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Wassilij Grigorjewitsch Perow 002.jpg
Vasily Perov: The drowned, 1867 painting
Specialty Critical care medicine

Drowning is defined as respiratory impairment from being in or under a liquid.[1] It is further classified by outcome into: death, ongoing health problems, and no ongoing health problems.[1] Drowning itself is quick and silent, although it may be preceded by distress which is more visible.[2]

Generally, in the early stages of drowning, very little water enters the lungs: a small amount of water entering the trachea causes a muscular spasm that seals the airway and prevents the passage of both air and water until unconsciousness occurs. This means a person drowning is unable to shout or call for help, or seek attention, as they cannot obtain enough air. The instinctive drowning response is the final set of autonomic reactions in the 20–60 seconds before sinking underwater, and to the untrained eye can look similar to calm safe behavior.[2][3] Lifeguards and other persons trained in rescue learn to recognize drowning people by watching for these movements.[2] If the process is not interrupted, loss of consciousness due to hypoxia is followed rapidly by cardiac arrest. At this stage, the process is still usually reversible by prompt and effective rescue and first aid. Survival rates depend strongly on the duration of immersion.

In 2013, there were about 1.7 million cases of drowning.[4] Unintentional drowning is the third leading cause of unintentional injury resulting in death worldwide. In 2013, it was estimated to have resulted in 368,000 deaths, down from 545,000 deaths in 1990.[5] Of these deaths, 82,000 occurred in children less than five years old.[5] It accounts for 7% of all injury related deaths (excluding those due to natural disasters), with 91% of these deaths occurring in low-income and middle-income countries.[6] Drowning occurs more frequently in males and the young.[7] The rate of drowning in populations around the world varies widely according to their access to water, the climate, and the national swimming culture.


Respiratory impairment from being in or under a liquid.[1][8]

Old terminology

There are several terms which were in general use, but are no longer recommended.

Active drowning
People, such as non-swimmers and the exhausted or hypothermic at the surface, who are unable to hold their mouth above water and are suffocating due to lack of air. Instinctively, people in such cases perform well-known behaviors in the last 20–60 seconds before being submerged, representing the body's last efforts to obtain air.[1][8] Notably, such people are unable to call for help, talk, reach for rescue equipment, or alert swimmers even feet away, and they may drown quickly and silently close to other swimmers or safety.[2]
Dry drowning
Drowning in which no water enters the lungs[1][8]
Near drowning
Drowning which is not fatal[1][8]
Wet drowning
Drowning in which water enters the lungs[1][8]
Passive drowning
Secondary drowning
Physiological response to foreign matter in the lungs due to drowning causing extrusion of liquid into the lungs (pulmonary edema) which adversely affects breathing[1][8]
Silent drowning
Drowning without a noticeable external display of distress.[1][9]

Signs and symptoms

Drowning is most often quick and unspectacular. Its media depictions as a loud, violent struggle have much more in common with distressed non-swimmers, who may well drown but have not yet begun to do so. In particular, an asphyxiating person is seldom able to call for help.[2] The instinctive drowning response covers many signs or behaviors associated with drowning or near-drowning:

  • Head low in the water, mouth at water level
  • Head tilted back with mouth open
  • Eyes glassy and empty, unable to focus
  • Eyes open, with fear evident on the face
  • Hyperventilating or gasping
  • Trying to swim in a particular direction but not making headway
  • Trying to roll over on the back to float

Frank Pia, a lifeguard and researcher of rescue techniques and drowning, notes that drowning begins at the point a person is unable to keep their mouth above water; inhalation of water takes place at a later stage.[10] Most people demonstrating the instinctive drowning response do not show obvious prior evidence of distress.[10]


Children have drowned in buckets and toilets.

