Drowning

Valeria Wu, MD

Drowning = submersion in liquid  respiratory distress or failure

Aspiration & asphyxia

  -  wash out surfactant affecting gas transfer  VQ mismatch, hypoxia, atelectasis

Physical exam may show:

  -  Lungs: rales, rhonchi, wheezes

  -  Mental status changes

  -  Hypothermia (even in warm water!)

Approach 

  -  ABCs!

  -  Temperature, treat hypothermia (especially with cardiac arrest)

  -  Evaluate for traumatic injuries

  -  Don’t forget: what caused them to drown in the first place? (ie Hypoglycemia, MI, seizure, syncope, dysrhythmia, trauma)

  -  Adjunctive lab work / imaging

References:

1. Rita K. Cydulka, David M. Cline, O. John Ma, Michael T. Fitch, Scott Joing, Vincent J. Wang: Tintinall’s Emergency Medicine Manual, 8th Edition. 
2. Walker, Richard A. "Near Drowning." Tintinalli's Emergency Medicine Manual, 8e Eds. Rita K. Cydulka, et al. McGraw-Hill, 2017