FEDERAL COLLEGE OF EDUCATION

P.M.B 1026 OKENE,

KOGI STATE

DEPT: HEALTH EDUCATION

COURSE CODE: HEE 204

COURSE TITLE: FIRST AID AND SPORT INJURY

LEVEL: 200L

ASSIGNMENT

S/NO NAMES MATRIC NO

1 ALIYU ZULEIHAT OYIZA UI/OK/015916
2 HARUNA OYIZA AMINAT UI/OK/015917
3 MUHAMMED FULELA UI/OK/015918
4 ORUMAH BLESSING JUMAI UI/OK/015919
QUESTION:

i. Discuss first aid for accident and sudden illness

ii. Injury caused by electric shock and light
ii. Drowning
iii. Asphyxia and accident in falling earth
iv. Injury to soft tissues, joint and bone

LECTURER IN CHARGE

MRS. L.A OGIRIMA

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First aid is the assistance given to any person suffering a sudden illness or injury,with care
provided to preserve life, prevent the condition from worsening, and/or promote recovery. It
includes initial intervention in a serious condition prior to professional medical help being
available, such as performing CPR while awaiting an ambulance, as well as the complete
treatment of minor conditions, such as applying a plaster to a cut.

FIRST AID TIPS YOU SHOULD KNOW IN CASE OF A ROAD-TRAFFIC ACCIDENT

1. Check yourself first: If you have been injured in the accident, first check yourself for
any injuries. Try to assess how well you can move your limbs, and if you experience symptoms
such as dizziness etc. Remember you need to be fit enough to help the others.
2. Check the other person(s) for injuries: If other people are injured, first assess the extent of
his/ her injuries. For e.g. is he bleeling from the head, neck, arms legs, abdomen back etc. Treat
the quietest person first, they are usually more seriously injured or cannot breathe. People who
can talk or scream, on the other hand, can breathe therefore can be treated a little later. Ask for
the patient’s name, if he responds, it means he is able to understand the situation and has most
likely not suffered a severe head injury.
3. Look for signs of breathing: Next, check if the person is breathing and if he has a pulse.
4. Call for help: Immediately call for an ambulance or rush the person to a hospital. Once you
know more about the patient’s condition you will in a better position to tell the doctors about
his/her condition.
5. Check for obstructions in the person’s mouth and throat: If you do not hear any breath
sounds, check his/her mouth for any obstructions. If there is something obstructing the airway,
use your index and middle finger to clear the airway.
6. Perform life saving techniques: If there is no pulse, start CPR or EAR. Keep the person’s
neck straight to start EAR (External Air Resuscitation) or CPR (Cardio pulmonary resuscitation).
There are 3 types of EAR; Mouth-to-mouth, Mouth-to-Nose, Mouth-to-Mask. You could read
more about how to perform EAR and CPR here.
7. Ways to help him/her in grave situations: If there is bleeding from the mouth or the patient
is vomiting, turn the person to his/her side. This will avoid any chances of the person choking.
Place the person’s arm that is under him straight out and the arm closest to you across his chest.

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8. Deal with open wounds: If there are extensive wounds, try to control the bleeding using
pressure to the area using a cloth. Press down with your palms rather than your finger tips. You
can also read about first aid measures for fractures.
9. Always suspect spinal injuries: If the person’s neck is in an awkward position (not normally
placed) or the person is unconscious, do not move the patient. Get help immediately. This could
mean that the person’s neck is broken, and moving him/her in such a situation can cause more
harm than good.
10. Keep the person warm: Usually accident victims feel excessively cold due to shock.
Therefore keeping them warm is essential to survival. You can use whatever you have to do this,
such as a T-shirt, jacket, etc.
11. Avoid feeding the person: Do not give the person any water, food or other fluids through
the mouth, it could lead to the patient choking.

ACCIDENT FOR SUDDEN ILLNESS

What are General Signs and Symptoms of Sudden Illness?
Changes in level of consciousness
Headache, dizziness, weakness
Nausea or vomiting
Change in breathing, pulse, skin color, or temperature
What are Common Sudden Illnesses?
-Fainting
-Diabetic emergencies
-Seizures
-Stroke
-Allergic Reactions & Poisoning
-Heart attack

How do you Care for Sudden Illness?

