Resuscitation After Aspiration of Chlorinated Fresh Water

Jerome H. Modell, USN, MC
JAMA. 1963;185(8):651-655. doi:10.1001/jama.1963.03060080047013.
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THE PROBLEM OF DROWNING is formidable, accounting for 7,000 deaths per year in the US,1 500 deaths per year in Australia,2 and 1,474 deaths per year in England and Wales.3 Numerous reports have been published of the physiological changes that occur after aspiration of fresh and sea water by animals,4-20 but reports on the effects of aspiration of water by man have been confined for the most part to findings at autopsy21-23 except for isolated clinical cases.24-27 With the increasing popularity of swimming pools containing chemically treated water, another type of drowning, which may differ in character from both fresh-and sea-water drowning, is now presenting itself, ie, drowning after the aspiration of chlorinated fresh water.

In contrast to the common history of panic and struggling28 which precede the hypoxia, hypercapnia, unconsciousness, and aspiration which are usually associated with drowning, histories of


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