Turner White CommunicationsAbout TWCSubscribeContact TWCHomeSearch
Hospital PhysicianJCOMSMPBRMsCart
Current Contents
Past Issue Archives
Self-Assessment Questions
Review of
Clinical Signs
Clinical Review
Pediatric Rounds
Resident Grand Rounds
Article Archives
Case Reports
Clinical Practice
Pediatric Rounds
Resident Grand Rounds
Review of
Clinical Signs

Guide to Reading
Hospital Physician
Editorial Board
Information for Authors

Reprints, Permissions, & Copyright
Site Map
Self-Assessment Questions

Emergency Medicine

Answer 3
  1. Up to 20% of patients who arrive in the ED comatose and flaccid with dilated pupils can be expected to fully recover. The appearance of a patient after a near-drowning accident cannot reliably predict the outcome.2 Patients who are hypothermic must be warmed to at least 32°C (90°F) before they can be declared dead. Not all patients require admission, but patients must be observed. Patients with a history of apnea, unconsciousness, hypoxia, or dysrhythmias; those with an abnormal electrocardiogram or chest radiograph; and those who remain symptomatic in the ED require admission. Cervical spine injuries should be suspected in all near-drowning patients with altered mental status because a diving injury may have precipitated the near-drowning episode. Most near-drowning victims do not aspirate enough fluid to cause mechanical difficulties in ventilation. However, aspiration of both water and waterborne contaminants can cause damage to pulmonary surfactant.

    2. Weinstein MD, Krieger BP. Near-drowning: epidemiology, pathophysiology, and initial treatment. J Emerg Med 1996;14:461–7.

Click here to return to the questions


Hospital Physician     JCOM     Seminars in Medical Practice
Hospital Physician Board Review Manuals
About TWC    Subscribe    Contact TWC    Home    Search   Site Map

Copyright © 2009, Turner White Communications
Updated 1/04/08 • kkj