-Do no harm
-Monitor breathing and consciousness

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-Check head to toe for other injuries
-Reassure the victim
-Care for shock; keep the victim from getting chilled or overheated.
-Call EMS personnel, if needed.
Fainting?
Signs & Symptoms
-Change in level of consciousness
-Shock like signs and symptom
-Looking and feeling ill
Care
-Position the person on a flat surface
-Elevate the legs
-Monitor breathing and consciousness
-Loosen clothing
-Call 9-1-1 as needed
Diabetic Emergencies
Signs and Symptoms
-Change in level of consciousness
-Irregular breathing/abnormal heartbeat (pulse)
-Looking and feeling ill

Care
-Care for any life-threatening conditions
-If the victim is conscious, give a substance containing sugar
-Keep the victim from getting chilled or overheated
-Call 9-1-1 as needed
Seizures
Signs & Symptoms
-Sudden loss of body control
-Feeling or looking ill
-Changes in level of consciousness

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Care
-Protect the victim from injury
-Do not restrain the victim
-Monitor breathing and pulse
-Position the victim so that fluids can drain from the mouth
-Reassure the victim
-Call EMS if needed
Stroke
Signs & Symptoms
-Looking or feeling ill
-Sudden weakness and numbness of the face, arm or leg
-Difficulty talking or speaking
-Blurred or dimmed vision
-Sudden severe headache, dizziness, confusion, or ringing in the ears
-Loss of consciousness
-Loss of bowl or bladder control

Care
-Check for life threatening conditions (airway, pulse, etc)
-FAST (Face - Arms - Speech - Time)
What are ways poison enters the body?
-Inhalation
-Ingestion
-Absorption
-Injection
Signs and Symptoms of Poisoning
The Scene
-Odors
-Open/empty/spilled containers
-Flames/smoke

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-Overturned/damaged plants

The Victim
-Nausea/vomiting/diarrhea
-Chest/abdominal pain
-Breathing difficulty
-Sweating profusely
-Weakness
-Changes in level of consciousness
-Burns in/around the mouth
-Irregular pupil size
-Convulsions/dizziness
Care for Poisoning
-Check the scene/gather clues
-Remove the victim from the source
-Check for life-threatening conditions
-Call 9-1-1
-Poison Control Center: 1- 800-222-1222
Bites & Stings
Bites and Stings are among the most common forms of injected poisons.
Some of the most common types of bites and stings are from:
-Insects
-Ticks
-Spiders, Scorpions & Snakes
-Domestic and wild Animals
-Humans
Common Bites & Stings of Insects
Signs & Symptoms
-A bite or sting mark
-A stinger, tentacle or venom sac left behind
-Redness

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-Swelling
-Pain or tenderness

Care
-Examine the sting site
-If the stinger is still present, remove it to prevent further poisoning.
-Wash the area with soap and water and cover the site, then apply ice or a cold pack
-Observe the victim for signals of allergic reaction
Allergic Reaction: Anaphylaxis
Signs & Symptoms
-Itching or hives
-Red watery eyes
-Coughing, wheezing, or difficulty breathing
-Throat tightness or closing or difficulty swallowing
-Nausea, stomach cramps, or vomiting
-Change in voice
-Dizziness, fainting or loss of consciousness
-Change of skin color
-Sense of doom

Care
-Use Epinephrine Auto-Injector
-Call 9-1-1
-Monitor Airway & Breathing
Misused & Abused Substances
-Substances are categorized according to their effect on the body.

