Modern concepts about drowning

Drowning remains one of the three leading causes of accidental death in the world, yet few textbooks deal with its evaluation and treatment. Because of overemphasis placed upon distinguishing between fresh- and sea-water drowning, the importance of immediate attention to simple and effective resuscitative procedures has been bypassed. We have outlined a continuum of evaluation and treatment in four stages: (1) emergency care at the scene and during transportation, (2) hospital admission resuscitation, (3) intensive care, and (4) return to normal. Four representative cases are presented in order to review pathophysiological concepts in this serious problem.