Drowning (Dry, Wet, Near)

  • Medical Author:
    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.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    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.

What are the risk factors of drowning?

There are two peak ages for drowning: children aged younger than 4 and young adults aged 15 to 25.

  • Infants less than one year old most often drown in bathtubs.
  • Children younger than age 5 most commonly drown in residential swimming pools.
  • Young adults tend to drown in larger bodies of water (for example, rivers and lakes). Neck fractures caused by diving into shallow water are associated with drowning in this age group. Alcohol is also implicated in up to 50% of drownings in this age group.
  • Medical emergencies that occur in the water also can lead to drowning. These may include, among others, seizures, heart attack (myocardial infarction), sudden cardiac death, and hypoglycemia (low blood sugar in a person with diabetes).

What are the symptoms of drowning?

The consequences and symptoms of drowning vary widely. A drowning victim may show no symptoms and have no complaints, or may be found dead.

It is the rare person who is found thrashing in water. Instead, most drownings are unwitnessed and the person is found floating or submerged in the water.

For those who are alive, they may be anxious, confused, and short of breath. Again, it is the function of the brain and lungs that are the main concerns in drowning victims.

Special situations

Young children may have a mammalian diving reflex that occurs when drowning occurs in very cold water. When suddenly immersed in cold water less than 68 F (20 C), the victim can stop breathing, slow their heart rate dramatically, and shunt all the blood flow to the heart and brain. Though not common, these children may be resuscitated and return to normal function. Cases have been reported of survival, even after being underwater for an hour.

When should one seek medical care for drowning?

All individuals who are victims of drowning, even if they have no symptoms, should be evaluated by a health care professional. Sometimes, subtle information will be revealed that may make the diagnosis of an underlying medical condition.

How is drowning diagnosed?

The initial evaluation of any drowning victim will begin with a history of the events.

  • How old is the patient?
  • Are there any underlying medical problems?
  • Does the patient take any prescription or non-prescription medications? Is there a history of drug or alcohol use?
  • How long was the person unattended prior to being found?
  • Was there any potential trauma associated with the drowning (diving/falling into the water/falling out of a boat, falling through ice)?
  • Was there loss of consciousness before, during, or after the drowning episode? Did the patient have a witnessed seizure? Did they complain of chest pain and were a victim of sudden cardiac arrest before falling into the water?
  • Has there been any change in behavior after being removed from the water?
  • Has the person had vomiting?

Physical examination will begin with taking and monitoring the vital signs (the ABCs will be evaluated - airway, breathing, and circulation). Careful examination of the whole body will be required, especially focusing on the neurological examination to assess brain function. Lung and heart examination will also be performed.

If trauma or a diving injury is a consideration, the neck and spine may be immobilized to protect against potential spinal cord damage.

Laboratory and X-ray testing will be utilized depending upon the situation and potential injuries.

Medically Reviewed by a Doctor on 8/22/2016

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