Medical The Experience of Drowning

[Biotech Diver]

Since drowning is one of, if not the most, way divers die, I thought people might want to read this article I came across. I think it belongs in this forum but if not, please feel free to delete or move it.

I think it's important to remind ourselves about the horrors of drowning and be more empathetic to the survivors of the victims. I learned a lot from this article and hope others will too.

Click on this link for the full article, which has a lot of detail and analysis.

The experience of drowning - PMC

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 ...

pmc.ncbi.nlm.nih.gov

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.

Introduction​

Drowning is defined as ‘the process of experiencing respiratory impairment from submersion/immersion in liquid’. <a href="The experience of drowning - PMC">1</a> It has three outcomes: nonfatal, nonfatal with injury or illness, or fatal: it causes approximately 1000 deaths a day worldwide and leaves many times that number with lifelong morbidity. <a href="The experience of drowning - PMC">2</a>

The events that result in drowning can be divided into the following sequence: (i) struggle to keep the airway clear of the water, (ii) initial submersion and breath-holding, (iii) aspiration of water, (iv) unconsciousness, (v) cardio-respiratory arrest and (vi) death – inability to revive.

There are many high-quality reviews on the physiology and pathophysiology of drowning.<a href="The experience of drowning - PMC">3</a>–<a href="The experience of drowning - PMC">7</a> Likewise, drowning following longer term immersion or in diving scenarios, and the treatment of drowning, are dealt with elsewhere.<a href="The experience of drowning - PMC">8</a>,<a href="The experience of drowning - PMC">9</a> Discussion of these areas does not need to be repeated. Whilst much of this review is applicable to other scenarios, such as warm water, it focuses on the duration and subjective experience of drowning shortly after immersion in cold water (which we arbitrarily take to be water temperature of less than 15°C). Cold water is a common factor in drowning cases and can be a major determinant of outcome. <a href="The experience of drowning - PMC">10</a>

From a medico-legal perspective, the questions of ‘how long does it take to drown?’ and ‘what is the pain and suffering associated with drowning?’ are often critical for determining the outcome of drowning-related cases in the courts. This is the primary focus of this short review. However, it is also hoped that this review will also increase the potential to identify a drowning individual, and improve understanding of the impact of time to rescue on outcome.

...

 

[Texasguy]

Woman drowned dog in airport bathroom after being denied boarding, police say

Authorities say a woman drowned her dog in a Florida airport bathroom and then boarded her international flight after she was prevented from bringing the white miniature schnauzer with her because of a paperwork issue

abcnews.go.com

 

[Nemrod]

Having aspirated seawater into my lungs and swallowed seawater with vomiting and laryngeal spasm which did eventually relax enough for me to breathe again, I came very close to drowning. Close enough to have experienced the first stages of drowning and I can say drowning is not at all comfortable or an easy way to die.

It is difficult to determine the subjective experience of drowning, and the ‘pain and suffering’ associated with the process, but this is often pivotal in legal cases. The experience of drowning has been reported to be real, profound and transformative.

The part from above that caught my attention was "The experience of drowning has been reported to be real, profound and transformative." Yes, I agree with that, real, profound and transformative. Drowning is painful and scary and even though I in the end did not drown, it was close enough to give me some insight into what drowning is really like. It is not fast, there is no on/off switch, drowning is fully perceived as being painful, long and with suffering.

 

[scott7685]

Having aspirated seawater into my lungs and swallowed seawater with vomiting and laryngeal spasm which did eventually relax enough for me to breathe again, I came very close to drowning. Close enough to have experienced the first stages of drowning and I can say drowning is not at all comfortable or an easy way to die.

It is difficult to determine the subjective experience of drowning, and the ‘pain and suffering’ associated with the process, but this is often pivotal in legal cases. The experience of drowning has been reported to be real, profound and transformative.

The part from above that caught my attention was "The experience of drowning has been reported to be real, profound and transformative." Yes, I agree with that, real, profound and transformative. Drowning is painful and scary and even though I in the end did not drown, it was close enough to give me some insight into what drowning is really like. It is not fast, there is no on/off switch, drowning is fully perceived as being painful, long and with suffering.

Nemrod - did you find it challenging to get back in the water after that experience?

