How is drowning classified?

Updated: Jun 19, 2019
  • Author: G Patricia Cantwell, MD, FCCM; Chief Editor: Joe Alcock, MD, MS  more...
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Answer

Drowning may be further classified as cold-water or warm-water injury. Warm-water drowning occurs at water temperatures of 20°C or higher, and cold-water drowning occurs at water temperatures of less than 20°C. Although ice-cold water has been reported to be protective, especially in young children, [6] prolonged immersions can nullify the effect of temperature on survivability. [7] Hypothermia occurs commonly in drowning and is usually secondary to conductive heat loss during submersion, not synonymous with cold-water drowning.

Additional classification may include the type of water in which the submersion occurred, such as freshwater and saltwater, or natural bodies of water versus man made. Although initial treatment of submersion victims is not affected by the type of water, serum electrolyte derangements may be related to the salinity of the water (particularly if large amounts of water are ingested), while long-term infectious complications are primarily related to whether the victim was submersed in a natural or a man-made body of water. [8]

Immediate threats include effects on the central nervous and cardiovascular systems (see Workup). Thus, the most critical actions in the immediate management of drowning victims include prompt correction of hypoxemia and acidosis (see Treatment).

The degree of CNS injury depends on the severity and duration of hypoxia. Posthypoxic cerebral hypoperfusion may occur. Long-term effects of cerebral hypoxia, including vegetative survival, are the most devastating (see Treatment).

Prevention is key for reducing morbidity and mortality from drowning. Community education is the key to prevention.


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