ABSTRACT
I. DEFINITIONS Drowning has been defined as death by submersion in a liquid. In contrast, near-drowning is survival or at least temporary survival of a patient beyond 23 hr following a submersion accident. Unfortunately, a variety of other modified definitions exist in the medical literature, which in the authors’ opinion cause confusion more than adding important information to the problems surrounding drowning accidents. Depending on the presence or absence of lung pathophysiology a differentiation has been made between dry and wet drowning. Secondary drowning has been defined as an accident in which death occurs some time after initial resuscitation because of severe acute lung injury due to fluid aspiration. In the German literature the term secondary drowning is used for patients developing acute lung injury with a time delay after fluid aspiration, regardless of their outcome. To help alleviate the confusion caused by differences in terminology the term neardrowning should be reserved for patients surviving a submersion accident beyond 23 hr, regardless of the presence or absence of fluid aspiration and acute lung injury.
