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Near drowning in cold water.

S R Mehta¹, K V Srinivasan, M S Bindra

¹Deputy Director Medical Services, 92 Base Hospital, C/o 56 APO, India.

The Journal of the Association of Physicians of India

|March 29, 2001

Summary

Cold water near drowning (ND) can cause rapid death due to hypothermia. Aggressive management, including continuous positive airway pressure, proved effective for most near drowning patients, though one experienced lasting cognitive deficits.

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Area of Science:

Emergency Medicine
Toxicology
Environmental Health

Background:

Drowning and near drowning are significant global causes of accidental death.
Cold water immersion can accelerate death through hypothermia, preceding actual drowning.
Near drowning incidents occur in various settings, including traffic accidents, pools, and boating.

Purpose of the Study:

To report on five cases of near drowning in cold water.
To analyze the varied clinical presentations and sequelae of cold water near drowning.
To discuss current management strategies and recent advancements in treating near drowning.

Main Methods:

Case series reporting on five near drowning patients.
Clinical assessment of varied presentations including coma, decerebrate rigidity, fixed dilated pupils, hypertension, and delayed pulmonary edema.

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Evaluation of treatment outcomes, focusing on energetic management with continuous positive airway pressure (CPAP).

Main Results:

Near drowning patients presented with diverse neurological and respiratory symptoms.
Aggressive management with CPAP was highly effective in most cases.
One patient developed transient organic psychosis and persistent mild cognitive deficits.

Conclusions:

Prompt and energetic management is crucial for improving outcomes in cold water near drowning.
Continuous positive airway pressure is a valuable therapeutic intervention.
Neurological and cognitive sequelae can occur even after successful resuscitation from near drowning.