SALT WATER DROWNING/NEAR DROWNING
a. The effect on the casualty is different when the incident occurs in salt water.
Salt water entering the lungs has a higher solute concentration than the plasma in the
bloodstream. This causes fluid to be drawn out of the bloodstream into the lungs,
causing a massive pulmonary edema (congestion of the lungs). The concentration of
salt in the sea water has drawn the normal body water into the lungs.
b. If enough fluid has been drawn out of the patient's bloodstream, the person
may go into shock and drown in his own interstitial fluid (fluid bathing the cells).
COLD WATER DROWNING/NEAR DROWNING
a. Hypothermia. If the incident occurs in cold water, the victim's body
temperature may drop below normal, usually between 78 and 90F. This condition is
termed hypothermia and can occur even in water that is not freezing. Since water
conducts heat well and the person's body is usually warmer than the water, the water
conducts heat from the individual to the surrounding water. As this conduction takes
place, the person's body temperature drops and, at the same time, his body functions
become slower. As his body temperature drops, his ability to think, act, and make
rational judgments deteriorates. Eventually, he lapses into a coma and dies.
b. The Diving Reflex. The mammalian diving reflex, first identified in sea going
animals, operates in cold water and extends the possible time of survival. This reflex,
more active in younger persons, is a reaction of the body whereby the heartbeat slows
and the peripheral arteries constrict thus sending oxygenated blood away from the
extremities and the intestines. Blood is sent, instead, to the vital organs--heart, brain,
and kidneys. Survival time is extended because the rerouting of blood results in the
body tissues needing less oxygen.
SUSPECTED INJURIES IN DROWNING/NEAR DROWNING
If the incident occurred when the victim was diving or in shallow water, consider
that he might have head, neck, or spine injuries. Treat the patient as if he had
sustained a serious spine injury. Ask a conscious person if he can feel or move his
toes. Also ask if he has tingling or less sensation in his arms, legs, or toes. If the
person is face down, turn his body as a whole unit over so that he is on his back. If the
person is unconscious, put him on a spine board, and begin artificial ventilation as you
move him to shore on the board. Secure him to the board before you move him out of