During drowning, the body is deprived of oxygen, which can damage organs, particularly the brain. Doctors evaluate people for oxygen deprivation and problems that often accompany drowning (such as spinal injuries caused by diving). Treatment focuses on correcting oxygen deprivation and other problems.
Water can also damage the lungs, causing acute respiratory distress syndrome or pulmonary edema. Drowning might cause multisystem organ failure, damage the heart, kidneys and/or liver. The amount of organ damage varies depending on the individual, their submersion time and the water's temperature.
Those who are comatosed and resuscitated with CPR often develop severe brain injury and hypoxic encephalopathy. At least 10-30% of children with brain damage require long term rehabilitation. Hypothermia can protect the brain in some children. Other risks of drowning include aspiration, ARDs, and death.
Fluid and body chemical (electrolyte) imbalances may develop. Other traumatic injuries may be present, and irregular heart rhythms can occur. All people who have experienced a near drowning who require any form of resuscitation, including rescue breathing alone, should be transported to the hospital for evaluation.
The events that result in drowning can be divided into the following sequence: (i) struggle to keep the airway clear of the water, (ii) initial submersion and breath-holding, (iii) aspiration of water, (iv) unconsciousness, (v) cardio-respiratory arrest and (vi) death – inability to revive.
Autopsy findings:
May see bloody froth in the airway, water in the stomach, cerebral edema, petrous or mastoid hemorrhage. "Washerwoman" changes of the hands (shriveling of the skin) develop when submerged in water for several hours; occurs regardless of whether the person died in the water.
The events that result in drowning can be divided into the following sequence: (i) struggle to keep the airway clear of the water, (ii) initial submersion and breath-holding, (iii) aspiration of water, (iv) unconsciousness, (v) cardio-respiratory arrest and (vi) death – inability to revive.
Most studies on near drowning report complications such as cardiopulmonary arrest, multiorgan failure, pulmonary oedema, pneumonia and hypoxic brain injury. Other reports highlight rarer haematological complications including haemolysis and coagulopathy (Layon & Modell, 2009.
Different combinations of variables show times of less than 7 seconds for sinking and only extremely small chest size changes could increase the time to as long as 10 seconds.
Even a weighted body will normally float to the surface after three or four days, exposing it to sea birds and buffeting from the waves. Putrefaction and scavenging creatures will dismember the corpse in a week or two and the bones will sink to the seabed.
Acute renal injury (AKI) due to near-drowning occurs as a relatively common complication and can cause irreversible damage to the kidneys. These injuries usually occur in the early stages of drowning, are self-limiting, and renal replacement therapy is rarely needed.
Drowning is usually classified as a mechanism of injury and drowning victims are considered trauma patients.
Morbidity and death from drowning are caused primarily by laryngospasm and pulmonary injury, resulting hypoxemia and acidosis, and their effects on the brain and other organ systems. A high risk of death exists secondary to the subsequent development of acute respiratory distress syndrome (ARDS).
Many factors may influence the pathophysiologic sequence of events in submersion injury and affect the chance of survival, including age, water temperature, duration and degree of hypothermia, the diving reflex, and the effectiveness of resuscitative efforts.
Near-Drowning Victims Face Serious Risks
Experts classify outcomes of near-drowning in three different ways: Survival with no lasting effects—These near-drowning victims may suffer temporary complications, but eventually recover fully with no lasting damage.
Nearly 40% of drownings treated in emergency departments require hospitalization or transfer for further care (compared with 10% for all unintentional injuries). Drowning injuries can cause brain damage and other serious outcomes, including long-term disability.
We think this is an urban legend. We've witnessed many cremations and never heard a scream. But then again, cremation retorts aren't silent either. Now, bodies do make all kinds of gnarly noises.
In warm, shallow water, decomposition works quickly, surfacing a corpse within two or three days. But cold water slows decay, and people who drown in deep lakes, 30 metres or below, may never surface.
However, there is a consensus that someone can die from drowning within minutes of submerging. They're unlikely to survive within an hour, and within twelve hours, they will almost certainly die from their injuries.
When the brain is deprived of oxygen, brain cells can begin to die within five minutes. Most drowning victims who suffer oxygen deprivation sustain permanent neurological and psychological damage.
The kidneys aren't able to process fluids as before and will also shut down during the dying process. The heart and lungs are generally the last organs to shut down when you die. The heartbeat and breathing patterns become irregular as they progressively slow down and fade away.
Drowning quickly causes respiratory and cardiac arrest from hypoxemia, while survivors can sustain pulmonary, neurologic, cardiovascular, and other injuries.
We have a natural swallowing reflex, so during the drowning process the patient may reflexively swallow placing extra fluids into the stomach. During care or when placed on the deck, these fluids may be forced out.
Bone proteins can help identify how long a body has been submerged in water. One of the most important tasks for forensic scientists after a body is found is to determine the exact time of death. This is key in piecing together the events that led up the death and is especially important when a crime is suspected.