View Full Version : Medical advice: drowning

06-17-2007, 04:28 PM
Can anyone help with info on drowning? I have a character who almost drowns at the age of 12 and is brain damaged to the point of being catatonic. She's still catatonic twenty years later.

Specifically, I need to know:
How long would she be in hospital after the accident?
What sort of treatment would she have?
Would she be OK being cared for at home?
How severe is her brain damage likely to be? Does she have the power of speech, memory; is she able to recognise family?

Big thanks in advance.

Plot Device
06-17-2007, 05:25 PM
My understanding is that brain damage starts to set in after 4 minutes of total oxygen deprivation. And after 7 minutes, death. So anything after 4 minutes and before 7 means a survivor can quite possibly be rendered a total vegetable.

As to what parts of the brain suffer damage first, I suspect the eyes/vision centers might be a significant target. Here are two annecdotes from people I know in real life:

I have a freind from college who told me her own ordeal of almost dying NOT from oxygen deprivation, but food deprivation. She was continually vomitting for several years and was unable to eat anymore. Feeding tubes were no good because feeding tubes need to deliver the food into the stomache and her stomach was rejecting everything. All they could do was IV's. And that wasn't enough. She was dying from starvation. She had zero body fat left. And that's dangerous because certain systems/organs/tissues need fatty sheaves around them, including the heart and various nerves.

She told me that she reached a point as she lay on her hospital bed where she went blind because when you reach advanced stages of starvation, the body starts shutting down all non-essential life functions to try and conserve energy. The eyes aren't vital, so off they went.

I have another friend (an acquaintance actualy--a freind of an ex-boyfriend) from high school who tried to kill himself as a teenager via carbon monoxide poisoning with the car in the garage. His family found him in time to save his life, but not before his vision was permanently damaged. He's now blind. I don't know all the details of his blindness (partially blind, fully blind, etc.) but it seems that the eyes are a sensitive target for shut-down when the body is in mortal distress.

06-17-2007, 07:10 PM
Some links to check out include emedicine's (http://www.emedicine.com/emerg/topic744.htm) and Merck's (http://www.merck.com/mmhe/sec24/ch294/ch294a.html), both respected sites. Neither seems to get very specific about the nature of brain damage a person might suffer.

Maryn, opposed to drinking and boating (common around here)

06-17-2007, 09:07 PM
The brain damage is not specific to drowning but is from what is called asphyxia, lack of oxygen. I've seen quite of few asphyxiated patients over the years and the end effects can be quite variable -- the brain is a mysterious organ. You've said your character is severe. He would then probably be on a ventilator in intensive care for several weeks, followed by several months in a rehab unit. The severity of his ICU course would depend upon how much the asphyxia affected organs besides the brain; kidneys, heart, and liver are commonly damaged but usually recover if the patient survives.

We don't use the term catatonia in this situation -- the term was once mainly applied to form of schizophrenia that has apparently disappeared. It is not a word neurologists commonly use.

The worst case scenario for your patient would be a persistent vegetative state--tracheostomy connected to a ventilator for breathing, a feeding tube through the abdominal wall for liquid feedings, and no meaningful consciousness. Some families choose this, most don't.

Best case would be complete recovery, which happens. If you want some defects, mild cases could have decreased metal capacity, down to the mental capacity of a toddler or so. You could plausibly make this as severe as your plot requires. So-called soft neuro signs would be things like memory difficulty, emotional lability, learning disability. Such a patient would probably also have some motor problems, maybe as mild as just being "clumsy."

Worse case would add motor problems to the cognitive problems, things once called "cerebral palsy," although we don't use that term much anymore. Mild cases would be one or both legs, more severe would include arms. Limbs have tight muscles, patient has difficulty using them. Often need crutches, may need wheel chair. Most of these patients continue to need special physical and occupational therapy help, but nearly all live at home--how independently depends upon their particular problems.

Deafness or blindness, partial or total, would not be unexpected.

Bottom line: the brain is quite variable, do what your plot needs, especially regarding personality, speech, intellectual capacity. All things are possible.

06-18-2007, 04:06 PM
Thanks for all the help. There's a lot here I can use. I'm aiming to make my character severely affected by her drowning. I was planning on having her being cared for at home a month or so after the incident but I can work around that if she's likely to be in hospital for longer. I'm working on the first draft so obviously it'll be easy to change the stuff that doesn't work.

02-27-2008, 11:07 PM
If someone is drowning and has already lost consciousness, is there a possibility to rescue him without knowing anything about first aid?
(Simply bring him out of the water and wait...could that be successful?)

02-28-2008, 04:53 AM
Do note whether or not the incident occurred in cold water. Average swimming pool/bath tub/open water in a reasonably warm location=much, much quicker death, likely impairment than a cold water near drowning. Amazing how long someone can be pulseless and apneic in a cold water scenario and come back hunky dory with a good resuscitation. Especially because your character may have been uite young when the near drowning happened, as you're writing about her 20 years later. Amazing how long a kid can be submerged and come out of it hunky dory. A kid in cold water=any decent paramedic can often hand resusc in the field.

Men - yes, loss of cons is not the problem, hypoxia is. Passing out does not mean the person is asphyxiated.

02-28-2008, 02:29 PM
Men - yes, loss of cons is not the problem, hypoxia is. Passing out does not mean the person is asphyxiated.

Oh...I am stupid. After all, dolphins can rescue drowning humans...and dolphins have no idea what to do apart from keeping them over water...

Thank you for the answer, and for not mentioning how stupid I am. ;)