Drowning
Normally respiration does not cease with syncope, and on land when the
person collapses, cerebral blood flow is increased, resulting in return
to consciousness. When syncope occurs in an aquatic environment, the
body attempts to breathe, but instead of taking in air, water enters the
airway, triggering laryngospasm and consequent inability to breathe.
This initiates the drowning process.22 With increasing
hypoxia, the laryngospasm abates and further aspiration of water may
occur. This often (30-50%) results in post-drowning pneumonia in
survivors.22 Such was the case in the case report
above. When drowning occurs in cold water environments, the body and
brain may cool sufficiently to prevent massive cerebral damage, but in
heated water, the increase in brain metabolism combined with hypoxia may
be catastrophic.22