischer
* Anders Franzén
* Honor Frost
* Fernando Garfella Palmer
* David Gibbins
* Graham Jessop
* Swietenia Puspa Lestari
* Pilar Luna
* Robert F. Marx
* Anna Marguerite McCann
* Innes McCartney
* Charles T. Meide
* David Moore
* Mark M. Newell
* Lyuba Ognenova-Marinova
* John Peter Oleson
* Mendel L. Peterson
* Richard Pyle
* William R. Royal
* Margaret Rule
* Gunter Schöbel
* Stephanie Schwabe
* Myriam Seco
* E. Lee Spence
* Robert Sténuit
* Peter Throckmorton

Scuba record
holders|

* Pascal Bernabé
* Jim Bowden
* Mark Ellyatt
* Sheck Exley
* Nuno Gomes
* Claudia Serpieri
* Krzysztof Starnawski

Underwater
filmmakers
and presenters|

* Samir Alhafith
* David Attenborough
* Ramón Bravo
* Jean-Michel Cousteau
* Richie Kohler
* Ivan Tors
* Andrew Wight

Underwater
photographers|

* Tamara Benitez
* Georges Beuchat
* Adrian Biddle
* Jonathan Bird
* Eric Cheng
* Neville Coleman
* Jacques Cousteau
* John D. Craig
* Ben Cropp
* Bernard Delemotte
* David Doubilet
* John Christopher Fine
* Dermot FitzGerald
* Rodney Fox
* Ric Frazier
* Stephen Frink
* Peter Gimbel
* Monty Halls
* Hans Hass
* Henry Way Kendall
* Rudie Kuiter
* Joseph B. MacInnis
* Luis Marden
* Agnes Milowka
* Noel Monkman
* Steve Parish
* Zale Parry
* Pierre Petit
* Leni Riefenstahl
* Peter Scoones
* Brian Skerry
* Wesley C. Skiles
* E. Lee Spence
* Philippe Tailliez
* Ron Taylor
* Valerie Taylor
* Albert Tillman
* John Veltri
* Stan Waterman
* Michele Westmorland
* John Ernest Williamson
* J. Lamar Worzel

Underwater
explorers|

* Caves
* Graham Balcombe
* Sheck Exley
* Martyn Farr
* Jochen Hasenmayer
* Jill Heinerth
* Jarrod Jablonski
* William Hogarth Main
* Tom Mount
* Jack Sheppard
* Bill Stone
* Reefs
*   * Wrecks
* Leigh Bishop
* John Chatterton
* Clive Cussler
* Bill Nagle
* Aristotelis Zervoudis

Aquanauts|

* Andrew Abercromby
* Joseph M. Acaba
* Clayton Anderson
* Richard R. Arnold
* Serena Auñón-Chancellor
* Michael Barratt (astronaut)
* Robert L. Behnken
* Randolph Bresnik
* Timothy J. Broderick
* Justin Brown
* Berry L. Cannon
* Scott Carpenter
* Gregory Chamitoff
* Steve Chappell
* Catherine Coleman
* Robin Cook
* Craig B. Cooper
* Fabien Cousteau
* Philippe Cousteau
* Timothy Creamer
* Jonathan Dory
* Pedro Duque
* Sylvia Earle
* Jeanette Epps
* Sheck Exley
* Albert Falco
* Andrew J. Feustel
* Michael Fincke
* Satoshi Furukawa
* Ronald J. Garan Jr.
* Michael L. Gernhardt
* Christopher E. Gerty
* David Gruber
* Chris Hadfield
* Jeremy Hansen
* José M. Hernández
* John Herrington
* Paul Hill
* Akihiko Hoshide
* Mark Hulsbeck
* Emma Hwang
* Norishige Kanai
* Les Kaufman
* Scott Kelly
* Karen Kohanowich
* Timothy Kopra
* Dominic Landucci
* Jon Lindbergh
* Kjell N. Lindgren
* Michael López-Alegría
* Joseph B. MacInnis
* Sandra Magnus
* Thomas Marshburn
* Matthias Maurer
* K. Megan McArthur
* Craig McKinley
* Jessica Meir
* Simone Melchior
* Dorothy Metcalf-Lindenburger
* Andreas Mogensen
* Karen Nyberg
* John D. Olivas
* Takuya Onishi
* Luca Parmitano
* Nicholas Patrick
* Tim Peake
* Thomas Pesquet
* Marc Reagan
* Garrett Reisman
* Kathleen Rubins
* Dick Rutkowski
* Tara Ruttley
* David Saint-Jacques
* Josef Schmid
* Robert Sheats
* Dewey Smith
* Steve Squyres
* Heidemarie Stefanyshyn-Piper
* Robert Sténuit
* Hervé Stevenin
* Nicole Stott
* James Talacek
* Daniel M. Tani
* Robert Thirsk
* Bill Todd
* Mark T. Vande Hei
* Koichi Wakata
* Rex J. Walheim
* Shannon Walker
* John Morgan Wells
* Joachim Wendler
* Douglas H. Wheelock
* Peggy Whitson
* Dafydd Williams
* Jeffrey Williams
* Sunita Williams
* Gregory R. Wiseman
* Kimiya Yui

