DISCLAIMER: I am not a doctor, nor do I play one on TV. I do not hold a current medical license or certification (I let them lapse because I no longer work in the medical field and don’t intend to ever again). What I do have is an extensive medical background in various fields. Everything you read here is the result of either education, training, research and interpretation, or personal experience. The information in this post is not to be taken as a substitute for professional medical advice or examination. Seriously, if you’re having an immediate medical problem and you’re reading this blog for help, get off the damned computer and call an ambulance!

Here, at long last, is the post I’ve been promising you for a long time. Today we’re going to talk about drowning.

We talked awhile back about choking, strangling, and other fun. There we learned the difference between asphyxia and choking. (“Asphyxia” is the Fancy Medical Speak for “suffocation.”) Basically asphyxia is non-mechanical while choking/strangling is mechanical, but they both work the same way; both take away oxygen. Hint: you need oxygen to live.

Drowning is a unique form of asphyxiation. If you want the Fancy Medical Speak version, when someone drowns, they’re asphyxiated (suffocated) by water (or blood, or a bowl of soup, or their own bodily fluids, cancer – anything liquid, really, and it can be as little as a teaspoon to cause this).

For the purposes of this post, we’re going to stick to water being the liquid. Also, we’re only going to talk about adults here, because CPR/treatment for a child is different than it is for adults. Infant CPR (newborns to under 1 year old) is even more difficult, so we’re going to stick with grown-ups here.

You’d think sticking with water would make this topic easier, but SURPRISE! There’s a difference between drowning in salt water versus fresh – that is, if your character falls overboard at sea, things will be a lot different than if they do it on a lake in the mountains (Link warning: that link is a bunch of medical technical speak you probably won’t need to know but I like to cite my sources so you don’t think I’m just making these posts up. Special thanks to my medivac corpsman husband!). What that link basically translates to for writers is “fresh water sucks more than salt because it does more damage and causes more shit to happen that takes longer to fix.” Something to keep in mind if your sodden character lives through the event.

Now, I’m not going to get into a bunch of stuff about how to help a drowning victim. There’s a lot of conflicting information and techniques change ALL THE TIME, so by the time I hit “publish” on this post, a new method for dealing with people who are pulled from the water will have cropped up, so learn CPR and call it good, mmm-kay?

So what am I going to talk about if not the different types of drowning or how to treat them? I could offer you a bunch of facts, like how males are more likely to drown that females (almost 80% of people who drown are male), or that kids between the ages of 1 and 4 have the highest drowning rates, or that about ten people die every day in the US from drowning.

No? Facts not doing it for you? You’re right…you can Google those yourself. You don’t need me to quote you drowning stats. You want something you can use in your writing. Okay – how about this? Did you know there’s such a thing as “dry drowning?” That’s right…you can drown on dry land! HA! Oh, fine…technically dry drowning is more choking/mechanical as it has to do with what’s called “laryngospasm,” but it sounds cool. You may know it more colloquially as “waterboarding.” Something to keep in mind if you have a character taken prisoner by one of the countries that dabbles in the practice.

Here’s a really important thing you should know about drowning as a writer – IT NEVER LOOKS LIKE IT DOES ON TV. On TV and in the movies they always have some asshat flailing and thrashing and calling for help because “they can’t swim.” The only time there’s flailing and thrashing when someone is drowning is if they are being forcibly held under the water by an assailant or other object (like a boat on top of them or they are caught in a shark cage or something). Drowning is quiet and easy to miss, which is why lifeguard training is intense. When someone is in trouble in the water, they don’t have the ability to shout for help; they’re too busy using their mouth above the water to gasp for any air they can before the water shuts it again. They don’t wave for help, either – they’re too busy trying to keep themselves from going under. Instinct prevents them from lifting their arms out of the water. So don’t have your character do this.

Now, suppose your character does succumb and goes under. How long do they have before they die? Well…it depends on a lot of factors, but the simple fact is, irreversible brain damage occurs between 4 and 10 minutes. (Link warning – UBER FANCY MEDICAL SPEAK THERE.) There’s a lot of debate about resuscitation times, but generally first responders (paramedics) continue CPR until they get to a hospital or are told to stop by a physician. The link above talks about odds of survival and resuscitation times up to 30 minutes, but really…12-15 minutes is fairly standard. Guidelines change all the time, which is why continuing education is important.

Say your character is heroically dragged from the water. YAY! CPR is administered and the person chokes and sputters. Here’s a hint – they’re actually vomiting. That’s right. They’re horking up the water they inhaled. Turn them over on their side, let them finish, wipe the mouth out and see what happens next. If they’re breathing on their own (just because they puked doesn’t mean they’re all right), put them in the recovery position and get them to help/safety (if that’s in the story). If they’re not breathing, continue rescue breathing (the hands-off part of CPR – chest compressions are only necessary if there isn’t a pulse) until they do or help comes to shove a tube down their throat. Remember when I talked above about the damage water does to the lungs? Yeah. The person might not be able to breath on their own/the damage might be too much, so get help. Or traumatize your readers by having them watch as the character dies. Either way. It’s your story!

I think that about covers everything. If you think of something I didn’t answer here, give a shout. You know…if you’re able.

Questions about medical issues with your writing? Leave them in the comments below and I’ll get back to you as soon as I can. (THESE MUST APPLY TO FICTIONAL SITUATIONS ONLY. I AM NOT YOUR DOCTOR, NOR A SUBSTITUTE FOR ONE.)