Drowning Emergencies

Q. Is it possible to survive drowning?

A. Yes

Quick rescue and early resuscitation are the most critical factors associated with better outcomes.

Orlowski score predicts likelihood of surviving neurologically intact. Best chance of survival is with two or fewer of the following characteristics:

• · Patient is 3 years of age or older.
• · Patient was submerged for greater than 5 minutes.
• · Resuscitation did not begin for more than 10 minutes after rescue.
• · Patient is comatose on delivery to emergency department.
• · Patient’s arterial blood is very acidic (pH less than 7.10)

Three or more of those characteristics, chance of survival is only 5%.

Q. Is there a difference between drowning in warm water and drowning in cold water?

A. Yes, when a person dives into cold water (below 70°F or 21°C) the mammalian diving reflex may drastically slow down metabolism and make the patient more likely to be resuscitated, even after prolonged submersion.

Here’s how it works:

Face submerged in cold water, larynx spasms, breathing is inhibited, heart rate slows, blood vessels throughout most of body constrict. Blood flow to heart and brain is maintained so oxygen is sent and used only where it is needed to immediately sustain life.

In other words, the colder the water, the more oxygen goes to the heart and brain.