Drowning without aspiration: is this an appropriate diagnosis?

It has been reported that 10-15% of drowning victims do not aspirate water. We have revisited the original studies quoted to reach this conclusion and find it is without foundation. Sudden cardiac standstill is known to occur on land and, therefore, may also occur when the victim is in water. In the absence of the common finding of significant pulmonary edema in the victim's respiratory system, to conclude his or her death was caused by "drowning without aspiration" is unwise. All causes of sudden death that might occur in which respiration may not take place should receive serious consideration when examining bodies with such findings that are found in water.

[1]  J. Modell,et al.  Effects of Volume of Aspirated Fluid During Chlorinated Fresh Water Drowning , 1966, Anesthesiology.

[2]  J. Modell,et al.  Clinical course of 91 consecutive near-drowning victims. , 1976, Chest.

[3]  V. Schneider,et al.  THE SIGNIFICANCE OF DIATOMS IN THE DIAGNOSIS OF DEATH BY DROWNING. , 1964, Journal of Forensic Sciences.

[4]  J. Modell.  The pathophysiology and treatment of drowning and near-drowning , 1971 .

[5]  J. Modell,et al.  Effect of intravenous vs. aspirated distilled water on serum electrolytes and blood gas tensions. , 1972, Journal of applied physiology.

[6]  J. Modell.  Resuscitation After Aspiration of Chlorinated Fresh Water , 1963 .

[7]  A. B. Craig.  Causes of loss of consciousness during underwater swimming. , 1961, Journal of applied physiology.

[8]  R. Fuller,et al.  The 1962 Wellcome prize essay. Drowning and the postimmersion syndrome. A clinicopathologic study. , 1963, Military medicine.

[9]  Joseph H. Davis,et al.  Pathophysiologic Observations in Prehospital Ventricular Fibrillation and Sudden Cardiac Death , 1974, Circulation.

[10]  H. G. Swann,et al.  Body salt and water changes during fresh and sea water drowning. , 1951, Texas reports on biology and medicine.

[11]  J. Modell,et al.  The effects of fluid volume in seawater drowning. , 1967, Annals of internal medicine.

[12]  A. B. Craig.  Underwater swimming and loss of consciousness. , 1961, JAMA.

[13]  J. Modell,et al.  Fluid administration increases oxygen delivery during continuous positive pressure ventilation after freshwater near‐drowning , 1983, Critical care medicine.

[14]  G. E. Hall,et al.  PHYSIOLOGICAL STUDIES IN EXPERIMENTAL ASPHYXIA AND DROWNING. , 1939, Canadian Medical Association journal.

[15]  C. Noble,et al.  DROWNING: ITS MECHANISM AND TREATMENT. , 1963, Canadian Medical Association journal.

[16]  J. Davis,et al.  Electrolyte changes in human drowning victims. , 1969, Anesthesiology.

[17]  J. Davis.  Bodies Found in the Water: An Investigative Approach , 1986, The American journal of forensic medicine and pathology.

[18]  M. Brucer,et al.  Fresh water and sea water drowning; a study of the terminal cardiac and biochemical events. , 1947, Texas reports on biology and medicine.

[19]  H. Swan,et al.  Blood changes in man following death due to drowning, with comments on tests for drowning. , 1953, A.M.A. archives of pathology.

[20]  J. Modell,et al.  Physiologic Effects of Near Drowning with Chlorinated Fresh Water, Distilled Water and Isotonic Saline , 1966, Anesthesiology.

[21]  A. Gettler.  A Method for the Determination of Death by Drowning , 1921 .

[22]  J. Modell,et al.  Drowning by total immersion. Effects on pulmonary surfactant of distilled water, isotonic saline, and sea water. , 1967, American journal of diseases of children.

[23]  A. Moritz.  CHEMICAL METHODS FOR THE DETERMINATION OF DEATH BY DROWNING , 1944 .

[24]  J H Davis,et al.  Bodies in water. Solving the puzzle. , 1992, The Journal of the Florida Medical Association.

[25]  L. Hellman.  Adventures in artificial respiration , 1954 .

[26]  J. Davis,et al.  The very sudden cardiac death syndrome -- a conceptual model for pathologists. , 1980, Human pathology.