Is There a Clinical Difference between Salt Water and Fresh Water Drowning?

Introduction: Salt water near-drowning events are not uncommon in coastal regions. The difference in tonicity between salt and fresh water in near-drowning events leads many to believe there should be differences in the approach to managing the patient. We present a case of near-drowning in salt water and a thorough review of the literature in managing these patients. Case Presentation: A sixteen year old male presented to our level 1 trauma center approximately 30 minutes after a near-drowning in salt water. The patient began to develop hypoxemia associated with profound pulmonary edema that was not responsive to elevated inspired oxygen levels and high levels of positive end-expiratory pressure (PEEP). Conclusion: Despite the alterations in the alveolar interface that are dependent on the tonicity of the fl uid, the ultimate treatment of drowning injuries remains consistent regardless of the tonicity of the water. Aggressive therapy, tailored to the individual patient, can improve pulmonary shunting. Patients with hypoxemia requiring intubation should be ventilated with (PEEP) as animal studies have shown rapid improvements in PaO2 with PEEP values in the range of 5-15. Case Report Is There a Clinical Difference between Salt Water and Fresh Water Drowning? Celia Y Quang, Ryan O Kennedy, Scott G Blair, Sidney B Brevard and Jon D Simmons* Division Acute Care Surgery and Burns, The University of South Alabama Medical Center, Mobile, AL, USA Dates: Received: 21 December, 2016; Accepted: 02 January, 2017; Published: 03 January, 2017 *Corresponding author: Jon D Simmons, M.D. Associate Professor, University of South Alabama, Division of Acute Care Surgery and Burns, 2451 Fillingim St., Suite 10-I, Mobile, AL 36617-2293, USA, E-mail: https://www.peertechz.com