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 ELECTRICAL INJURIES
Electrical injury is damage caused by generated electrical current passing through the body.
Symptoms range from skin burns, damage to internal organs and other soft tissues to cardiac
arrhythmias and respiratory arrest. Diagnosis is based on history, clinical criteria, and selective
laboratory testing. Treatment is supportive, with aggressive care for severe injuries.
Although accidental electrical injuries encountered in the home (eg, touching an electrical outlet
or getting shocked by a small appliance) rarely result in significant injury or sequelae, accidental
exposure to high voltage results in about 400 deaths annually in the US. There are > 30,000
nonfatal shock incidents/yr in the US and electrical burns account for about 5% of admissions to
burn units in the US.
Electrical devices that touch or may be touched by the body should be properly insulated,
grounded, and incorporated into circuits containing protective circuit-breaking equipment.
Ground-fault circuit breakers, which trip when as little as 5 mA of current leaks to ground, are
effective and readily available. Outlet guards reduce risk in homes with infants or young
children.
Prehospital care
The first priority is to break contact between the patient and the current source by shutting off the
current (eg, by throwing a circuit breaker or switch, by disconnecting the device from its
electrical outlet). High- and low-voltage power lines are not always easily differentiated,
particularly outdoors. Caution: If power lines could be high voltage, no attempts to disengage the
patient should be made until the power is shut off.
Resuscitation
Patients are resuscitated while being assessed. Shock, which may result from trauma or massive
burns, is treated. Standard burn fluid resuscitation formulas, which are based on the extent of
skin burns, may underestimate the fluid requirement in electrical burns; thus, such formulas are
not used. Instead, fluids are titrated to maintain adequate urine output (about 100 mL/h in adults
and 1.5 mL/kg/h in children). For myoglobinuria, maintaining adequate urine output is
particularly important, while alkalinizing the urine may help decrease the risk of renal failure.
Surgical debridement of large amounts of muscle tissue may also help to decrease myoglobinuric
renal failure.
Severe pain due to an electrical burn is treated by the judicious titration of IV opioids.
Other measures
Asymptomatic patients who are not pregnant, have no known heart disorders, and who have had
only brief exposure to household current usually have no significant acute internal or external
injuries that would necessitate admission and can be discharged.
Cardiac monitoring for 6 to 12 h is indicated for patients with the following conditions:

DROWNING
Drowning is defined as respiratory impairment from being in or under a liquid. It is further
classified by outcome into: death, ongoing health problems, and no ongoing health problems.
Drowning itself is quick and silent, although it may be preceded by distress which is more
visible.

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Generally, in the early stages of drowning, very little water enters the lungs: a small amount of
water entering the trachea causes a muscular spasm that seals the airway and prevents the
passage of both air and water until unconsciousness occurs. This means a person drowning is
unable to shout or 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. Lifeguards
and other persons trained in rescue learn to recognize drowning people by watching for these
movements. If the process is not interrupted, loss of consciousness due to hypoxia is followed
rapidly by cardiac arrest. At this stage, the process is still usually reversible by prompt and
effective rescue and first aid. Survival rates depend strongly on the duration of immersion.
DROWNING
 Someone is drowning
1. Get Help
 Notify a lifeguard, if one is close. If not, ask someone to call 911.
 If you are alone, follow the steps below.
2. Move the Person
 Take the person out of the water.
3. Check for Breathing
 Place your ear next to the person's mouth and nose. Do you feel air on your cheek?
 Look to see if the person's chest is moving.
4. If the Person is Not Breathing, Check Pulse
 Check the person's pulse for 10 seconds.
5. If There is No Pulse, Start CPR
Carefully place person on back.
 For an adult or child, place the heel of one hand on the center of the chest at the nipple
line. You can also push with one hand on top of the other. For an infant, place two fingers
on the breastbone.
 For an adult or child, press down about 2 inches. Make sure not to press on ribs. For an
infant, press down about 1 and 1/2 inches. Make sure not to press on the end of the
breastbone.

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  Do 30 chest compressions, at the rate of 100 per minute or more. Let the chest rise
completely between pushes.
 Check to see if the person has started breathing.
Note that these instructions are not meant to replace CPR training. Classes are available through
the American Red Cross, local hospitals, and other organizations.
6. Repeat if Person Is Still Not Breathing
 If you've been trained in CPR, you can now open the airway by tilting the head back and
lifting the chin.
 Pinch the nose of the victim closed. Take a normal breath, cover the victim's mouth with
yours to create an airtight seal, and then give 2 one-second breaths as you watch for the
chest to rise.
 Give 2 breaths followed by 30 chest compressions.
 Continue this cycle of 30 compressions and 2 breaths until the person starts breathing or
emergency help arrives.
TREATMENT FOR DROWNING
Rescue breaths
Open the airway
After the first 30 chest compressions, place one hand on their forehead. Place two fingers under
the tip of their chin and gently tilt their neck back. This will open their airway.
1. To open your child's airway,
gently tilt her head back with one hand, and lift her chin with the other. Put your ear to the child's
mouth and nose, and look, listen, and feel for signs that she is breathing.
2. If your child doesn't seem to be breathing>
Infants under age 1: Place your mouth over infant's nose and lips and give two breaths, each
lasting about 1? seconds. Look for the chest to rise and fall. Children 1 and older: Pinch child's
nose and seal your lips over her mouth. Give two slow, full breaths (1? to 2 seconds each). Wait
for the chest to rise and fall before giving the second breath.
3 If the chest rises,
check for a pulse (see number 4). If the chest doesn't rise, try again. Retilt the head, lift the
child's chin, and repeat the breaths.

