Drowning in the elderly in Paraíba-Brazil

Drowning is a global problem, and is among the main causes of death in the world, and the elderly are part of this new reality as a special group who also suffer submersion accidents. The aim of this study was to analyze deaths due to drowning in the elderly in the state of Paraíba from 2005 to 2015. This is a retrospective, descriptive study associated with spatial analysis of regions with a higher incidence of drowning in people aged 60 years or older in the state of Paraíba. Data were collected from the IML (Gemol and Numol) records from 2005 to 2015, totaling 80 cases of drowning. Sociodemographic characteristics such as age group, gender, spatiality and local description of the occurrence (rivers, dams, sea, waterfall, cacimbas, dams and domestic environments), care provider, file of the Legal Medical Institute of the Scientific Police, international code of diseases – ICD 10 (code W74), shift of occurrence. As results we located the region of Mari sector of the wild region of Paraíba – Açude Olho D’agua (Latitude 7.11º S and Longitude 35.2º ), was the place with the highest number of drownings, where dams/lakes (55%), male (91%), married (46%), aged between 60 and 69 years (60%), the local population made the first care (41%), 14h was of higher occurrence (11%), and on Sundays (29%). We can conclude that drowning occurs in several aquatic scenarios, and in this study occurred in fresh water, several factors were associated with drowning in the elderly, such as cognition deficits, polypharmaceuticals and physical limitations, such outcomes can help encourage protection policies for this group as well as family members guide in freshwater regions and accentuate care.

It is necessary to point out that a drowning situation requires some skills to get away from it.
The human being, in order to remain on the surface, struggles desperately, holding his breath in an attempt not to vacuum liquid. This whole scenario worsens when the drowning victim is an elderly person, the difficulty of effective reaction in this situation is clear. Muscle strength is diminished over the years, as well as its ability to stay on the surface. Their decreased respiratory capacity and body fragility are aggravating factors for the effective risk of drowning, so these points are addressed, we need to adequately investigate the profile of these elderly who drowned (JOOST, 2016).
The main objective of this study was to analyze the incidence of drowning death in the state of Paraíba between 2005 and 2015, trying to evaluate and answer society questions associated with drowning in this special group.

TYPE OF STUDY
This is a retrospective and documentary ecological study of convenience. According to Gallacher (2001) an ecological study is one in which the unit of analysis is a population or a group of people who usually belong to a defined geographical area and seek to assess how social and environmental contexts can affect the health of the population. It is also intended to use spatial statistics in the present study, since it aims to identify phenomena whose distribution is affected by its geographical location and its relationship with its neighbors. Through this method it is possible to model the occurrence of phenomena, incorporating, for example, the determining factors, the spatial distribution structure or the identification of patterns. Patos, in which data were collected from the other municipalities of this state.

POPULATION AND SAMPLE
The population was composed of elderly people aged 60 years or older, who had deaths reported from January 1, 2005 to December 31, 2015, and whose cadavers were admitted to the death verification services from the various regions of the state of Paraíba, with cadaveric determination of death by drowning, according to a report issued by a coroner of the Institute of Legal Medicine of the state , and documented in the service's own form.

INCLUSION AND EXCLUSION CRITERIA
We included all reported cases of drowning deaths, which occurred within 72 hours after the incident, of older people aged 60 years or older who whose GEMOL and NUMOL identification records contained the following items: gender, age, place of occurrence (Rio, dam, waterfall or domicile), municipality of occurrence. For exclusion criteria: cases that were involved with In the attendance forms were also described the cardiac conditions as the presence of calcification on examination and reduction of cardiac mass, the cadaveric data observed in the study showed the presence of cadaveric stiffness (65%), cold skin (100%), water in the respiratory tract (100%), anserine skin (90%), foam mushroom (67%), contents inside the larynx/trachea was foamy with thrubbery residues (54%), presence of liquid content inside the stomach (100%), putrefaction was observed in 12% of cases.
It was the local population who made the first care to the victim in 43.21% of the cases, followed by family members and acquaintances (14%), third to the military police (13%), firefighters (9%) and SAMU (3%).