Fast Five Quiz: Summer Health Concerns

Richard H. Sinert, DO

Disclosures

June 06, 2019

Drowning remains a significant worldwide public health concern, as nearly 372,000 people drown worldwide each year. It is a major cause of disability and death, particularly in children. Drowning usually occurs silently and rapidly. The classic image of a victim helplessly gasping and thrashing in the water is infrequently reported. The more ominous scenario of a motionless individual floating in the water or quietly disappearing beneath the surface is more typical.

Swimming may serve as an arrhythmogenic trigger and result in the diving reflex, which can lead to drowning. The diving reflex is elicited by contact of the face with cold water and consists of breath-holding, bradycardia, and intense peripheral vasoconstriction. The exertion associated with swimming may additionally result in predisposition to syncopal events.

Arterial and central venous catheters may be useful in monitoring cardiac output and related hemodynamic parameters. Pulmonary artery catheters are less frequently used, yet may prove useful in patients with unstable cardiovascular status or in those who require multiple inotropic and vasoactive medications.

Ascertaining whether the drowning occurred in warm or cold water is essential. This depends on the temperature of the water, not of the patient. Maintaining mild hypothermia (core temperature of 32-34°C) may be indicated for 12-24 hours in patients who remain comatose after a drowning episode.

Read more on drowning.

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