Chest | Pulmonology | Drowning (Disease)


Drowning is death from asphyxia due to suffocation caused by water entering the lungs and preventing the absorption of oxygen leading to cerebral hypoxia. Near drowning is the survival of a drowning event involving unconsciousness or water inhalation and can lead to serious secondary complications, including death, after the event.

The death rate from drowning does not reflect the potential morbidity (disability) due to brain injury for those who survive a drowning episode.

Causes and Risk factors

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 , 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).

Near drowning means a person almost dies from not being able to breathe because they are under water. The official definition is survival for greater than 24 hours after being rescued. It is estimated 6,000-8,000 people die from drowning every year. The most common causes of near drowning are: drinking alcohol, head injuries, attempted suicide, falling through thin ice, poor swimming abilities, leaving small children unattended around bodies of water, and trying to save someone who is drowning.

Diagnosis and Treatment

Testing will be performed in accordance with the severity of the injuries and how long the patient was under water. After removal from the water immediate CPR if the person is not breathing is essential to survival. Up to one third of near drowning patients suffer moderate to severe brain damage.

Treatment in the hospital will depend on the associated injuries and how long the patient was under water. Some patients will be able to go home after a period of observation, while others will need admission to the hospital. ...

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