Podcast # 340: Drowning

Author: Chris Holmes, MD

Educational Pearls:

• Epidemiology: 80% male, ages 1-4 at greatest risk, African-American > Caucasian.

• Freshwater and ocean water may have more bacteria than pool water.

• Salt water is hyperosmolar, which theoretically increases risk of pulmonary edema.

• Greatest physiologic insult is from hypoxia secondary to fluid aspiration or laryngeal spasm. Patient survival is related to presentation on arrival.

• Workup includes CXR and ABG; consider C-spine immobilization/imaging when cervical injury is strongly suspected (i.e. diving injury).

• Treatment consists of supplemental oxygen therapy. Consider CPAP or intubation.

References

Szpilman D, Bierens JJ, Handley AJ, Orlowski JP. Drowning. N Engl J Med. 2012. 366(22):2102-10. doi: 10.1056/NEJMra1013317.

Schmidt A, Sempsrott J. Drowning In The Adult Population: Emergency Department Resuscitation And Treatment. Emerg Med Pract. 2015. 17(5):1-18.