Epidemiological aspects of drowning and non-fatal drowning in the waters of Amsterdam.

We examined who, when, and where people non-fatally drowned of drowned in Amsterdam between January 2011 and December 2015 so that in the future more targeted and effective measures can be taken to prevent drowning. Data on non fatal drownings (N = 515, fire department database) were combined with the forensic medicine data on drowning fatalities (N=88). Who drowns in Amsterdam? The majority of those who drowned were men (82%). A high percentage of the people who drowned were under the influence of alcohol or drugs (up to 55%). No children drowned in the Canal District during the study period. The majority of those who drowned in the Canal District (67%) were not official inhabitants of Amsterdam (e.g., tourists and homeless people.) When do people non-fatally drown in Amsterdam? Forty-seven percent of the non-fatal drownings in the Canal District occurred on Saturday and Sunday nights between midnight and six o'clock in the morning. No specific hot times could be defined for other parts of Amsterdam. Where do people non-fatally drown or drown in Amsterdam? Compared to the non-fatal drownings, there are fewer drowning casus in the Canal District than in other parts of Amsterdam. Given the high number of non-fatal drownings and the remaining drownings in the Canal District, further prevention is necessary and should focus on hot times and hotspots. Additional measures must be taken to enable those who fall into the canals to climb out.

External foam and the post-mortem period in freshwater drowning; results from a retrospective study in Amsterdam, the Netherlands.

INTRODUCTION: Determining the time of death of bodies recovered from water can be difficult. A feature of drowning is the presence of external foam. This study describes the presence of external foam in relation to the post-mortem period. METHOD: The study utilizes a database of death reports dated between January 2011 and July 2016. For bodies recovered from fresh water, the presence or absence of external foam was noted. RESULTS: In this study, 112 death reports are included. Of these reports, 18 mentioned external foam, which account for 16.1% of the entire study population. In the population with a post-mortem period of less than 24 h, external foam was detected in 27.7% of cases. All 18 incidents with external foam had an estimated post-mortem period of less than 24 h. CONCLUSION: In our study, external foam was only present in freshwater drowning cases with a post-mortem period of less than 24 h. Based on this finding, the presence of external foam may be useful as an additional indicator when estimating the time of death in freshwater drowning.

[Recognising positional asphyxia: not always the cause of death in victims in an unusual position]. / Herkennen van positionele asfyxie.

Deceased individuals may be found in a position that raises the question of whether or not the individual died from being in that position. We describe 3 victims of 35, 84 and 54 years of age, respectively. All were found in an unusual position that may have impeded breathing. Breathing may be impaired by compression of the thoracic wall or by extrathoracic airway obstruction caused by the position. Reduced independence, with causes varying from dementia to inebriation, is a risk factor for positional asphyxia. Restraining a person in the so-called "hogtie position" does not lead to positional asphyxia. Positional asphyxiation in individuals dying in the hogtie position must not be confused with excited delirium syndrome (EDS). On the other hand, the diagnosis of positional asphyxia must be seriously considered in deceased individuals found in a position that may impede breathing.

[Dyspnoea caused by upper-airway obstruction: simple diagnosis by establishing a flow-volume loop]. / Dyspneu door vernauwing in de bovenste luchtwegen: eenvoudige diagnostiek met een flowvolumecurve.

Three patients, men aged 72, 78 and 19 years, experienced shortness of breath and laboured breathing. All three had an upper-airway obstruction detected by a flow-volume loop and confirmed by bronchoscopy. The first patient had oesophageal carcinoma with vocal-cord paralysis and soon died. The second patient had a large struma; flow-volume loop improved after strumectomy. The third patient was diagnosed with extragonadal testicular carcinoma. The flow-volume loop improved after the first chemotherapy session. Flow-volume loop is an easy, non-invasive diagnostic tool that can be used even in severely-ill patients. It can provide information about the location of the obstruction and can differentiate between obstructive pulmonary disease and upper-airway obstruction. Therefore, it is recommended to obtain a flow-volume loop during the assessment of patients with upper airway obstruction.