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. 2022 Mar;90(1):17-26.
doi: 10.1177/00258172211053127. Epub 2021 Nov 18.

The experience of drowning

Michael Tipton  1 , Hugh Montgomery  2
Affiliations

The experience of drowning

Michael Tipton et al. Med Leg J. 2022 Mar.

Abstract

Internationally, drowning is a leading cause of accidental death that features in many legal cases. In these cases, possible mitigations and the 'pain and suffering' in terms of the duration and subjective experience of drowning are often pivotal in determining levels of compensation and outcome. As a result, there is a requirement to understand the stages of the drowning process, and the duration and physiological and subjective responses associated with each stage. In this short review we focus on these issues.

Keywords: Drowning; cold water; pathophysiology; psychophysiology.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: MT is a co-founder of the International Drowning Researchers’ Alliance (http://idra.world/). HM is supported by the National Institute of Health Research’s Biomedical Research Centre (NIHR BRC) at University College London Hospitals (UCLH).

Figures

Figure 1.
Figure 1.
The ‘Physiological Pathways to Drowning’ following immersion/submersion in cold water, with possible interventions for partial mitigation (dashed boxes). IS: immersion suit; LJ: lifejacket; EBA: emergency breathing aid.
Figure 2.
Figure 2.
Relationship between oxygen consumption (aerobic physical activity) and time to unconsciousness during drowning for a 70 kg human at a lung capacity of 5.5 L in one atmosphere. Maximum volume of oxygen available = 1724 mL, loss of consciousness assumed when 50% of available oxygen has been used (see text). Solid circles = all air in lung available. Open circles = no air in lung available. Blue region represents likely intensities of exercise (Table 2).
Figure 3.
Figure 3.
The stages of fresh water drowning in the dog. See text for details. From Fainer et al. with permission.
See this image and copyright information in PMC

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