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4. Check for a pulse
Put two fingers on your child's neck to the side of the Adam's apple (for infants, feel inside the
arm between the elbow and shoulder). Wait five seconds. If there is a pulse, give one breath
every three seconds. Check for a pulse every minute, and continue rescue breathing until the
child is breathing on her own or help arrives.
5. If you can't find a pulse
Infants under age 1: Imagine a line between the child's nipples, and place two fingers just
below its centerpoint. Apply five half-inch chest compressions in about three seconds. After five
compressions, seal your lips over your child's mouth and nose and give one breath. Children 1
and older: Use the heel of your hand (both hands for a teenager or adult) to apply five quick
one-inch chest compressions to the middle of the breastbone (just above where the ribs come
together) in about three seconds. After five compressions, pinch your child's nose, seal your lips
over his mouth, and give one full breath.
ASPHYXIA AND ACCIDENT IN FALLING EARTH
Motor vehicle related trauma is one of the leading causes of traumatic death. Although most of
these deaths are because of severe blunt force trauma, there are people without severe injury who
die of asphyxia related to the motor vehicle collision. There were 37 deaths because of motor
vehicle related asphyxia in San Diego County during 1995-2004. Almost half (48.6%) of these
deaths were because of compression asphyxia, 29.7% were positional asphyxia deaths, and
16.2% died of a combination of compression and positional asphyxia. We were unable to classify
the mechanism of asphyxia for the remaining 5.4% of asphyxia deaths. Almost all occupants
dying from asphyxia were involved in rollover crashes and may have been incapacitated by
obesity, drug or alcohol intoxication, or blunt force trauma. Compression asphyxia deaths
occurred both from vehicle crush with intrusion into the passenger compartment and from
ejection of the occupant and subsequent crushing by the vehicle. Positional asphyxia occurred in
positions interfering with normal respiration, including inversion. None of the occupants had
injury severe enough to result in death at the scene if they had not first died of asphyxia. This
study suggests classifying the mechanism of asphyxia for these fatalities may be a challenge to
forensic pathologists who seldom see these rare deaths.

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WHAT IS A SOFT TISSUE INJURY?
Soft tissue injuries (STI) are when trauma or overuse occurs to muscles, tendons or ligaments.
Most soft tissue injuries are the result of a sudden unexpected or uncontrolled movement like
stepping awkwardly off a curb and rolling over your ankle. These are injures we see every day at
our Edinburgh physiotherapy and sports injury clinics. However, soft tissue damage can also
occur from excessive overuse or chronically fatigued structures, especially muscles and tendons.
For example, if you were to do a long run when already fatigued (from a previous run or
exercise), then it is possible to cause trauma or a strain to key running musculoskeletal structures
like your calf muscles or achilles tendons, also see: “How to prevent running injuries”.
What is the difference between a strain and a sprain?
Tendons are fibrous bands that attach muscles to bone. Trauma to muscles or tendons due to
overstretching is referred to as a ‘strain’. Ligaments are also fibrous bands that hold bones
together. Trauma by over-stretching of ligaments is referred to as a ‘sprain’. Strains and sprains
are both very common, and can occur from accidents during sport, at home or at work.
What are the symptoms of soft tissue injuries?
When soft tissue is damaged, there is usually immediate pain along with immediate or delayed
swelling (excessive swelling can slow the healing process – see treatment below). Stiffness is
also very common as a result of the trauma and swelling. Bruising may also develop after 24-48
hours.
In the case of moderate to severe soft tissue injuries of muscles, tendons and ligaments around a
joint, there may be instability experienced, especially to weight bearing joints like the hip, knee
and ankle.
How long will it take to recover from a soft tissue injury?
The recovery time from grade 1 soft tissue injuries in one to two weeks and three to four weeks
for a grade 2. Grade three soft tissue injuries require immediate assessment and treatment, with
much longer recovery times. Recovery times can also depend on your age, general health and
occupation. If you are not sure of the nature or extent of your injury, contact an experienced
Specialist Physiotherapist for advice.
TREATMENT FOR SOFT TISSUE INJURIES:
There are principally three stages of treatment and recovery from soft tissue injuries like ankle
sprains

