2. Scope of Problem
• 8000 US deaths a year, almost ¼ in children
• Second only to MVA as cause of death in
children ages 1-4
• Near drowning thought to occur least four
times as often
3. • Liquid prevents gas exchange in lung
• Consequences: hypoxemia and acidosis, with
multiorgan effects
4. Events in Drowning
• Initial laryngospasm and breath
holding, followed by active inhalation of
liquid-80-99% of drowning victims at autopsy
have inhaled liquid while alive
• Some victims may avoid inhalation of fluids
until cardiac arrest (dry drowning)
5. Effects
• Cardiac ischemia, instability, arrythmias
• Cerebral anoxia/hypoxia
• Electrolyte disturbance (fresh water)
• Aspiration results in
atelectasis, hypoxia, shunting
• May also have debris inhaled
6. Outcomes
• Cerebral ischemia major determinant. Most
children who survive are found within two
minutes.
• Hypothermia improves survival in children due
to reflex bradycardia and shunting of blood to
brain
7. Rx
• Supportive care
• ARDS common
• Multiorgan failure common
• Suspect infection, also unusual organisms