Approximately 90% of drownings take place in freshwater (rivers, lakes and swimming pools) and 10% in seawater. Drownings in other fluids are rare, and often relate to industrial accidents.[citation needed] In New Zealand's early colonial history, so many settlers died while trying to cross rivers that drowning was known as "The New Zealand death".[11]

People have drowned in as little as 30 mm of water lying face down.[12] Children have drowned in baths, buckets and toilets; inebriates or those under the influence of drugs have died in puddles.

Drowning can also happen in ways that are less well known:

  • Ascent blackout, also called deep water blackout – caused by latent hypoxia during ascent from depth, where the partial pressure of oxygen in the lungs under pressure at the bottom of a deep free-dive is adequate to support consciousness but drops below the blackout threshold as the water pressure decreases on the ascent. It usually strikes upon arriving near the surface as the pressure approaches normal atmospheric pressure.[13]
  • Shallow water blackout – caused by hyperventilation prior to swimming or diving. The primary urge to breathe is triggered by rising carbon dioxide (CO2) levels in the bloodstream.[14] The body detects CO2 levels very accurately and relies on this to control breathing.[14] Hyperventilation reduces the carbon dioxide content of the blood but leaves the diver susceptible to sudden loss of consciousness without warning from hypoxia. There is no bodily sensation that warns a diver of an impending blackout, and victims (often capable swimmers swimming under the surface in shallow water) become unconscious and drown quietly without alerting anyone to the fact that there is a problem; they are typically found on the bottom.


Risk factors

Populations groups at risk:[15]

  • In the US:
    • Children and young adults: Drowning rates are highest for children under 5 years of age and persons 15–24 years of age.
    • Minorities: The fatal unintentional drowning rate for African Americans between 2005 and 2009 was significantly higher than that of whites across all ages. The fatal drowning rate of African American children of ages from 5 to 14 is almost three times that of white children in the same age range, and 5.5 times higher in swimming pools. These disparities might be associated with lack of basic swimming skills in some minority populations.

Behavioral and physical factors:[15][16]

  • In the US:
    • Use of alcohol increases the risk of drowning. Among adolescents and adults, alcohol use is involved in almost a quarter of emergency department visits for drowning.
    • Inability to swim: Participation in formal swimming lessons can reduce the risk of drowning among children aged 1 to 4 years.
    • Free access to water: Effective barriers prevent young children from gaining access to the water
    • Ineffective supervision: Drowning can occur anywhere there is water, and even in the presence of lifeguards.
    • Risk can vary with location depending on age. Children between 1 and 4 usually drown in home swimming pools. Drownings in natural water settings increase with age. More than half of drownings among those 15 years and older occurred in natural water environments.
    • Failure to wear life jackets or personal flotation devices was implicated in 88% of the boating related drownings in the US during 2010.


Drowning can be considered as going through four stages:[17]

  2. Fluid is aspirated into the airways and/or swallowed
  3. Cerebral anoxia stops breathing and aspiration
  4. Cerebral injury due to anoxia becomes irreversible

Oxygen deprivation





The hypoxemia and acidosis caused by asphyxia in drowning affect various organs. There can be central nervous system damage, cardiac arhythmias, pulmonary injury, reperfusion injury, and multiple-organ secondary injury with prolonged tissue hypoxia.[22]



Water aspiration

If water enters the airways of a conscious person, the person will try to cough up the water or swallow it, often inhaling more water involuntarily. When water enters the larynx or trachea, both conscious and unconscious persons experience laryngospasm, in which the vocal cords constrict, sealing the airway. This prevents water from entering the lungs. Because of this laryngospasm, in the initial phase of drowning, water generally enters the stomach and very little water enters the lungs. Though laryngospasm prevents water from entering the lungs, it also interferes with breathing. In most persons, the laryngospasm relaxes some time after unconsciousness and water can then enter the lungs causing a "wet drowning". However, about 7–10% of people maintain this seal until cardiac arrest.[18] This has been called "dry drowning", as no water enters the lungs. In forensic pathology, water in the lungs indicates that the person was still alive at the point of submersion. Absence of water in the lungs may be either a dry drowning or indicates a death before submersion.[23]

Aspirated water that reaches the alveoli destroys the pulmonary surfactant, which causes pulmonary oedema and decreased lung compliance which compromises oxygenation in affected parts of the lungs. This is associated with metabolic acidosis, and secondary fluid and electrolyte shifts. During alveolar fluid exchange, diatoms present in the water may pass through the alveolar wall into the capillaries to be carried to internal organs. Presence of these diatoms may be diagnostic of drowning.

