ABSTRACT
Drowning is a complex phenomenon embracing a range of psychological, physical, clinical and pathological mechanisms. Post mortem findings ascribed to drowning reflect the pathophysiology of submersion, immersion and aspiration of the drowning medium. Water immersion results in a number of changes to the body, and these changes are dependent on a variety of factors including: water temperature, the nature of the water, bacterial contamination, tidal flow, the nature of the sea or river bed, the presence of marine life, the habits of the individual, and clothing worn. As immersion time increases, macerated skin begins to separate from underlying tissues, leading to skin and nail peeling and apparent 'degloving' of the skin of the hands and feet. Immersion in water causes an interplay between cardiorespiratory responses to skin and deep body temperature, including cold shock, physical incapacitation, and hypovolaemia, as precursors of collapse and submersion.
