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
- Drowning facts and prevention
- What is drowning and what are the statistics?
- What happens during 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?
- What are the complications of drowning?
- How can drowning be prevented?
- What is the prognosis for a drowning victim?
How is drowning treated?
Treatment begins at the water's edge. The American Heart Association recommends that if possible, one person is sent to activate Emergency Medical Services and call 911. Another is sent to bring an automatic external defibrillator (AED) to the victim's side.
If no pulse can be identified and the patient is not breathing, CPR should be started. Drowning is one of the special situations where hands-only CPR is NOT indicated. If there is a potential for a neck injury, special care needs to be taken to prevent further injury to the victim by keeping the neck and body in alignment.
If the patient is breathing but not awake, they should be placed on their side in the rescue position to prevent aspiration if vomiting should occur.
- Further treatment by EMTs, paramedics, and staff at the hospital will depend upon the severity of the symptoms. Those patients who have no symptoms may require nothing more than observation.
- Those who are in cardiopulmonary arrest will likely undergo CPR with attempts to restore a regular heart rhythm and heart-beat.
- Those patients who have symptoms related to the function of their heart, lung, or brain will need further evaluation and treatment tailored to their specific circumstances and situation.
- And unfortunately, for those who are found dead with no potential for resuscitation, further treatment or evaluation may not be indicated.
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 caused by water aspirated into the lung can also occur and may lead to pneumonia and acute respiratory distress syndrome (ARDS).
- If the drowning occurs in colder water, there is the risk of hypothermia or a drop in core body temperature.
- Drowning may occur as a consequence of injury or illness. For example, cervical spine fractures (broken neck) due to diving injuries may result in breathing problems and subsequent drowning. Drowning can occur as a result of syncope or loss of consciousness in the water, due to a variety of medical conditions including heart attack and seizure.
How can drowning be prevented?
Most drownings are preventable, and simple steps can be taken to help with water safety.
- Learn how to swim.
- When in the water, use the buddy system.
- Do not use alcohol or drugs when swimming or boating.
- Supervise children closely around water and make certain they are the focus of your attention. Even bathtubs and buckets full of water can be dangerous.
- Swimming pools should have barriers (fences, gates, alarms) to prevent children from entering unattended.
- Learn CPR.
What is the prognosis for a drowning victim?
The prognosis for many drowning victims is poor. The brain does not tolerate lack of oxygen well and the amount of potential damage is dependent upon the time the patient spends hypoxemic in the water.
Even if the brain survives, acute respiratory distress syndrome (ARDS) may cause significant short and long-term problems as the lungs try to recover from their injuries.
The key to the treatment of drowning is prevention.
Michael R. Sayre, Robert A. Berg, Diana M. Cave, Richard L. Page, Jerald Potts and Roger D. Hands-Only (Compression-Only) Cardiopulmonary Resuscitation: A Call to Action for Bystander Response to Adults Who Experience Out-of-Hospital Sudden Cardiac Arrest: Cardiovascular Care Committee Science Advisory for the Public From the American Heart Association Emergency. Circulation 2008;117:2162-2167.
World Health Organization. Drowning.
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