near drowning


near drown·ing

initial survival following immersion in liquid; the victim may die more than 24 hours later, for example, from adult respiratory distress syndrome.
A non-fatal symptom complex due to prolonged submersion in water

near drowning

Survival after immersion in water. About 330,000 persons, most of whom are children, adolescents, or young adults, survive an immersion injury in the U.S. each year, and of these, about 10% receive professional attention. Many who suffer near drowning do so because of preventable or avoidable conditions, such as the use of alcohol or drugs in aquatic settings or the inadequate supervision of children by adults. Water sports (e.g., diving, swimming, surfing, or skiing) and boating or fishing accidents also are common causes of near drowning. A small percentage of near drowning episodes occur when patients with known seizure disorders convulse while swimming or boating.

Etiology

The injuries suffered result from breath holding (“dry drowning”), the aspiration of water into the lungs (“wet drowning”), and/or hypothermia.

Symptoms

Common symptoms of near drowning result from oxygen deprivation, retention of carbon dioxide, or direct damage to the lungs by water. These include cough, dyspnea, coma, and seizures. Additional complications of prolonged immersion may include aspiration pneumonitis, noncardiogenic pulmonary edema, electrolyte disorders, hemolysis, disseminated intravascular coagulation, and arrhythmias.

Treatment

In unconscious patients rescued from water, the airway is secured, ventilation is provided, and cardiopulmonary resuscitation is begun. Oxygen, cardiac, and blood pressure monitoring, rewarming techniques, and other forms of support are provided (e.g., anticonvulsants are given for seizures; electrolyte and acid-base disorders are corrected).

Prognosis

Most patients who are rapidly resuscitated from a dry drowning episode recover fully. The recovery of near drowning victims who have inhaled water into the lungs depends on the underlying health of the victim, the duration of immersion, and the speed and efficiency with which oxygenation, ventilation, and perfusion are restored.

See also: drowning