Fresh water is hypotonic and hyponatremic relative to blood, so causes osmotic diffusion of water into the blood and sodium to the alveoli leading to hypervolemia and haemodilution with haemolysis, hyponatremia, and hyperkalemia,[clarification needed][24] The resulting elevation of plasma K+ (potassium) level and depression of Na+ (sodium) level alter the electrical activity of the heart, which can cause ventricular fibrillation. In animal experiments this effect was shown to be capable of causing cardiac arrest in 2 to 3 minutes.[citation needed] Acute renal failure can also result from hemoglobin from the burst blood cells accumulating in the kidneys, and cardiac arrest can also result if cold fresh water taken into the bloodstream sufficiently cools the heart.[citation needed]

Sea water is hypertonic relative to blood, so water diffuses from blood into the water in the alveoli, and the electrolytes diffuse into the blood, leading to hypovolemia, haemoconcentration and hypernatremia. The laboratory blood tests may show these shifts, which may be diagnostically useful.[24] In animal experiments the thicker blood requires more work from the heart leading to cardiac arrest in 8 to 10 minutes.[citation needed]

Autopsies on drowned persons show no indications of these effects and there appears to be little difference between drownings in salt water and fresh water. After death, rigor mortis will set in and remains for about two days, depending on many factors, including water temperature.[citation needed]

Cold water immersion





[S]omething that almost no one in the maritime industry understands. That includes mariners [and] even many (most) rescue professionals: It is impossible to die from hypothermia in cold water unless you are wearing flotation, because without flotation – you won’t live long enough to become hypothermic.

— Mario Vittone, lecturer and author in water rescue and survival[27]

Heat transfers very well into water, and body heat is therefore lost extremely quickly in water compared to air,[30] even in merely 'cool' swimming waters around 70F (~20C).[28] A water temperature of 10 °C (50 °F) can lead to death in as little as one hour, and water temperatures hovering at freezing can lead to death in as little as 15 minutes.[28] This is because cold water can have other lethal effects on the body, so hypothermia is not usually a reason for drowning or the clinical cause of death for those who drown in cold water.




The World Health Organization in 2005 defined drowning as "the process of experiencing respiratory impairment from submersion/immersion in liquid".[1] This definition does not imply death, or even the necessity for medical treatment after removal of the cause, nor that any fluid enters the lungs. The WHO further recommended that outcomes should be classified as: death, morbidity, and no morbidity.[1] There was also consensus that the terms wet, dry, active, passive, silent, and secondary drowning should no longer be used.[1]

Experts differentiate between distress and drowning.



Forensic diagnosis of drowning is considered one of the most difficult in forensic medicine. External examination and autopsy findings are often non-specific, and the available laboratory tests are often inconclusive or controversial. The purpose of investigation is generally to distinguish whether the death was due to immersion, or whether the body was immersed post mortem. The mechanism in acute drowning is hypoxemia and irreversible cerebral anoxia due to submersion in liquid.[24]

Drowning would be considered as a possible cause of death when the body was recovered from a body of water, or in close proximity to a fluid which could plausibly have caused drowning, or when found with the head immersed in a fluid. A medical diagnosis of death by drowning is generally made after other possible causes of death have been excluded by means of a complete autopsy and toxicology tests. Indications of drowning are seldom completely unambiguous, and may include bloody froth in the airway, water in the stomach, cerebral oedema and petrous or mastoid haemorrhage. Some evidence of immersion may be unrelated to the cause of death, and lacerations and abrasions may have occurred before or after immersion or death.[17]

