Nonfatal Drowning in People with Parkinson's Disease

We read with great interest the recent case report by Tosserams and colleagues ¹ on a 56‐year‐old proficient swimmer and the decline in his swimming abilities attributed to Parkinson's disease.

We also appreciate the earlier article by Neves and colleagues ² on the risk of drowning in people with Parkinson's disease. We applaud the authors for raising awareness of drowning as a consequence of a decline in swimming abilities, particularly in the context of Parkinson's disease. Our concern, and reason for corresponding, is the continued use of outdated terminology in the title and text of both articles, namely the term near drowning.

In 2003, an advisory statement of the International Liaison Committee on Resuscitation recommending the use of a uniform way of reporting data on drowning: the “Recommended Guidelines for Uniform Reporting of Data from Drowning: The ‘Utstein Style’” was published ³ with an update in 2017. ⁴ This consensus‐based document was created to provide more consistency in describing drowning research and improve comparability between individual studies. In this statement, drowning was defined as “a process resulting in primary respiratory impairment from submersion/immersion in a liquid medium.” Implicit in this definition is that a liquid/air interface is present at the entrance of the victim's airway, partially or completely preventing the drowned person from breathing air. The victim may live or die after this process, but whatever the outcome, he or she has been involved in a “drowning incident.”⁵ The use of the term near drowning, which was considered to be confusing, was thus abandoned. ⁵ For more than a decade, this uniform definition of drowning has been adopted by the World Health Organization, and it has also been incorporated in the European Resuscitation Council guidelines. ⁵ , ⁶ The use of outdated terminology is unfortunately not a rarity in peer‐reviewed literature, as a systematic review found that 32% of drowning‐related articles from July 2010 to January 2016 included nonuniform terminology. ⁷

We see this as an opportunity for education and hope that readers may work toward improving the use of uniform drowning terminology in practice and research so that patient treatment and data collection may be optimized. Therefore, we urge all authors to describe drowning incidents using the terminology advised by International Liaison Committee on Resuscitation and the World Health Organization. Those who survive the initial incident should be considered to have survived a nonfatal drowning. Further details on discontinued drowning terminology can be found in the documents “‘Dry Drowning' and Other Myths” ⁸ and “Non‐Fatal Drowning Terminology: Draft Position Statement.” ⁹

Author Roles

(1) Manuscript: A. Writing of the First Draft, B. Review and Critique.

A.C.Q.: 1A, 1B

J.W.: 1A, 1B

D.S.: 1A, 1B

Disclosures

Ethical Compliance Statement

The authors confirm that the approval of an institutional review board or patient consent was not required for this work. All authors confirm to have read the Journal's position on issues involved in ethical publication and affirm that this work is consistent with those guidelines.

Funding Sources and Conflict of Interest

No financial or material support was received for this research. Jonathon Webber and David Szpilman were involved in the development of the revised Utstein Style for Drowning that has been accepted for publication.

Financial Disclosures for the Previous 12 Months

Nothing to report.