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Stage one: During the first 24-72 hours, it is important to protect the injured area, gain an
accurate diagnosis and follow the PRICE regime (see below). If possible, gentle pain free
movement should be encouraged.
Stage two: Reduce swelling and stiffness and begin to regain normal movement.
Stage three: Regaining of normal function and return to normal activities.

Injury to Bone, Muscle and Joint

Musculo-Skeletal Injury describes a myriad of injuries to muscles, joints and their supporting
structures and Physiotherapy has much to offer in the first 48 hours following an injury. Patients
most frequently present for physiotherapy with pains, aches or stiffness which interferes with
normal life. These problems include
 Joint pain + stiffness e.g. frozen shoulder, rotator cuff impingement syndromes, arthritic
knees, patellofemoral pain syndromes
 Back and Neck injuries e.g. facet joint pain, prolapsed disc, sciatica, arm pain /pins and
needles
 Sports Injuries e.g. acute hamstring pull, calf strain, IT band syndrome, (runners knee),
ligament injury and post surgical repair
 Foot or ankle pain following acute ligament sprain, painful flat feet from collapsed arches,
plantar fasciitis or heel pain, ruptured tendoachilles
 Chronic Pain Syndromes and Posture related imbalance syndromes, e.g. Repetative Strain
Injury (RSI)
 Pain can result from normal wear and tear espically in people over 40. It is normal for the
collagen in our tissues to become less elastic over time and this can result in minor
abnormalities in the way our joints move or how the tissues function. These tissues,
when subjected to apparently minor trauma can become injured and result in pain i.e.
bending to tie shoe laces resulting in debilitating Low Back Pain, clipping a hedge resulting
in shoulder pain.
 Injury can occur from overload or overuse espically when performing repetative activity.
This type of injury can occur suddenly at home and on the sports field as in lifting a heavy
weight, reaching to catch something or can come on gradually over months like the shoulder
tendonitis and 'frozen' shoulder. Other frequent injuries which fall into this category will

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 include Tennis and Golfers elbow, Rotator Cuff tendinosis, Repeatative Strain Injury in the
arms of the computer worker and carpel tunnel syndrome.
 Direct trauma such as falling in the garden, a collision on the sports field or in a road traffic
accident can result in a myriad of injuries and may include fracture, crucuate or ankle
ligament sprain, tear or rupture of muscle and tendon, "dead Leg" and "stinger". This type of
injury requires immediate first aid, Protect ,Rest, Ice, Compression and Elevation (PRICE)
and your physiotherapist can help from very early on, speeding recovery. Once the acute
phase of repair has occured evidence based medicine reports that early movement and normal
contraction of muscle accelerates healing. Physiotherapy has much to offer in the first 48
hours following soft tissue injury. Bone fracture usually requires a period of immobilization
in a cast or brace but early movement, under the supervision of your physiotherapist once the
cast is removed is vital to speed recovery. This holds through whether you have broken your
wrist, your leg or fractured a small bone in your foot.
 Hospital Consultants and GP's frequently referr patients to Sandymount Physio for follow up
treatment. Our physiotherapists will liase direcly with referring doctors and follow
recognised protocols of treatment with you following hip, knee and shoulder joint
replacement surgery, ligament repair, shoulder tendon and labral repairs. Physiotherapists
can assist with regaining shoulder movement following breast surgery and mastectomy.
 At the end of treatment or in the event of a slower than expected recovery it is our policy to
provide written reports of findings and treatment to the referring doctor and to update a
consultant as requested by the client.
What are the types of injuries?
The most common leg and arm injuries are fractures, sprains, strains, and bruises. Some injuries
can be treated at home, while others need to be treated or checked by your healthcare provider.
Read the injury descriptions below and follow the instructions for care.
Fractures
A fracture is a break or crack in the bone and needs to be treated by a doctor. If you think your
child has a broken bone, follow the first aid instructions below.
First Aid
 Shoulder or arm: Use a sling made of a triangular piece of cloth. A cold pack may help.
Drive your child to the doctor.