Diatoms should normally never be present in human tissue unless water was aspirated, and their presence in tissues such as bone marrow suggests drowning, however, they are present in soil and the atmosphere and samples may easily be contaminated. An absence of diatoms does not rule out drowning, as they are not always present in water.[17] A match of diatom shells to those found in the water may provide supporting evidence of the place of death.[24] Drowning in salt water can leave significantly different concentrations of sodium and chloride ions in the left and right chambers of the heart, but this will dissipate if the person survived for some time after the aspiration, or if CPR was attempted,[17] and have been described in other causes of death.[24]

Most autopsy findings relate to asphyxia and are not specific to drowning. The signs of drowning are degraded by decomposition. Large amounts of froth will be present around the mouth and nostrils and in the upper and lower airways in freshly drowned bodies. The volume of froth is generally much greater in drowning than from other origins. Lung density may be higher than normal but normal weights are possible after cardiac arrest reflex or vaso-vagal reflex. The lungs may be over inflated and waterlogged, filling the thoracic cavity, and the surface may have a marbled appearance, with darker areas associated with collapsed alveoli interspersed with paler aerated areas. Fluid trapped in the lower airways may block the passive collapse that is normal after death. Haemorrhagic bullae of emphysema may be found. These are related to rupture of alveolar walls. These signs, while suggestive of drowning, are not conclusive.[24]


Drowning prevention campaign in Ghana

Water safety

Most drowning is preventable. It has been estimated that more than 85% of drownings could have been prevented by supervision, training in water skills, technology, regulation and public education.[8]





Many people who are drowning manage to save themselves, or are assisted by bystanders or professional rescuers. Less than 6% of people rescued by lifeguards need medical attention, and only 0.5% need CPR. The statistics are not as good for rescue by bystanders, but even there, a minority require CPR.

Rescue involves bringing the person's mouth and nose above the water surface. A drowning person may cling to the rescuer and try to pull himself out of the water, submerging the rescuer in the process. Rescuers should avoid endangering themselves unnecessarily and where possible should provide assistance from a safe position, such as a boat, or by providing flotation or a means of towing from a distance.[8]

Where it is necessary to approach a panicking person in deep water, it is advised that the rescuer approach with a buoyant object, or from behind, twisting the person's arm on the back to restrict movement. If the rescuer does get pushed under water, they can dive downwards to escape.[citation needed]


Rescue, and where necessary, resuscitation, should be started as early as possible for best results. If conscious, the person should be taken out of the water as soon as possible. In-water resuscitation may increase the chances of a favourable result by a factor of about three, if there will be any delay in getting the person out of the water, but the necessary skills require training. Only rescue ventilation is practicable in the water, chest compressions require a suitable platform, so in-water assessment of circulation is pointless. If the person does not respond after a few breaths, cardiac arrest may be assumed, and getting them out of the water becomes the priority.[8]


First aid

The checks for responsiveness and breathing are carried out with the person horizontally supine. If unconscious but breathing, the recovery position is appropriate. If not breathing, rescue ventilation is necessary. Drowning can produce a gasping pattern of apnea while the heart is still beating, and ventilation alone may be sufficient, as the heart may be basically healthy, but hypoxic. The airway-breathing-circulation (ABC) sequence should be followed, rather than starting with compressions as is typical in cardiac arrest,[34] as the basic problem is lack of oxygen. Five initial breaths are recommended, as the initial ventilation may be difficult because of water in the airways which can interfere with effective alveolar inflation. Thereafter a sequence of two breaths and 30 chest compressions is recommended, repeated until vital signs are re-established, the rescuers are unable to continue, or advanced life support is available.[8]

Attempts to actively expel water from the airway by abdominal thrusts, Heimlich maneuver or positioning head downwards should be avoided as there is no obstruction by solids, and they delay the start of ventilation and increase the risk of vomiting, with a significantly increased risk of death, as aspiration of stomach contents is a common complication of resuscitation efforts.[8][35]

