Near drowning
LIFE-THREATENING DISORDERNear drowning refers to surviving—temporarily, at least—the physiologic effects of hypoxemia and acidosis that result from submersion in fluid. Hypoxemia and acidosis are the primary problems in victims of near drowning.
Near drowning occurs in three forms:
dry: The victim doesn’t aspirate fluid but suffers respiratory obstruction or asphyxia (10% to 15% of patients)
wet: The victim aspirates fluid and suffers from asphyxia or secondary changes due to fluid aspiration (about 85% of patients)
secondary: The victim suffers recurrence of respiratory distress (usually aspiration pneumonia or pulmonary edema) within minutes or 1 to 2 days after a near-drowning incident.
Causes
Near drowning results from an inability to swim or, in swimmers, from panic, a boating accident, a heart attack or a blow to the head while in the water, drinking heavily before swimming, or a suicide attempt.
Results of aspiration
Regardless of the tonicity of the fluid aspirated, hypoxemia is the most serious consequence of near drowning, followed by metabolic acidosis. Other consequences depend on the kind of water aspirated.
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