Usability of Emergency Department Narratives for Describing Non-fatal Drowning in the United States, 2013-2022

Objective: To determine the usability of National Electronic Injury Surveillance System All Injury Program (NEISS-AIP) narrative data in identifying drowning circumstances, and to describe drowning-related emergency department (ED) visits in the U.S. from 2013 to 2022. Methods: We identified non-fatal unintentional drowning incidents using an expanded version of the definition used by CDC WISQARS. It includes a separate search of visits using the diagnosis of the incident and text analysis of the narratives using key words to describe drowning incidents and circumstances. Descriptive statistics of non-fatal drowning incidents and their circumstances were calculated. Results: There were 2423 ED visits representing 94 000 non-fatal drowning ED visits identified (2.90 per 100 000 persons) from 2013 to 2022. The majority of non-fatal drowning ED visits occurred among children aged 1-4 (25.78 per 100 000 children). We found over 55% of non-fatal drowning visits happened in a pool and among children 14 and younger, 28.5% were alone without an adult when the non-fatal drowning occurred. Conclusion: NEISS-AIP narrative data is unique in identifying certain characteristics of non-fatal drowning such as specific bodies of water that may not be included in other data sources. Fatal and non-fatal drowning incidents are preventable, and these data can inform implementation of effective intervention strategies.