Treatment for hypothermia may also be necessary. Because of the diving reflex, people submerged in cold water and apparently drowned may revive after a relatively long period of immersion.[36] Rescuers retrieving a child from water significantly below body temperature should attempt resuscitation even after protracted immersion.[36]

Advanced pre-hospital care

Administration of oxygen at 15 litres per minute by face mask or bag valve mask is often sufficient, but tracheal intubation with mechanical ventilation may be necessary. Suctioning of pulmonary oedema fluid should be balanced against the need for oxygenation. The target of ventilation is to achieve 92% to 96% arterial saturation and adequate chest rise. Positive end-expiratory pressure will generally improve oxygenation. Drug administration via peripheral veins is preferred over endotracheal administration. Hypotension remaining after oxygenation may be treated by rapid crystalloid infusion.[8] Cardiac arrest in drowning usually presents as asystole or pulseless electrical activity. Ventricular fibrillation is more likely to be associated with complications of pre-existing coronary artery disease, severe hypothermia, or the use of epinephrine or norepinephrine.[8]


Drowning victims who arrive at a hospital with spontaneous circulation and breathing usually recover with good outcomes.[36] Early provision of basic and advanced life support improve probability of positive outcome.[8]

Longer duration of submersion is associated with lower probability of survival and higher probability of permanent neurological damage.[36]

Duration of submersion Risk of death or severe long term neurological impairment[8]
0–5 min 10%
6–10 min 56%
11–25 min 88%
>25 min nearly 100%
Signs of brain-stem injury predict death or severe neurological consequences

Contaminants in the water can cause bronchospasm and impaired gas exchange, and can cause secondary infection with delayed severe respiratory compromise.[36]

Low water temperature can cause ventricular fibrillation, but hypothermia during immersion can also slow the metabolism, allowing a longer hypoxia before severe damage occurs.[36] Hypothermia which reduces brain temperature significantly can improve outcome. A reduction of brain temperature by 10 °C decreases ATP consumption by approximately 50%, which can double the time that the brain can survive.[8]

The younger the victim, the better the chances of survival.[36] In one case, a child submerged in cold (37 °F (3 °C)) water for 66 minutes was resuscitated without apparent neurological damage.[36] However, over the long term significant deficits were noted, including a range of cognitive difficulties, particularly general memory impairment, although recent magnetic resonance imaging (MRI) and magnetoencephalography (MEG) were within normal range.[37]


Drowning is a major worldwide cause of death and injury in children. Long term neurological outcomes of drowning cannot be predicted accurately during the early stages of treatment and although survival after long submersion times, mostly by young children, has been reported, many survivors will remain severely and permanently neurologically compromised after much shorter submersion times. Factors affecting probability of long term recovery with mild deficits or full function in young children include the duration of submersion, whether advanced life support was needed at the accident site, the duration of cardiopulmonary resuscitation, and whether spontaneous breathing and circulation are present on arrival at the emergency room.[38]

Data on long-term outcome are scarce and unreliable. Neurological examination at the time of discharge from hospital does not accurately predict long term outcomes. Some victims who suffered from severe brain injury and were transferred to other institutions died months or years after the drowning and are recorded as survivors. Non-fatal drownings have been estimated as two to four times more frequent than fatal drownings.[38]


Drowning deaths per million persons in 2012
Disability-adjusted life year for drowning per 100,000 inhabitants in 2004.[39]
  no data
  < 100
  > 700

In 2013, drowning was estimated to have resulted in 368,000 deaths, down from 545,000 deaths in 1990.[5] There are more than 20 times that many non-fatal incidents.[40] It is the third leading cause of death from unintentional trauma after traffic injuries and falls.[41]

