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Chest Apr 2021Drowning is "the process of experiencing respiratory impairment from submersion or immersion in liquid." According to the World Health Organization, drowning claims the... (Review)
Review
Drowning is "the process of experiencing respiratory impairment from submersion or immersion in liquid." According to the World Health Organization, drowning claims the lives of > 40 people every hour of every day. Drowning involves some physiological principles and medical interventions that are unique. It occurs in a deceptively hostile environment that involves an underestimation of the dangers or an overestimation of water competency. It has been estimated that > 90% of drownings are preventable. When water is aspirated into the airways, coughing is the initial reflex response. The acute lung injury alters the exchange of oxygen in different proportions. The combined effects of fluid in the lungs, loss of surfactant, and increased capillary-alveolar permeability result in decreased lung compliance, increased right-to-left shunting in the lungs, atelectasis, and alveolitis, a noncardiogenic pulmonary edema. Salt and fresh water aspirations cause similar pathology. If the person is not rescued, aspiration continues, and hypoxemia leads to loss of consciousness and apnea in seconds to minutes. As a consequence, hypoxic cardiac arrest occurs. The decision to admit to an ICU should consider the patient's drowning severity and comorbid or premorbid conditions. Ventilation therapy should achieve an intrapulmonary shunt ≤ 20% or Pao:Fio ≥ 250. Premature ventilatory weaning may cause the return of pulmonary edema with the need for re-intubation and an anticipation of prolonged hospital stays and further morbidity. This review includes all the essential steps from the first call to action until the best practice at the prehospital, ED, and hospitalization.
Topics: Combined Modality Therapy; Drowning; Emergency Service, Hospital; Emergency Treatment; Hospitalization; Humans; Near Drowning; Pulmonary Edema; Resuscitation
PubMed: 33065105
DOI: 10.1016/j.chest.2020.10.007 -
Minerva Anestesiologica Jan 2012Approximately 500,000 deaths due to drowning are reported annually, 30,000 of which are reported in Europe. Because of the relatively low incidence of drowning victims... (Review)
Review
Approximately 500,000 deaths due to drowning are reported annually, 30,000 of which are reported in Europe. Because of the relatively low incidence of drowning victims at emergency departments, most emergency physicians do not routinely handle drowning victims. Although confusion regarding the classification and pathophysiology of drowning could be reduced by following the Utstein style consensus, the application of therapeutic modalities and, most important, the estimation of probable prognostic outcomes remain difficult for emergency physicians. This article presents an overview of the classification, pathophysiology, emergency-department treatment and prognostic outcomes of drowning accidents.
Topics: Accidents; Adult; Aging; Algorithms; Child; Drowning; Emergency Medical Services; Humans; Hypothermia; Hypoxia; Near Drowning; Prognosis; Retrospective Studies; Rewarming
PubMed: 21623341
DOI: No ID Found -
The Malaysian Journal of Pathology Dec 1992A body recovered from the water does not necessarily imply that death was due to drowning. The diagnosis of drowning is discussed together with the significance of the... (Review)
Review
A body recovered from the water does not necessarily imply that death was due to drowning. The diagnosis of drowning is discussed together with the significance of the "diatom" and biochemical tests.
Topics: Diatoms; Drowning; Fresh Water; Homicide; Humans; Near Drowning; Postmortem Changes; Respiratory System; Seawater; Strontium; Suicide
PubMed: 1304628
DOI: No ID Found -
The New England Journal of Medicine Jan 1993
Review
Topics: Child; Drowning; Humans; Near Drowning; Survival Rate
PubMed: 8418406
DOI: 10.1056/NEJM199301283280407 -
The Journal of Emergency Medicine 1985Near-drowning is defined as survival for at least some period of time after suffocation from submersion in a liquid. This article is a comprehensive review of the... (Review)
Review
Near-drowning is defined as survival for at least some period of time after suffocation from submersion in a liquid. This article is a comprehensive review of the demography, pathophysiology, treatment, and prevention of near-drowning, an accident that affects approximately 6,000 to 7,000 Americans per year. Forty percent of these victims are children younger than 5 years. Alcohol plays a role in approximately one-half of near-drownings of older victims. Major factors prolonging survival are an age of less than 2 years and immersion in cold water (less than 20 degrees C). Hypoxia and acidosis are the primary physiological derangements, and treatment must be directed toward their correction. The hypothermic patient requires special considerations. The role of aggressive cerebral resuscitation has not been elucidated. Prevention of the circumstances that lead to near-drowning must be stressed as a public service.
