The Pathophysiology and Treatment of Drowning

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Abstract
SUMMARY: The pathophysiological changes which occur in both animals and man during drowning and near‐drowning with aspiration have been reviewed. Although the fluid and electrolyte changes will differ in patients, depending primarily on the quantity and nature of the fluid that was aspirated, the primary disturbance requiring emergency therapy is acute asphyxia with persistent arterial hypoxemia and acidosis. Initially, the hypoxia is due to perfusion of non‐ventilated alveoli. Arterial hypoxemia persists, however, even after a significant intra‐pulmonary shunt can no longer be demonstrated. All efforts should be directed to correct this situation with whatever equipment is most readily available. While the patient is being so treated, his fluid and electrolyte status should be evaluated and cor‐rected accordingly. Other drug therapy should be supplied as indicated. With this physiological approach to therapy the success rate in resuscitating drowning and near‐drowning victims will continue to improve.

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