In many countries, drowning is one of the main causes of preventable death for children under 12 years old. In the United States in 2006, 1100 people under 20 years of age died from drowning.[42] Typically the United Kingdom suffers 450 drownings per year, or 1 per 150,000, whereas the United States suffers 6,500 drownings yearly, around 1 per 50,000. In Asia, according to a study by The Alliance for Safe Children, suffocation and drowning were the leading causes of preventable death for children under five years of age;[43][44] a 2008 report by the organization found that in Bangladesh, for instance, 46 children drown each day.[45]

Males, due to a generally increased likelihood for risk taking, are 4 times more likely to have submersion injuries.[40]

In the fishing industry, the largest group of drownings is associated with vessel disasters in bad weather, followed by man-overboard incidents and boarding accidents at night; either in foreign ports, or under the influence of alcohol.[40] Scuba diving deaths are estimated at 700 to 800 per year, associated with inadequate training and experience, exhaustion, panic, carelessness and barotrauma.[40]

United States


People who drown are more likely to be male, young, or adolescent.[7]

Surveys indicate that 10% of children under 5 have experienced a situation with a high risk of drowning. Worldwide, about 175,000 children die through drowning every year.[46] The causes of drowning cases in the US from 1999 to 2006 are as follows:[47]

31.0% Drowning and submersion while in natural water
27.9% Unspecified drowning and submersion
14.5% Drowning and submersion while in swimming pool
9.4% Drowning and submersion while in bathtub
7.2% Drowning and submersion following fall into natural water
6.3% Other specified drowning and submersion
2.9% Drowning and submersion following fall into swimming pool
0.9% Drowning and submersion following fall into bathtub

Dry drowning

Dry drowning is a term that has never had an accepted medical definition, and that is currently medically discredited.[48][49] Following the 2002 World Congress on Drowning in Amsterdam, a consensus definition of drowning was established. Based on this definition, drowning is the "process of experiencing respiratory impairment from submersion/immersion in liquid."[50] This definition resulted in only three legitimate drowning subsets: fatal drowning, non-fatal drowning with illness/injury, and non-fatal drowning without illness/injury.[51] In response, major medical consensus organizations have adopted this definition worldwide and have officially discouraged any medical or publication use of the term "dry drowning".[48] Such organizations include the International Liaison Committee on Resuscitation,[52] the Wilderness Medical Society,[53] the American Heart Association,[54] the Utstein Style system,[52] the International Lifesaving Federation,[55] the International Conference on Drowning,[50] Starfish Aquatics Institute,[56] the American Red Cross,[57] the Centers for Disease Control and Prevention (CDC),[58][59][60] the World Health Organization [61] and the American College of Emergency Physicians.[62]

Drowning experts have recognized that the end result pathophysiology of hypoxemia, acidemia, and eventual death is the same whether water entered the lung or not. As this distinction does not change management or prognosis, but causes significant confusion due to alternate definitions and misunderstandings, it is generally established that pathophysiological discussions of "dry" versus "wet" drowning are not relevant to drowning care.[63]

"Dry drowning" is frequently cited in the news with a wide variety of definitions.[64] and is often confused with the equally inappropriate and discredited term "secondary drowning" or "delayed drowning".[65] Various conditions including spontaneous pneumothorax, chemical pneumonitis, bacterial or viral pneumonia, head injury, asthma, heart attack, and chest trauma have been misattributed to the erroneous terms "delayed drowning", "secondary drowning", and "dry drowning". Currently, there has never been a case identified in the medical literature where a patient was clinically observed to be without symptoms and who died hours or days later as a direct result of drowning alone.[48]

Capital punishment

In Europe, drowning was used as capital punishment. During the Middle Ages, a sentence of death was read using the words "cum fossa et furca", or "with pit and gallows".[66]

Drowning survived as a method of execution in Europe until the 17th and 18th centuries.[67] England had abolished the practice by 1623, Scotland by 1685, Switzerland in 1652, Austria in 1776, Iceland in 1777, and Russia by the beginning of the 1800s. France revived the practice during the French Revolution (1789–1799) and was carried out by Jean-Baptiste Carrier at Nantes.[68]


