Immersion injury. Drowning and near drowning

Near drowning remains one of the most frequently encountered environmental injuries in the United States. Physicians can do much to educate their patients on prevention. Both at the scene and in the emergency department, physicians should direct initial attention to aggressive respiratory management, because hypoxia is the primary cause of mortality and morbidity in the near-drowning victim. An apparently lifeless victim of cold-water immersion may go on to full recovery with such management. In patients who survive the initial insult, the degree of hypoxic encephalopathy is the major determinant of outcome.