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  Leg: Use padded boards, pillows, or newspapers to splint the fracture. At a minimum,
carry your child and don't permit your child to put any weight on the leg. A cold pack
may help. Drive your child to the doctor.
 Neck: Protect the neck from any turning or bending. Do not move your child until a neck
brace or spine board has been applied. Call a rescue squad (911) for help.
Sprains
Sprains are stretches or tears of ligaments (bands of tissue that connect one bone to another).
They are caused by sudden twisting injuries and require medical attention (unless they are very
mild). Knees and ankles are often sprained.
First Aid
 Immediately wrap the injured area with an elastic bandage and put ice on the injury to
reduce bleeding, swelling, and pain.
 While some mild sprains can be cared for at home, most injuries to ligaments need to be
checked by your healthcare provider. You can drive your child to the doctor.
Home Care
Treat most sports injuries with R.I.C.E. (rest, ice, compression, and elevation) for the first 24 to
48 hours.
 Apply compression with a snug, elastic bandage for 48 hours. Numbness, tingling, or
increased pain means the bandage is too tight.
 Apply a cold pack or crushed ice in a plastic bag for 20 minutes. Avoid frostbite. Repeat
every hour for 4 hours.
 Give acetaminophen or ibuprofen as needed for pain relief. Continue for at least 48 hours.
 Keep injured ankle or knee elevated and at rest for 24 hours. After 24 hours, allow any
activity that doesn't cause pain.
 After 48 hours, you can use a heating pad for 10 minutes a few times per day to help
absorb the blood.
Strains
Strains are stretches, pulls, or tears of muscles. They are usually caused by overexertion (for
example, when several muscles hurt after a strenuous practice, athletic game, or long hike). Most
muscle injuries can be cared for safely at home.
Home Care
 Put an ice bag or cold pack on the area for 20 minutes. Repeat this 3 to 4 times the first
day.
 Give your child acetaminophen or ibuprofen for at least 48 hours.
 If stiffness continues after 48 hours, have your child soak in a hot bath. If the pain is in
one particular area, use a heating pad or hot compresses. Apply heat for 10 minutes 3
times a day until it improves.

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Your child should learn about stretching exercises and return to exercise gradually. Next time,
your child should be in better condition before going full throttle. Getting back in condition takes
at least 7 days.
Bruises
Bruises of muscles are the most common injury in contact sports and can also be treated at home.
Bone bruises usually follow direct blows to the bone in exposed areas (for example, the elbow,
hip, or knee) and are usually minor injuries.
Home Care
 Put an ice bag or cold pack on the area for 20 minutes. Repeat this 3 to 4 times the first
day. After 48 hours apply heat with a heating pad or hot compresses for 10 minutes 3
times a day.
 Give your child acetaminophen or ibuprofen for severe pain.
 Rest the injured part as much as possible. The pain usually starts to ease after 48 hours,
but there may be some discomfort for 2 weeks.
When should I call my child's healthcare provider?
Call IMMEDIATELY if:
 The bone is deformed or crooked.
 Your child won't use an arm normally (especially if the injury occurred after someone
pulled on the arm). Young children who won't straighten the elbow or turn the palm up
usually have a partial dislocation of the elbow.
 Your child won't stand on the injured leg.
 The pain is severe.
 Your child can't walk without pain and a limp.

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 REFERENCES
Written by Barton D. Schmitt, MD, author of “My Child Is Sick,” American Academy of
Pediatrics Books. Published by RelayHealth.
Copyright ©2014 McKesson Corporation and/or one of its subsidiaries. All rights
reserved.

E.F. van Beeck; C.M. Branche; D. Szpilman; J.H. Modell; J.J.L.M. Bierens (2005), A new
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problem, 83, Bulletin of the World Health Organization (published 11 November 2005),
pp. 801–880, retrieved 19 July 2012

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: p. 14. Retrieved 29 December 2010.

O'Connell, Claire (3 August 2010). "What stops people shouting and waving when drowning?".
Irish Times. Retrieved 29 December 2010.

Global Burden of Disease Study 2013, Collaborators (22 August 2015). "Global, regional, and
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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
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