  1. ^ a b c d e f g h i j k l E.F. van Beeck; C.M. Branche; D. Szpilman; J.H. Modell; J.J.L.M. Bierens (2005), A new definition of drowning: towards documentation and prevention of a global public health problem, 83, Bulletin of the World Health Organization (published 11 November 2005), pp. 801–880, archived from the original on 22 October 2012, retrieved 19 July 2012 
  2. ^ a b c d e Vittone, Mario; Pia, Francesco (Fall 2006). "'It Doesn't Look Like They're Drowning': How To Recognize the Instinctive Drowning Response" (PDF). On Scene: The Journal of U.S. Coast Guard Search and Rescue: p. 14. Retrieved 29 December 2010. 
  3. ^ O'Connell, Claire (3 August 2010). "What stops people shouting and waving when drowning?". Irish Times. Archived from the original on 22 October 2012. Retrieved 29 December 2010. 
  6. ^ "Drowning". Fact sheet N°347. World Health Organization. November 2014. Archived from the original on 7 July 2016. Retrieved 26 June 2016. 
  7. ^ a b c "Drowning". Centers for Disease Control and Prevention. 23 September 2014. Archived from the original on 10 May 2016. Retrieved 26 June 2016. 
  8. ^ a b c d e f g h i j k l m n o p q Szpilman, David; Bierens, Joost J.L.M.; Handley, Anthony J.; Orlowski, James P. (4 October 2012). "Drowning". The New England Journal of Medicine. Massachusetts Medical Society. 366 (22): 2102–2110. doi:10.1056/NEJMra1013317. Archived from the original on 21 April 2017. Retrieved 1 February 2017. 
  10. ^ a b Pia, Frank (1999). "Chapter 14: Reflections on Lifeguard surveillance programs". In Fletemeyer, John R.; Freas, Samuel J. Drowning: New Perspectives on Intervention and Prevention. p. 234. ISBN 978-1-57444-223-6. 
  14. ^ a b Lindholm, P; Lundgren, C. E. (2006). "Alveolar gas composition before and after maximal breath-holds in competitive divers". Undersea & Hyperbaric Medicine : Journal of the Undersea and Hyperbaric Medical Society, Inc. 33 (6): 463–7. PMID 17274316. Archived from the original on 24 March 2011. Retrieved 30 December 2010. 
  19. ^ Lane, Jordan D. (2017). "Drowning Deaths From Unsupervised Breath Holding: Separating Necessary Training From Unwarranted Risk". Military Medicine. Association of Military Surgeons of the U.S. 182 (January/February): 1471–1473. doi:10.7205/MILMED-D-16-00246. Retrieved 26 January 2016. 
  20. ^ a b Lindholm, Peter (2006). Lindholm, P.; Pollock, N. W.; Lundgren, C. E. G., eds. Physiological mechanisms involved in the risk of loss of consciousness during breath-hold diving (PDF). Breath-hold diving. Proceedings of the Undersea and Hyperbaric Medical Society/Divers Alert Network 2006 June 20–21 Workshop. Durham, NC: Divers Alert Network. p. 26. ISBN 978-1-930536-36-4. Archived (PDF) from the original on 19 May 2016. Retrieved 24 January 2017. 
  21. ^ North, Robert (December 2002). "The pathophysiology of drowning" (PDF). South Pacific Underwater Medicine Society Journal. SPUMS. 32 (4). Archived (PDF) from the original on 11 February 2017. Retrieved 9 February 2017. 
  24. ^ a b c d e f Farrugia, Audrey; Ludes, Bertrand (12 September 2011). "3 - Diagnostic of Drowning in Forensic Medicine". In Vieira, Duarte Nuno. Forensic Medicine – From Old Problems to New Challenges (PDF). InTech. pp. 53–60. ISBN 978-953-307-262-3. Archived (PDF) from the original on 15 February 2017. Retrieved 4 February 2017. 
