Drowning for love: the aquatic victim-instead-of-rescuer syndrome: drowning fatalities involving those attempting to rescue a child.

Introduction: Non-intentional child drowning remains a leading cause of child mortality. A related and secondary syndrome is composed of those who drown in impulsive, altruistic attempts to go to the aid of a drowning child. Such 'rescuers' who attempt to save a drowning child may themselves drown, a tragic event we term the AVIR syndrome or aquatic victim-instead-of-rescuer.

Methods: This study is composed of a five-year (1 July 2002 to 30 June 2007) total population Australian survey, using the National Coroners Information System to identify cases and an analysis of every immersion rescuer-victim dyad where the primary 'victim' was a child and where the 'rescuer' drowned.

Results: In Australia (2002-2007), 17 rescuers drowned in 15 incidents in which the primary victim was a drowning child. In 93% of the incidents, the primary 'child-victim' survived, 82% of the victims were unfamiliar with the aquatic location (i.e. were a visitor) and 76% of the victims were a male parent, partner of first-degree relative. Alcohol was not generally involved.

Conclusion: We define the AVIR syndrome as one that typically involves the following: a male, parent, partner or relative; an unfamiliar water hazard; a 'rescuer' who is a tourist; alcohol is not usually involved; and the primary victim usually survives. We posit that an increased awareness of such risks, the promotion of rudimentary rescue skills (e.g. being able to throw a lifeline) and increased advocacy for parents to learn the simple and basic life-saving skills of non-contact rescue will help reduce these drowning tragedies.