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Asphyxia due to aspiration of fluid into air spaces.

Types of Drowning

  1. Wet drowning (Primary drowning or typical drowning):  In this, water is inhaled into lungs. It can be fresh water drowning or sea water drowning
Fresh water drowning: hemodilution hemolysis hyperkalemia ventricular fibrillation.
Sea water drowning: increased salinity withdraws water from blood into the lung hemoconcentraton hypernatremia and increase in Mg++ that leads to bradycardia
  1. Dry Drowning:
    In this type, water does not enter the lungs, but death results (laryngeal spasm) due to inrush of water into the nasopharynx or larynx. Seen in epileptic, alcoholic, drug addict, HT, Heart patient. 
  2. Secondary drowning =
    Post-immersion syndrome = near drowning: In this type, death occurs from within half hour to several days after resuscitation. Electrolyte disturbances and metabolic acidosis occur. Death occurs due to a) cerebral anoxia with irreversible brain damage, b) Myocardial anoxia Q- delayed heart failure.
  3. Hydrocution = Immersion Syndrome = Submersion Inhibition=Cold water drowning:
    1. It occurs when death results from cardiac arrest due to vagal inhibition as a result of cold water stimulating the vagal nerve endings at any of these- (a) of the surface of the body, (b) water striking the epigastrium, (c) cold water entering ear drums, nasal passage and the pharynx and larynx which causes stimulation of nerve endings of vagus in the mucosa.
    2. It is caused by duck diving i.e. falling or diving into the water feet first or by the inexperienced, or diving involving horizontal entry into the water with a consequent blow on the abdomen.

P.M. Appearance

  1. P.M. staining : in stagnant water, on face, upper part of chest and lower arm and feet.            
                          : in moving water, it doesn’t appear
  2. Washer woman’s hand : seen in 12-18 hrs.
  3. Cutis anserine : (goose skin/goose flesh)
    1. Paltauf’s hemorrhages: sub-pleural hemorrhage due to rupture of alveolar walls when pressure increases during forced expiration.
    2. Temporal bone hemorrhage: seen in drowning, hanging, CO poisoning and head injury.

Signs of Antemortem drowning

  1. Froth in drowning : fine, white, leathery and persistent. Seen in mouth and nostrils. Which keeps on reappearing on being wiped. It’s the most characteristic sign.  Absence of foam seen in laryngeal spasm and immersion syndrome.
  2. Cadeveric spasm: weeds, grass, sticks grasped in the hand (surest sign of A.M. Drowning)
  3. Emphysema aquosum:  lungs are over distended and alveolar walls are torn. On section, an oedematous condition due to the presence of watery, frothy, sometimes blood stained fluid is seen,
  4. The presence of fine froth in the lungs and air passages
  5. Presence of Water in stomach and intestines.  It requires peristalsis which is a vital act.
  6. Diatom test
  7. Gettlers test

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