Benjamin Wedro, MD, FACEP, FAAEM
Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
- What is drowning and what are the statistics?
- What happens during drowning?
- What are the complications of drowning?
- Does the type of drowning matter?
- Wet vs. dry drowning
- Salt vs. fresh water drowning
- What are the risk factors of drowning?
- What are the symptoms of drowning?
- When should one seek medical care for drowning?
- How is drowning diagnosed?
- How is drowning treated?
- How can drowning be prevented?
- What is the prognosis for a drowning victim?
What is drowning and what are the statistics?
According to the World Health Organization, "Drowning is the process of experiencing respiratory impairment from submersion/immersion in liquid." The possible outcomes of drowning are classified as death, morbidity (the development of disability or injury), and no morbidity.
This simple definition was agreed upon at the 2002 World Congress of Drowning held in Amsterdam. Prior to that meeting, some definitions and classifications of drowning were not necessarily well defined, and their meanings were subject to a variety of interpretations by different countries and health organizations. While some people still try to sort drowning events into categories (for example wet vs. dry, primary vs. secondary, fatal vs. non-fatal), these terms may or may not adequately describe a patient's situation, the effects of drowning on their body, or the potential outcome.
Drowning is the third most common cause of accidental death worldwide, accounting for 7% of all injury related deaths. According to the World Health Organization, more than 350,000 people die every year from drowning. This number significantly underestimates the actual number because they do not include those who drown in floods, boating, or water transport accidents. Almost half of all drowning in the world occur in China and India.
The death rate from drowning does not reflect the potential morbidity (disability) due to brain injury for those who survive a drowning episode. Most countries do not keep non-fatal drowning statistics.
What happens during drowning?
Drowning occurs when water comes into contact with the larynx (voice box).
- After an initial gasp, there is a period of voluntary breath holding.
- This is followed by spasm of the larynx and the development of hypoxemia (hypo=low + ox=oxygen + emia=blood), or decreased levels of oxygen in the bloodstream.
- Lack of oxygen causes aerobic metabolism to stop, and the body becomes acidotic. If not corrected quickly, the lack of oxygen in combination with too much acid may lead to problems with the electrical conduction system of the heart (cardiac arrest) and lack of blood supply to the brain.
- As body function declines, aspiration may occur as the larynx relaxes allowing water to enter the lungs. However, up to 20% of drowning victims have persistent spasm of the larynx, and no water is aspirated (this was formerly known as "dry" drowning).
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