Near drowning

MODELL, JEROME H. M.D.

Department of Anesthesiology, University of Florida College of Medicine, J. Hillis Miller Health Center, Gainesville.

Address for correspondence: Dr. Jerome H. Modell, University of Florida College of Medicine, Box J-254, J. Hillis Miller Health Center, Gainesville, FL 32610-0254.

Circulation 74:p IV-28, December 1986.

Several conditions that contribute to drowning and near drowning must be considered in the treatment of near-drowned victims. Regardless of the cause, mechanical ventilation should begin as soon as possible and closed-chest cardiac massage should be administered when there is any question about the adequacy of cardiac output. After aspiration of either fresh or seawater, a large intrapulmonary physiologic shunt can occur, which requires aggressive mechanical ventilatory support to ensure adequate oxygenation and to return pulmonary function to normal. Near drowning is a multisystem disease and, while abnormalities of the lung and brain have been emphasized, definitive therapy must be tailored to each patient and must address all of the patient's needs.