The most recently updated definition of drowning is “the process of experiencing respiratory impairment from submersion/immersion in liquid.” The primary insult in these patients is asphyxia, and the resulting hypoxia, hypercarbia, and acidosis will progress until cardiac arrest, multiple organ dysfunction, and death. The patient’s prognosis will depend on where the drowning process was interrupted on this continuum. This review includes an overview of the epidemiology, risk factors, pathophysiology, assessment and stabilization, diagnosis, treatment and disposition, and outcomes of drowning. Figures show how nonambulatory infants and toddlers may drown after pulling up on the edge of a toilet, leaning over, and falling head first into the toilet bowl and an algorithm for the approach to the drowning patient. Tables list risk factors for drowning, indications for intubation, prognostic factors for death or survival with severe neurologic sequelae, and key preventive measures. This review contains 2 highly rendered figures, 4 tables, and 73 references.
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