Near drowning.

Irrespective of the immersion medium, the primary consequence of any near drowning episode is hypoxemia and resultant hypoxia. The gravest consequence of hypoxia is cerebral insult. A major contributor to cerebral recovery in cold water drowning is hypothermia and resultant cerebral hypometabolism. Though the causal mechanism of this phenomenon is the focus of debate, hypothermia at presentation remains a good prognostic indicator. Nursing and medical care should be directed towards reversal of hypoxemia and cerebral salvage with this factor in mind, rather than expectation of relatively rare sequelae. This article reviews the pathophysiology of near drowning and contemporary trends in its treatment.