Writers and journalists|

* Michael C. Barnette
* Victor Berge
* Philippe Diolé
* Gary Gentile
* Bret Gilliam
* Bob Halstead
* Trevor Jackson
* Steve Lewis
* John Mattera

Rescuers|

* Craig Challen
* Richard Harris
* Rick Stanton
* John Volanthen

Frogmen|

* Lionel Crabb

Commercial salvors|

* Keith Jessop

Science of underwater diving

| Diving
physics|

* Breathing performance of regulators
* Buoyancy
* Archimedes' principle
* Neutral buoyancy
* Concentration
* Diffusion
* Molecular diffusion
* Force
* Oxygen fraction
* Permeation
* Psychrometric constant
* Solubility
* Henry's law
* Saturation
* Solution
* Supersaturation
* Surface tension
* Hydrophobe
* Surfactant
* Temperature
* Torricellian chamber
* Underwater acoustics
* Modulated ultrasound
* Underwater vision
* Snell's law
* Underwater computer vision
* Weight
* Apparent weight

| Gas laws|

* Amontons's law
* Boyle's law
* Charles's law
* Combined gas law
* Dalton's law
* Gay-Lussac's law
* Ideal gas law

|

Pressure|

* Absolute pressure
* Ambient pressure
* Atmospheric pressure
* Gauge pressure
* Hydrostatic pressure
* Metre sea water
* Partial pressure

Diving
physiology|

* Artificial gills
* Cold shock response
* Diving reflex
* Equivalent narcotic depth
* Lipid
* Maximum operating depth
* Metabolism
* Physiological response to water immersion
* Tissue
* Underwater vision

| Circulatory
system|

* Blood shift
* Patent foramen ovale
* Perfusion
* Pulmonary circulation
* Systemic circulation

|

Decompression
theory|

* Decompression models:
* Bühlmann decompression algorithm
* Haldane's decompression model
* Reduced gradient bubble model
* Thalmann algorithm
* Thermodynamic model of decompression
* Varying Permeability Model
* Equivalent air depth
* Equivalent narcotic depth
* Oxygen window in diving decompression
* Physiology of decompression

Respiration|

* Blood–air barrier
* Breathing
* CO₂ retention
* Dead space
* Gas exchange
* Hypocapnia
* Respiratory exchange ratio
* Respiratory quotient
* Respiratory system
* Work of breathing

Diving
environment|

| Classification|

* List of diving environments by type
* Altitude diving
* Benign water diving
* Confined water diving
* Deep diving
* Inland diving
* Inshore diving
* Muck diving
* Night diving
* Open-water diving
* Black-water diving
* Blue-water diving
* Penetration diving
* Cave diving
* Ice diving
* Wreck diving
* Recreational dive sites
* Underwater environment

|

Impact|

* Environmental impact of recreational diving
* Low impact diving

Environmental
factors|

* Algal bloom
* Currents:
* Current
* Longshore drift
* Ocean current
* Rip current
* Tidal race
* Undertow
* Upwelling
* Ekman transport
* Halocline
* Reef
* Coral reef
* Stratification
* Thermocline
* Tides
* Turbidity
* Wind wave
* Breaking wave
* Surf
* Surge
* Wave shoaling

