In New Zealands early colonial history, so many settlers died while trying to cross the rivers that drowning was called "the New Zealand death. "People have drowned in as little as 30 mm (1.2 in) of water while lying face down. Children have drowned in baths, buckets, and toilets. People who are inebriated or otherwise intoxicated can drown in puddles. Death can occur due to complications following an initial drowning. Inhaled fluid can act as an irritant inside the lungs. Even small quantities can cause the extrusion of liquid into the lungs (pulmonary edema) over the following hours; this reduces the ability to exchange the air and can lead to a person "drowning in their own body fluid." Vomit and certain poisonous vapors or gases (as in chemical warfare) can have a similar effect. The reaction can take place up to 72 hours after the initial incident and may lead to a serious injury or death. Risk factors
Many behavioral and physical factors are related to drowning:
Drowning is the most common cause of death for people with seizure disorders, largely in bathtubs. Epileptics 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. The use of alcohol increases the risk of drowning across developed and developing nations. Alcohol is involved in approximately 50% of fatal drownings, and 35% of non-fatal drownings. Inability to swim can lead to drowning. Participation in formal swimming lessons can reduce this risk.
The rescuer must bring the victim to the surface by grabbing either (or both) of the victims arms and swimming upward, which may entice the victim to travel in the same direction, thus making the task easier, especially in the case of an unconscious victim. Should the victim be located in deeper waters (or simply complicates matters too much) the rescuer should dive, take the victim from behind, and ascend vertically to the water surface holding the victim. After a successful contact with the victim, any ballast (such as weight belt) should be discarded. Finally, the victim must be taken out of the water, which is achieved by a towing maneuver. This is commonly done placing the victim body in a face-up horizontal position, passing one hand under the victims armpit to then grab the jaw with it, and towing by swimming backwards. The victims mouth and nose must be kept above the water surface. If the person is cooperative, the towing may be done in a similar fashion with the hands going under the victims armpits. Other styles of towing are possible, but all of them keeping the victims mouth and nose above the water. Unconscious people may be pulled in an easier way: pulling on a wrist or on the shirt while they are in a face-up horizontal position.