Near-drowning.

It can be seen that the physiologic changes occurring in near-drowning are complex. The pulmonary changes including edema, shunting, and alterations in surfactant properties cause disturbances in oxygenation and acid-base balance which can have severe consequences for the near-drowning victim if immediate and intelligent treatment is not directed toward their correction. Although blood volume, serum electrolyte, and hematologic changes are generally not severe, they must still be considered. The secondary effects, which make up the clinical situation met with in patients eventually admitted to the hospital, may result in disaster in those who appear to have recovered from the acute episode unless careful vigilance is maintained. The possession of a sound knowledge base related to these aspects is essential in the treatment and care of near-drowning victims.