Drowning is a leading cause of death in children ages 1-4, second only to motor vehicle accidents. Around 8000 people die from drowning each year in the US, with near drownings occurring up to four times as often. When someone drowns, liquid prevents gas exchange in the lungs, causing hypoxemia and acidosis which affects multiple organs. Most drowning victims inhale liquid, though some may avoid it until cardiac arrest. Effects include cardiac issues, cerebral anoxia, electrolyte disturbances, and lung problems from liquid aspiration. Outcomes depend highly on cerebral ischemia, with most child survivors found within two minutes. Hypothermia can improve survival in children through reflex bradycardia and

1. Drowning
Steven Podnos MD

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