Near drowning in children.

The basic pathophysiology of submersion injury has been reviewed with an emphasis on effects to the lungs and brain. Factors that affect outcome are the submersion time, the presence of immersion hypothermia and/or the "dividing reflex" and the initial resuscitation. Principles of in-hospital management were discussed. In view of the accidental nature of these injuries and potentially devastating sequelae, accident prevention has been emphasized. Nurses can play a leading role in educating parents and the public at large in ways to prevent drowning and near-drowning accidents in children.