Drowning (cont.)
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.
In this Article
- What is drowning?
- What happens during drowning?
- What are the complications of drowning?
- Does the type of drowning matter?
- 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 happens during drowning?
Drowning occurs when water comes into contact with the larynx (voice box).
- After an initial gasp, there is an initial 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, the larynx may relax and allow 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).
What are the complications of drowning?
- Hypoxemia causing brain damage is the major complication in drowning victims
who do not die.
- Direct lung tissue damage because of water aspirated into the lung can also
occur and lead to pneumonia and
acute respiratory distress syndrome (ARDS).
- If the drowning occurs in colder water risks include hypothermia or a
drop in body temperature. (If the body temperature drops below 95F (35C) get
medical attention immediately.)
- Cervical spine fractures may occur in diving injuries associated with drowning.
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