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Drowning Deaths
Published in Sudhir K. Gupta, Forensic Pathology of Asphyxial Deaths, 2022
Routine autopsy practices fail to demonstrate evidence of entry of water into the airway in about 15% of drowning cases. These cases have been termed ‘dry drowning’ due to the dry status of the lungs. Protracted laryngospasm following the first bolus of influx is the main postulated reason for these cases. Persistent laryngospasm and closure of glottis obstruct air entry to lower respiratory tract, resulting in asphyxia and death. However, many newer studies have demonstrated fluid entry into the lungs in almost all cases of drowning and challenge this postulation of laryngeal spasm resulting in ‘dry drowning’.
Drowning
Published in Burkhard Madea, Asphyxiation, Suffocation,and Neck Pressure Deaths, 2020
The actual occurrence of dry drowning has been questioned during the past two decades, and a consensus now exists that the term ‘dry drowning’ should be discarded, as it represents a nonentity [63,81,98,85].
Immersion and drowning
Published in Jason Payne-James, Richard Jones, Simpson's Forensic Medicine, 2019
Jason Payne-James, Richard Jones
Explanations for the death of individuals recovered from water without autopsy signs of aspiration of water led to the concept of ‘dry drowning’, although alternative explanations for such deaths include trauma, the effects of intoxication, arrhythmia, laryngospasm or some other neurologically mediated mechanism. The need for this terminology has been questioned and the use of the term ‘dry drowning’ is obsolete and confusing.
Drowning is never dry
Published in Expert Review of Respiratory Medicine, 2019
Andrew Schmidt, Seth Hawkins, Linda Quan
In 2002, international leaders in the science of drowning resuscitation and prevention met to begin the process of standardizing the discussion of drowning around the world. It was well known that the term drowning carried numerous different definitions in the scientific literature; this was later validated by a review of 60 years of literature which found 33 different definitions for drowning [2]. To address this, they defined drowning as: ‘The process of experiencing respiratory impairment due to submersion or immersion in a liquid’ [3]. For this definition, ‘submersion’ refers to the entire body under water and ‘immersion’ refers to a part of the body being covered in water, involving at least the face and airway. This definition has since been accepted by the World Health Organization, Centers for Disease Control and Prevention, American Heart Association, European Resuscitation Council, American Red Cross, and every other governing body associated with the treatment of drowning patients. Inherent in this definition are that a drowning event (1) must involve a liquid medium, (2) is a process that begins at time of submersion or immersion, and (3) requires respiratory distress immediately following the submersion/immersion. Respiratory impairment may include any involuntary derangement from sustained cough to respiratory arrest, not to include voluntary breath holding [4]. Moreover, the definition is not dependent on the outcome. Furthermore, recommendations were made to discontinue the use of modifiers such as near, dry, wet, secondary, and delayed. The term ‘near drowning’ had been used to describe a drowning event in which the patient survived but for varying periods of time. Instead, the event can result in a non-fatal drowning wherein ‘there must be evidence of respiratory impairment to be classified as a non-fatal drowning’ [4]. The modifiers ‘dry’ and ‘wet’ were originally used in forensic science to describe the presence or absence of water in the airways following a fatal drowning. Pathologists described the 10% of drowning cases without evidence of water in the alveoli or airways on autopsy as ‘dry drowning’, which they attributed to laryngospasm leading to suffocation [5]. ‘Secondary’ and ‘delayed’ have been used to describe the development of symptoms or sudden death hours to days following a submersion in patients who were otherwise clinically normal [6]. Recently, the modifier ‘dry’ has also been used to describe these cases, referring to a patient who suddenly ‘drowns’ while on land.