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Drowning (cont.)

Drowning Symptoms

Drowning is a silent killer. Victims may not be able to call for help because they are expending all of their energy trying to breathe or keep their head above water. When water is inhaled, the upper airway or larynx (voice box) may go into a spasm, making it difficult to cry for help.

Victims of drowning usually do not thrash in the water as often depicted on television or in the movies. Most victims are found floating or submerged in the water.

The drowning sequence

  • The victim struggles to keep his or her head above the water
  • After the head submerges or drops below the water surface, breath holding occurs
  • When water enters the upper airways, it causes the larynx to go into spasm
  • Most often the spasm relaxes, allowing water through the larynx into the bronchial tree and the lungs. Approximately 10% to 20% of drowning victims have persistent laryngeal spasm and no fluid is found in their lungs on autopsy.
  • The brain stops functioning within just a few minutes without oxygen, and permanent damage occurs if there is no oxygen for more than six minutes.
  • The heart muscle needs oxygen to function and deadly, irregular heart rhythms may occur with oxygen deprivation.
  • Young victims in cold water drowning may be spared this sequence because of the mammalian diving reflex.

Signs of drowning

In real life, drowning doesn't look at all like it is depicted on television or in the movies. The victim does not flail and thrash in the water. Instead, drowning tends to be a deceptive quieter act, and victims tend to appear lethargic or are found unresponsive floating on the water, or submerged beneath it.

The drowning victim often is bobbing with their head tilted back just at the waterline and the mouth wide open. There are attempts to keep rolling on to the back. The respiratory effort may be rapid but is often shallow. The eyes tend to be wide open and may hold a sense of panic. If there is a swimming effort, it is weak and uncoordinated.

Drowning Risk Factors

The following are drowning risks in infants and children:

  • Lack of supervision in the bathtub or other body of water
  • A swimming pool is a risk factor in itself. Children, who have drowned, usually have been out of sight for less than 5 minutes.
  • Lack of life jackets (personal floatation devices) on boats. Pool toys are not a substitute for a "real" life jacket.
  • Child abuse or neglect

The following are drowning risks in teenagers and adults:

  • Alcohol consumption. Alcohol use is a factor in half of all teenage and adult drowning deaths.
  • Inability to swim
  • Medical emergency in the water. This includes victims who experience a heart attack, stroke or seizure in the water. It also includes open water drowning victims who sustain an animal bite or sting.
  • Fatigue or exhaustion when swimming. The buddy system is meant to prevent drowning associated with unsupervised swimming or failing to follow water safety rules.
  • Not appreciating the environment. This includes diving into shallow water and sustaining a head or neck injury, or falling into the water when walking on thin ice.
  • Boating accidents
  • Lack of life jackets (personal floatation devices or PFDs)
  • Scuba diving accidents
  • Suicide attempts
Medically Reviewed by a Doctor on 6/26/2015

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