Saturday, November 10, 2012

Drowning

Drowning is a process, not a single event. That is, drowning takes a rather extended time period, rather than an instantaneous action.


At its most basic level, drowning is suffocation, depriving the body of oxygen cells need to function. From a medical standpoint, the most critical cells are brain cells; other cells can die, but if enough brain cells die, then the body dies, no matter how much of the rest of the body's remains alive.


For this discussion, let's assume that drowning starts at the moment the person takes their last breath of air, NOT when they fall in the water. After that moment, the bloodstream does not get any new oxygen. So, as it circulates, cells remove the last of the existing oxygen from the blood; this process takes a handful of seconds (perhaps as many as a dozen). After the bloodstream's oxygen is depleted, cells switch from aerobic (with oxygen) to anaerobic (without oxygen) chemical processes to get their needed energy. Depending on the physical fitness of the individual, a person can burn anaerobically for up a couple of minutes at full speed; think about the time that you can hold your breath - that's the time you are burning anaerobically at full speed.


After this time, the body recognizes that it is in immediate danger, and begins to shut down various functions, in an attempt to conserve any stored energy. In the brain, this shutdown quickly leads to loss of consciousness. The body continues to slow down as much as it can, while still burning reserves anaerobically to provide energy. Eventually, the body runs out of reserves, and cells die. When enough brain cells die, the person is dead.


Restoring oxygen to the person at any stage above can revived them, though, if the person has been without air for an extended time, brain cells may have died, which is permanent. That is, recovery may be possible, but brain damage is permanent.



Assuming a normally fit person, otherwise conscious and uninjured, who is drowning in warm (21C/70F) water, I would estimate 2-3 minutes before full loss of consciousness, and 5-10 minutes before brain damage, and 15 minutes before irrecoverable death.


Note that there is a recently discovered reflex which helps humans when drowning - it is called the Mammalian Diving Reflex.
When cold (below 21C/70F) water hits the face, the body immediately begins the "shutdown to conserve" process above. This only works if the face is underwater. The colder the water, the faster the body shuts down. Also, the younger the person, the faster the reflex takes action. There are documented cases of children falling through ice-covered ponds who have survived over 30 minutes without brain damage.