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Drowning is a type of suffocation induced by the submersion of the mouth and nose in a liquid. Submersion injury refers to both drowning and near-miss incident. Most instances of fatal drowning occur alone or in situations where others present are either unaware of the victim's situation or unable to offer assistance. After successful resuscitation, drowning victims may experience breathing problems, confusion, or unconsciousness. Occasionally, victims may not begin experiencing these symptoms until several hours after they are rescued. An incident of drowning can also cause further complications for victims due to low body temperature, aspiration, or acute respiratory distress syndrome. Drowning is more likely to happen when spending extended periods of time near large bodies of water. Risk factors for drowning include alcohol use, drug use, epilepsy, minimal swim training or a complete lack of training, and, in the case of children, a lack of supervision. Common drowning locations include natural and man-made bodies of water, bathtubs, and swimming pools. Drowning occurs when a person spends too much time with their nose and mouth submerged in a liquid to the point of being unable to breathe. If this is not followed by an exit to the surface, low oxygen levels and excess carbon dioxide in the blood trigger a neurological state of breathing emergency, which results in increased physical distress and occasional contractions of the vocal folds. Significant amounts of water usually only enter the lungs later in the process. While the word "drowning" is commonly associated with fatal results, drowning may be classified into three different types: drowning that results in death, drowning that results in long-lasting health problems, and drowning that results in no health complications. Sometimes the term "near-drowning" is used in the latter cases. Among children who survive, health problems occur in about 7.5% of cases. Steps to prevent drowning include teaching children and adults to swim and to recognise unsafe water conditions, never swimming alone, use of personal flotation devices on boats and when swimming in unfavourable conditions, limiting or removing access to water, and exercising appropriate supervision. Treatment of victims who are not breathing should begin with opening the airway and providing five breaths of mouth-to-mouth resuscitation. Cardiopulmonary resuscitation (CPR) is recommended for a person whose heart has stopped beating and has been underwater for less than an hour.