Fresh water drowning and near-drowning-an update

The current status of fresh water near-drowning including some recent advances has been reviewed, with particular emphasis on cerebral salvage. The goal of paramount importance is intact cerebral survival after near-drowning but sadly death and incomplete recovery remain persistent problems. The use of a neurological classification is presented which has facilitated clinical and therapeutic studies. Aggressive therapeutic measures are described which have reduced morbidity and mortality but may easily lead to “vegetative” survival of some cases who formerly died. Many factors which affect prognosis are discussed but most are uncontrolled and uncontrollable.