Drowning

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Medical Author:

Benjamin Wedro, MD, FACEP, FAAEM

Benjamin Wedro, MD, FACEP, FAAEM

Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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• Drowning Overview
• Drowning Risks
• Drowning Symptoms
• When to Seek Medical Care
• Drowning Diagnosis
• Drowning Treatment
• Drowning Self-Care at Home
• Drowning Medical Treatment
• Drowning Follow-up
• Drowning Prevention
• Drowning Prognosis
• Synonyms and Keywords
• Author and Editor
• Read more on Drowning from Healthwise

According to the World Health Organization, drowning is defined as "the process of experiencing respiratory impairment from submersion/immersion in liquid." Drowning may result in death or complete recovery. However, victims may often sustain some physical or mental injury. Most drownings occur within a short distance of safety, whether that be in the bathtub, the edge of a pool or shoreline, and may often be prevented.

Because the head is submerged, air and oxygen can't get into the lungs and the victim suffocates. The tissues and organs in the body require oxygen to function, and begin to fail within a matter of minutes if deprived of it. Without oxygen, the heart muscle can become irritable and cause the electrical system to malfunction, preventing the heart from beating. Brain damage occurs within six minutes if it lacks oxygen rich blood flow.

Who is likely to drown, when, and where?

• The World Health Organization estimates that there are 388,000 drowning deaths worldwide each year. In the Unites States, the latest yearly stastistics from the CDC reported almost 4,000 people had died from drowning.
• Drowning is the third leading cause of accidental death in the United States. For children, it is the second leading cause of accidental death in school-age children, and the number one cause of death in preschoolers.
• More than half of drowning deaths occur in swimming pools.
• One-quarter to one-third of drowning victims have had swimming lessons.
• Children less than one year of age usually drown in bathtubs because they are not coordinated or strong enough to lift themselves out of the water.
• Children aged 1-4 most often drown in swimming pools.
• As children age, the percentage that drown in natural water such as rivers, lakes, ponds, and oceans begins to increase. For those older than age 15, 65% of drownings occur in natural water.
• Alcohol is a factor in up to half of adolescent and adult drowning deaths.

Mammalian Dive Reflex

Drowning suffocation causes a lack of oxygen, resulting in death in only a few minutes. An exception to this rule appears in victims who have been suddenly and rapidly submerged into ice-cold water. Some of these victims have been reported to survive up to an hour underwater without any physical damage. This phenomenon is known as the mammalian dive reflex, which is activated when the face and body plunge into ice-cold water. The acute cooling results in the very quick slowing of body metabolism and diverts blood to the essential organs of the body, the heart, lungs, and brain. With very slow metabolism, the amount of residual oxygen in the blood stream may be enough to maintain basic organ function for many minutes.

The mammalian diving reflex is most well developed in children, and is gradually decreased with age. The drowning victim may appear dead since the heart may be beating so slow that the heart beats cannot be counted, and the blood pressure so low that it can't be detected. It is very important to begin resuscitation attempts in this situation.

The mammalian dive reflex situation does not apply to victims who have gradually cooled and developed hypothermia.

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