Drowning incidents precipitated by unusual causes (DIPUCs): A narrative review of their diagnoses, evaluation and management

Drowning is a cause of significant morbidity and mortality worldwide. In most circumstances, the proximate cause is attributable to human factors, such as inexperience, fatigue, intoxication, or hazardous water conditions. The phenomenon of drowning incidents precipitated by unusual circumstances (D...

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Main Authors: Kevin M. Duignan, Hannah Luu, João H. Delgado, Shawn London, Richard M. Ratzan
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Resuscitation Plus
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666520424002212
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author Kevin M. Duignan
Hannah Luu
João H. Delgado
Shawn London
Richard M. Ratzan
author_facet Kevin M. Duignan
Hannah Luu
João H. Delgado
Shawn London
Richard M. Ratzan
author_sort Kevin M. Duignan
collection DOAJ
description Drowning is a cause of significant morbidity and mortality worldwide. In most circumstances, the proximate cause is attributable to human factors, such as inexperience, fatigue, intoxication, or hazardous water conditions. The phenomenon of drowning incidents precipitated by unusual circumstances (DIPUCs) – either fatal or nonfatal – involving otherwise healthy individuals under generally safe conditions has not been comprehensively addressed in the medical and drowning literature to date. In this review, we discuss etiologies of DIPUCs, diagnostic clues, suggested workup, suggested postmortem testing, and implications for surviving patients and families. Identifying the cause of a drowning incident can be extremely challenging for the initially treating physician, relying perforce on historical context, environmental clues, physical exam, medical history, eyewitness accounts or video recordings. If no clear explanation for a drowning incident emerges despite a thorough investigation, clinicians should consider some of the less common diagnoses we describe in this paper, and, when appropriate, refer for an autopsy with postmortem molecular genetic testing. While time-consuming, these efforts can prove life-saving for some non-fatal drowning victims and the families of all victims of DIPUCs.
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spelling doaj-art-007c9f6f37ac4e918a2e639f3a3a3a0f2025-08-20T01:57:00ZengElsevierResuscitation Plus2666-52042024-12-012010077010.1016/j.resplu.2024.100770Drowning incidents precipitated by unusual causes (DIPUCs): A narrative review of their diagnoses, evaluation and managementKevin M. Duignan0Hannah Luu1João H. Delgado2Shawn London3Richard M. Ratzan4University of Connecticut School of Medicine, Emergency Medicine Residency, MC 1930, 263 Farmington Ave., Farmington, CT 06030-1930, United StatesUniversity of Connecticut School of Medicine, Emergency Medicine Residency, MC 1930, 263 Farmington Ave., Farmington, CT 06030-1930, United StatesHartford Hospital, 80 Seymour St, Hartford, CT 06102, United StatesHartford Hospital, 80 Seymour St, Hartford, CT 06102, United States; Corresponding author.Hartford Hospital, 80 Seymour St, Hartford, CT 06102, United StatesDrowning is a cause of significant morbidity and mortality worldwide. In most circumstances, the proximate cause is attributable to human factors, such as inexperience, fatigue, intoxication, or hazardous water conditions. The phenomenon of drowning incidents precipitated by unusual circumstances (DIPUCs) – either fatal or nonfatal – involving otherwise healthy individuals under generally safe conditions has not been comprehensively addressed in the medical and drowning literature to date. In this review, we discuss etiologies of DIPUCs, diagnostic clues, suggested workup, suggested postmortem testing, and implications for surviving patients and families. Identifying the cause of a drowning incident can be extremely challenging for the initially treating physician, relying perforce on historical context, environmental clues, physical exam, medical history, eyewitness accounts or video recordings. If no clear explanation for a drowning incident emerges despite a thorough investigation, clinicians should consider some of the less common diagnoses we describe in this paper, and, when appropriate, refer for an autopsy with postmortem molecular genetic testing. While time-consuming, these efforts can prove life-saving for some non-fatal drowning victims and the families of all victims of DIPUCs.http://www.sciencedirect.com/science/article/pii/S2666520424002212DrowningCardiac arrestAccidental deathHealth disparitiesInjury scienceCardiomyopathy
spellingShingle Kevin M. Duignan
Hannah Luu
João H. Delgado
Shawn London
Richard M. Ratzan
Drowning incidents precipitated by unusual causes (DIPUCs): A narrative review of their diagnoses, evaluation and management
Resuscitation Plus
Drowning
Cardiac arrest
Accidental death
Health disparities
Injury science
Cardiomyopathy
title Drowning incidents precipitated by unusual causes (DIPUCs): A narrative review of their diagnoses, evaluation and management
title_full Drowning incidents precipitated by unusual causes (DIPUCs): A narrative review of their diagnoses, evaluation and management
title_fullStr Drowning incidents precipitated by unusual causes (DIPUCs): A narrative review of their diagnoses, evaluation and management
title_full_unstemmed Drowning incidents precipitated by unusual causes (DIPUCs): A narrative review of their diagnoses, evaluation and management
title_short Drowning incidents precipitated by unusual causes (DIPUCs): A narrative review of their diagnoses, evaluation and management
title_sort drowning incidents precipitated by unusual causes dipucs a narrative review of their diagnoses evaluation and management
topic Drowning
Cardiac arrest
Accidental death
Health disparities
Injury science
Cardiomyopathy
url http://www.sciencedirect.com/science/article/pii/S2666520424002212
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