b'DrowningChapterDrowning is one of the major causes of death in children. Infants and children can accidentally drown very quickly if left unsupervised at a pool, at the beach, river or in a bath.Drowning is death by suffocation from immersion in water or other liquid. Air cannot get into the lungs and this may cause the throat to spasm.The Reaction to Water InhalationIf water enters the airways of a conscious patient, they will try to cough it up or swallow it thereby inhaling more water involuntarily. When water enters the airways, both conscious and unconscious patients experience laryngospasm, (e.g. the larynx or the vocal cords constrict and seal the airways). This prevents water from entering the lungs. Unfortunately, this can also interfere with air entering the lungs. In most patients, the laryngospasm relaxes a short time after unconsciousness and water then enters the lungs causing a wet drowning. However, about 10 to 15% of patients maintain this seal until cardiac arrest. This is known as dry drowning because no water enters the lungs. In forensic pathology, water in the lungs indicates that the patient was still alive at the point of immersion. The absence of water in the lungs may either be a dry drowning or indicates death occurred before immersion.How to Manage a Drowning or Near Drowning Incident DRSABCD Remove the patient from the water as soon as possible but do not endanger your own safety.Throw a rope or object to provide buoyancy to the patient.Plan and effect a safe rescue. In minor incidents, removal from the water is often followed by coughing and spontaneous return of breathing. In more serious incidents, assess the patient. Commence CPR if unconscious and not breathing normally.Assess the patient on their back (or in the position found) with the head and the body at the same level, rather than in a head down position. The patient should also not be routinely turned onto the side to assess airway and breathing. This reduces the likelihood of regurgitation and vomiting and also avoids unnecessary movement. The exceptions to this would be in the event of an airway obstruction caused by fluid (water or blood) or foreign matter (sand, debris, vomit). In this instance the patient should be promptly turned onto their side to clear the airway. The mouth should be opened and turned slightly downwards to allow any foreign material to drain using gravity. Vomiting and regurgitation often occur during the resuscitation of a drowned patient. If the patient has been turned onto their side to clear the airway, reassess their Airway / Breathing and general condition. If breathing commences, the patient can be left on their side with appropriate head tilt. If not breathing normally, commence CPR Avoid any delay or interruption to CPR.210 Medical Emergencies'