  32. ^ a b Pia, Frank (June 1984). "The RID factor as a cause of drowning". Parks & Recreation. Archived from the original on 5 March 2016. Retrieved 1 October 2012 – via pia-enterprises.com. 
  33. ^ "2005 ILCOR resuscitation guidelines" (PDF). Circulation. 112 (22 supplement). 29 November 2005. doi:10.1161/CIRCULATIONAHA.105.166480 (inactive 31 January 2017). Archived (PDF) from the original on 27 February 2008. Retrieved 17 February 2008. There is insufficient evidence to recommend for or against the use of oxygen by the first aid provider. 
  35. ^ MedlinePlus Encyclopedia Near drowning
  38. ^ a b Suominen, Pertti K.; Vähätalo, Raisa (15 August 2012). "Neurologic long term outcome after drowning in children". Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. BioMed Central. 20 (55). doi:10.1186/1757-7241-20-55. ISSN 1757-7241. Archived from the original on 3 February 2017. Retrieved 2 February 2017. 
  42. ^ Committee on injury, violence, and poison prevention. "Policy Statement—Prevention of Drowning". Pediatrics. doi:10.1542/peds.2010-1264. Archived from the original on 9 June 2010. 
  45. ^ "Children Drowning, Drowning Children" (PDF). The Alliance for Safe Children. Archived from the original (PDF) on 28 July 2011. Retrieved 6 October 2010. 
  47. ^ "Archived copy". Archived from the original on 27 September 2017. Retrieved 9 September 2017. [not specific enough to verify]
  48. ^ a b c Hawkins, SC; Sempsrott, J.; Schmidt, A. "Drowning in a Sea of Misinformation: Dry Drowning and Secondary Drowning". Emergency Medicine News. Archived from the original on 7 August 2017. 
  49. ^ Szpilman, D; Bierens JL; Handley A; Orlowski JP. "Drowning". New England Journal of Medicine. 10 (2): 2102–2110. doi:10.1056/nejmra1013317. 
  52. ^ a b Idris, AH (2003). "Recommended Guidelines for Uniform Reporting of Data from Drowning". Circulation. 108 (20): 2565–2574. doi:10.1161/01.cir.0000099581.70012.68. 
  53. ^ Schmidt, AC; Sempsrott JR; Hawkins SC (2016). "Wilderness Medical Society Practice Guidelines for the Prevention and Treatment of Drowning". Wilderness & Environmental Medicine. 27 (2): 236–51. doi:10.1016/j.wem.2015.12.019. Retrieved August 25, 2017. 
  54. ^ "2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 112 (24). 2005. doi:10.1161/CIRCULATIONAHA.105.166565. Archived from the original on 26 August 2017. Retrieved 25 August 2017. 
  57. ^ Tobin, JM; Rossano JW; Wernicki PG (2017). "Dry Drowning: A Distinction without a Difference". Resuscitation. Retrieved August 25, 2017. [permanent dead link]
  58. ^ Gilchrist, A (2004). "Nonfatal and Fatal Drownings in Recreational Water Settings-United States 2001-2002". Morbidity and Mortality Weekly Report. 53: 447–452. 
  59. ^ "Dry Drowning". Snopes. June 8, 2017. Retrieved August 25, 2017. 
  60. ^ "Water-Related Injuries". US Centers for Disease Control and Prevention. Jun 12, 2008. Archived from the original on July 19, 2008. Retrieved August 25, 2017. 
  64. ^ "Death After Swimming is Extremely Rare – And is NOT "Dry Drowning"". American College of Emergency Physicians. Archived from the original on 21 October 2017. Retrieved 20 October 2017. 
  68. ^ "Drowning and Life Saving". Encyclopædia Britannica (11th ed.). 1911. Archived from the original on 10 August 2016. 

External links

External resources

  • Canadian Red Cross: Drowning Research: Drownings in Canada, 10 Years of Research Module 2 – Ice & Cold Water Immersion
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