 

[Nemrod]

Nemrod - did you find it challenging to get back in the water after that experience?

No and yes, actually, I kept diving afterwards. Soaking night sweats caused by double pneumonia and fevers and all. However, afterwards, I began reflecting on exactly what happned. It took a few days for it all to come into focus. I do not think that unusual, it took some time to process. And I made a number of changes and continuing to do so. I have always had a phobia about anything restricting my breathing or pressing on my chest, even something like a BC sternum strap or a too tight wet suit or anything, not even dive related. I do not like it and more so now. Several times since, I have just had the feeling I was not getting enough air (even though I am) and enough so that I have aborted a dive.

 

[Biotech Diver]

This article corrected a lot of misconceptions I had about drowning. I always believed it to be a somewhat peaceful way to go based on what I've read and watched on various videos. I was an aircrewman in the Navy and I remember them telling us in P'Cola that after the second lung-full of water you just black out and it's painless. I believed it, maybe for the better because I've never had a fear of the water or drowning. I thought the helo dunker and egressing out of simulated ejection seat was a blast. I'd pay money to do that all over again. The movie An Officer and a Gentleman was actually pretty accurate for a lot of things, especially the egress out of the ejection seat simulator. I might be using the wrong terminology for the simulator but it was basically this seat in like a roll cage and it was on rails. You get in it then the release it and it goes to the bottom of the pool at at least 10 feet, and then it flips over on the roof so you are upside down. You have to egress out of it wearing all of your flight gear (boots, flight suit, helmet, gloves) and make it to the surface. I did the simulator at Widby Island WA when I was attached to VP69.

 

[CG43]

Humans cannot tolerate salt water or fresh water in their lungs.
Therefore the first rule when diving should be : Never inhale water !
If you can't breathe in and out, you can still breathe paradoxically with your mouth or larynx closed.
So chest up and diaphragm up at the same time or chest down and diaphragm down at the same time.
This happens all by itself through reflexes, is not necessarily pleasant but you don't die from it.
You can and should know and train this . Freedivers call it contractions and for them it is quite normal
when diving.
If this state lasts too long, the diver can enter a peaceful state due to lack of oxygen and high CO2 levels.

I had this experience when I couldn't find my way out under ice and the tank was empty.
Sure , my chest and diaphragm were twitching up and down violently ,
but I could tolerate that because I was trying to find my way out . There were phases of fear , anger , hope and in the end I became calmer and calmer and past away in peace without to have inhaled water .
This circumstance probably had a very favorable effect on my resuscitation and health consequences.
My first freedives after activated memories of the acccident but that was only three or four freedives.

I don't want to miss this experience under any circumstances and I don't want to repeat it either.

 

[Nemrod]

Therefore the first rule when diving should be : Never inhale water !

I was using a double hose regulator with a DSV. The powerful Venturi is what forced the water past my larynx.

 

[CG43]

I was using a double hose regulator with a DSV. The powerful Venturi is what forced the water past my larynx.

In your case, the water came as a surprise and you did not give in to a strong respiratory stimulus
as is probably usually the case when people drown.
If the mouthpiece suddenly detaches from the reg. during inhalation, a similar situation can occur.

Every diver should be aware that no matter how unpleasant the breathing stimulus may be,
paradox breathing, i.e. allowing twitching of the chest and diaphragm, is much easier to stand
than the consequences of inhaling water. The water only makes your feelings much more worse.

As a young diver I read what salt water does to the lungs and what fresh water does to the lungs.
Then I decided for myself: As long as you are conscious, you will never inhale water, never!
This decision and freediving practice certainly helped me during my accident.

 

[ThePipingSheriff]

About 7 months ago I had an IPE and began to hyperventilate at about 70 feet. I knew I wasnt right, but made a controlled ascent to 15 feet for a safety stop. My wife always says "Don't drown." The idea of it scares the hell out of me. At about 55 seconds into the safety stop I thought "If something bad is going to happen to me its going to happen to me on the surface." I made it to the surface and was literally exhausted. I inflated my BC and began to cough up blood. By the grace of god and a helicopter ride I made it out of the hospital in a couple of days. It could have been worse, but it was going to happen above the water!!