Other

* Bathysphere
* Defense against swimmer incursions
* Diver detection sonar
* Offshore survey
* Underwater domain awareness

| Awards and events|

* Hans Hass Award
* International Scuba Diving Hall of Fame
* London Diving Chamber Dive Lectures
* NOGI Awards

|

Deep-submergence
vehicle|

* Aluminaut
* DSV Alvin
* American submarine NR-1
* Bathyscaphe
* Archimède
* FNRS-2
* FNRS-3
* FNRS-4
* Harmony class bathyscaphe
* Sea Pole-class bathyscaphe
* Trieste II
* Deepsea Challenger
* Ictineu 3
* JAGO
* Jiaolong
* Konsul-class submersible
* DSV Limiting Factor
* Russian submarine Losharik
* Mir
* Nautile
* Pisces-class deep submergence vehicle
* DSV Sea Cliff
* DSV Shinkai
* DSV Shinkai 2000
* DSV Shinkai 6500
* DSV Turtle
* DSV-5 Nemo

| Deep-submergence
rescue vehicle|

* LR5
* LR7
* MSM-1
* Mystic-class deep-submergence rescue vehicle
* DSRV-1 Mystic
* DSRV-2 Avalon
* NATO Submarine Rescue System
* Priz-class deep-submergence rescue vehicle
* Russian deep submergence rescue vehicle AS-28
* Russian submarine AS-34
* ASRV Remora
* SRV-300
* Submarine Rescue Diving Recompression System
* Type 7103 DSRV
* URF (Swedish Navy)

|

Special
interest
groups|

* Artificial Reef Society of British Columbia
* CMAS Europe
* Coral Reef Alliance
* Diving Equipment and Marketing Association
* Divers Alert Network
* Green Fins
* Historical Diving Society
* Karst Underwater Research
* Nautical Archaeology Program
* Nautical Archaeology Society
* Naval Air Command Sub Aqua Club
* Project AWARE
* Reef Check
* Reef Life Survey
* Rubicon Foundation
* Save Ontario Shipwrecks
* SeaKeys
* Sea Research Society
* Society for Underwater Historical Research
* Society for Underwater Technology
* Underwater Archaeology Branch, Naval History & Heritage Command

Submarine escape
and rescue|

* Escape trunk
* International Submarine Escape and Rescue Liaison Office
* McCann Rescue Chamber
* Submarine Escape and Rescue system (Royal Swedish Navy)
* Submarine escape training facility
* Submarine Escape Training Facility (Australia)
* Submarine rescue ship

Neutral buoyancy
facilities for
Astronaut training|

* Neutral Buoyancy Laboratory
* Neutral buoyancy pool
* Neutral buoyancy simulation as a training aid
* Neutral Buoyancy Simulator
* Space Systems Laboratory
* Yuri Gagarin Cosmonaut Training Center

Other|

* Nautilus Productions

* Category
* Commons
*   * Glossary
* Indexes: dive sites
* divers
* diving
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Lifesaving and lifeguarding

International standards bodies|

* International Lifesaving Federation
* International Liaison Committee on Resuscitation

National societies|

* DLRG
* Lifesaving South Africa
* Royal Life Saving Society Australia
* Royal Life Saving Society Canada
* Royal Life Saving Society UK
* Royal Life Saving Society Commonwealth
* Surf Life Saving Australia
* Surf Life Saving New Zealand
* United States Lifesaving Association
* RFESS - Royal Spanish Lifesaving Association
* Wasserwacht

Sub-national societies|

* The Hong Kong Life Saving Society

Topics|

* Lifesaving
* Lifesaving (sport)
* Lifeguard
* Surf lifesaving
* First aid
* Cardiopulmonary resuscitation
* Drowning chain
* Rip current

Awards|

* Lifesaving Medal
* Albert Medal for lifesaving
* Bronze Medallion
* Bronze Cross
* National Lifeguard

Life-saving appliances|

* Lifebuoy
* Rescue buoy
* Throw bag
* Life saving reel
* IRB
* Surf ski
* Paddle board

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