Topics: Acidosis; Coma; Emergencies; Female; Fresh Water; Hospitalization; Humans; Hypothermia; Hypoxia; Inhalation; Male; Near Drowning; Prognosis; Resuscitation; Seawater; Ventricular Fibrillation
PubMed: 3912425
DOI: 10.1016/0736-4679(85)90219-7 -
Cleveland Clinic Journal of Medicine Jul 2018Drowning is a common and often preventable cause of death, especially in children. The mass media often propagate misinformation about "dry" and "secondary" drowning,... (Review)
Review
Drowning is a common and often preventable cause of death, especially in children. The mass media often propagate misinformation about "dry" and "secondary" drowning, diverting attention from appropriate efforts to prevent drowning and rescue and treat those who do drown.
Topics: Adolescent; Cardiopulmonary Resuscitation; Child; Child, Preschool; Drowning; Humans; Infant; Public Health
PubMed: 30004377
DOI: 10.3949/ccjm.85a.17070 -
Revue Medicale Suisse Aug 2007Drowning is always a serious event, with high morbidity and mortality. Definitions were recently revised and simplified according to Utstein-style. The circumstances and... (Review)
Review
Drowning is always a serious event, with high morbidity and mortality. Definitions were recently revised and simplified according to Utstein-style. The circumstances and prognosis differ in different age groups. Consequences of drowning are hypoxemia, acidosis and hypothermia. The management of drowning victims should be directed to the correction of these 3 elements. An early basic life support and an efficient oxygenation are keys of good prognosis, this one being mainly related to hypoxic cerebral damages. The most frequent complications except anoxic encephalopathy are bacterial pneumonia and ARDS.
Topics: Drowning; Emergency Medical Services; Humans; Prognosis
PubMed: 17892147
DOI: No ID Found -
Fa Yi Xue Za Zhi Feb 2022Drowning is the death caused by asphyxiation due to fluid blocking the airway. In the practice of forensic medicine, it is the key to determine whether the corpse was... (Review)
Review
Drowning is the death caused by asphyxiation due to fluid blocking the airway. In the practice of forensic medicine, it is the key to determine whether the corpse was drowned or entered the water after death. At the same time, the drowning site inference and postmortem submersion interval (PMSI) play an important role in the investigating the identity of the deceased, narrowing the investigation scope, and solving the case. Based on diatoms testing, molecular biology, imaging and artificial intelligence and other technologies, domestic and foreign forensic scientists have done relative research in the identification of the cause of death, drowning site inference and PMSI, and achieved certain results in forensic medicine application. In order to provide a reference for future study of bodies in the water, this paper summarizes the above research contents.
Topics: Artificial Intelligence; Diatoms; Drowning; Forensic Pathology; Humans; Lung; Water
PubMed: 35725698
DOI: 10.12116/j.issn.1004-5619.2021.410625 -
Emergency Medicine Clinics of North... May 1992Many thousands of individuals are near drowning victims each year in this country. The majority of these will be young, previously healthy people. The key to their... (Review)
Review
Many thousands of individuals are near drowning victims each year in this country. The majority of these will be young, previously healthy people. The key to their successful outcome and return to productive, full lives is aggressive resuscitation by emergency physicians and prehospital care providers. After multiple studies over many years there is consensus on one point: the most important enemy of the near drowning victim is hypoxia. Attention should be focused on immediate institution of resuscitative measures at the earliest possible opportunity, and the basic principles of both ACLS and ATLS. Finally, most of these near drownings should never take place. Emergency physicians must take the lead in public education on prevention of drowning and near drowning.
Topics: Algorithms; Emergencies; Humans; Near Drowning; Prognosis
PubMed: 1559473
DOI: No ID Found -
Lancet (London, England) May 2017
Topics: Drowning; Humans
PubMed: 28513436
DOI: 10.1016/S0140-6736(17)31269-2