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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 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 (voicebox) may go into a spasm, making it difficult to cry for help.

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%-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.

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, as it appears in the movies. Instead, drowning tends to be a deceptive quieter act, and victims tend to appear lethargic.

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.

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