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Pathophysiology and management of drowning 

Pathophysiology and management of drowning
Pathophysiology and management of drowning

Jerome H. Modell

and Sean Kiley

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date: 23 May 2022

Drowning is a process beginning with airway submergence under a fluid medium, progressing to aspiration, and ultimately death in the absence of intervention. Aspiration of both fresh- and saltwater can cause pulmonary oedema, decreased compliance, intrapulmonary shunting, and severe hypoxia. Devastating neurological injury resulting from prolonged cerebral hypoxia is proportional to the duration of submersion and delay in effective resuscitation and oxygenation. Victims presenting to the emergency department awake and alert, or even stuporous, are likely to have a good neurological outcome with follow-up intensive care. Those presenting comatose are much more likely to have severe neurological deficits. Keys to survival are: timely rescue from the water, immediate initiation of aggressive supportive care regarding airway, cardiovascular and pulmonary function, and optimization of tissue oxygenation.

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