Fast Five Quiz: Drowning and Water-Related Health Concerns

Richard H. Sinert, DO

Disclosures

May 13, 2022

Metabolic acidosis secondary to lactic acidosis is the most common laboratory abnormality noted in patients who experience nonfatal drownings. This finding may be present in otherwise asymptomatic patients. Patients are likely to be asymptomatic if they experience brief, witnessed submersions with immediate resuscitation. Those who are symptomatic may exhibit:

  • Altered vital signs (eg, hypothermia, tachycardia, or bradycardia)

  • Anxious appearance

  • Tachypnea, dyspnea, or hypoxia; if dyspnea occurs, no matter how slight, the patient is considered symptomatic

  • Altered level of consciousness, neurologic deficit

  • Cough

  • Wheezing

  • Hypothermia

  • Vomiting, diarrhea, or both

Acute renal impairment is known to occur in nonfatal drowning. Although usually mild (serum creatinine level < 0.3 mmol/L or 3.4 mg/dL), severe renal impairment requiring dialysis may occur.

Chest radiography is not required in all patients with nonfatal drowning experiences. However, it is recommended in patients with continued hypoxia or respiratory symptoms that worsen.

Learn more about the workup of nonfatal drowning.

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