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Drowning Deaths
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Old 07-18-2021, 05:03 PM
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Drowning refers to death occurring within 24 h of a submersion incident and may be a difficult diagnosis to make as there are no diagnostic (pathognomonic) findings at autopsy. Although drowning may be considered a specialized form of asphyxia in which environmental oxygen (air) is displaced by a liquid (usually water), the mechanism of death is much more complicated as it also involves hydrostatic and osmotic effects of inhaled fluid within the small airways.

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Fig.1 A scene photograph showing an automobile that had been swept away in a flash flood, only to be discovered after flood waters receded.

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Fig.2 The driver of the motor vehicle depicted in Fig.1 covered in river sand and still belted into the vehicle seat.

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Fig.3 The force of water may produce significant damage to property, as is shown in this car following the South East Asian tsunami. It is therefore understandable how bodies may show marked injuries following such events.

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Fig.4 Natural disasters such as the tsunami may result in thousands of casualties from drowning.

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Fig.5 Drowned bodies are often decomposed because of the time taken to locate them. This infant was found after the tsunami in Thailand and shows marked loss of facial features.

Drowning deaths are relatively common, with two age peaks occurring. The first involves infants, toddlers, and young children who fall into water and cannot extricate themselves, and the second includes adolescents and young adults who may be risk-taking and intoxicated. Drowning may occur indoors, especially in the young in bathtubs, water troughs, and even buckets containing water, or outdoors in swimming pools, ponds, lakes, the ocean, rivers, fountains, and wells.

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Fig.6 Victims of flash flooding may be difficult to find as bodies may be moved considerable distances and buried under mud and debris.

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Fig.7 The face of a drowning victim may be preserved under a mask, as in this case of a diver who had been missing for 8 months. The upper face beneath the mask is much better preserved than the lower face over the jaw. The chest shows adipocere formation.

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Fig.8 Pulmonary edema fluid exuding from the nose of a drowning victim.

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Fig.9 Pulmonary edema fluid exuding from the mouth of a victim of a flash flood drowning.

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Fig.10 The plume of frothy white pulmonary edema fluid after drowning may be quite large.

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Fig.11 In salt water drowning, the lungs fill with fluid and can be seen completely covering the heart when the chest plate is removed. This is called emphysema aquosum.

A number of myths surround drowning, including the belief that excellent swimmers cannot drown, that all drowning deaths are accidents, that a victim must be completely submerged to drown, and that there are always positive findings at autopsy for a pathologist to definitely determine that drowning has occurred.

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Fig.12 ‘‘Cadaveric spasm,’’ or ‘‘instantaneous rigor mortis,’’ in a drowning victim. Note the vegetation clutched in the hand.

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Fig.13 Another example of cadaveric spasm in a drowning victim. The vegetation held in the hands may be useful in localizing the site where the victim entered the water.

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Fig.14 Wrinkling of the hands may occur following immersion in water, so-called ‘‘washerwoman hands’’.

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Fig.15 After some time, the wrinkling becomes pronounced.

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Fig.16 The feet may also show similar wrinkling to the hands.

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Fig.17 After more time, the skin of the hands and feet separates and peels off.

‘‘Near drowning’’ refers to survival for at least 24 h after an immersion incident and may occur because of prompt resuscitation efforts. Unfortunately, if the brain has been deprived of oxygen for a significant period of time, brain death may eventually ensue and so such cases are variably described as ‘‘drowning,’’ or ‘‘the sequelae of near drowning,’’ or ‘‘anoxic/hypoxic brain injury due to near drowning.’’ On occasion, a person who has nearly drowned but was rescued may at first appear to have made a complete recovery. This period of apparent normality however may be followed by the development of severe respiratory distress with subsequent death. This has been called the ‘‘post-immersion syndrome’’ or ‘‘secondary or dry drowning.’’

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Fig.18 A decomposing drowning victim recovered from a river after several weeks in the water, with extensive adherent river ‘‘slime’’.

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Fig.19 Postmortem skin defects on the trunk region of the drowning victim which may be misinterpreted as true injuries.

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Fig.20 Postmortem skin defects on the decomposing drowning victim.

As there are no specific autopsy findings in victims, the diagnosis of drowning is considered one of exclusion that requires a detailed history of a victim being found in water, with no potentially lethal injuries or diseases present (unless, of course, these led to the fatal immersion episode). A variety of nonspecific findings are typically found. External findings of wrinkled, ‘‘washerwoman’’ changes to the skin of the hands and feet merely indicate that the body has been in water, as do injuries to the backs of the hands and feet from being dragged along the bottom. The most consistent finding is pulmonary edema fluid, although, it is not always present. When there is a significant amount of fluid in the lungs, they are heavy, with frothy white or red-tinged fluid in the bronchi and upper airways. This may be seen as foam extending out of the mouth and nostrils. Bleeding within the small airways may be responsible for the reddish color of the foam.

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Fig.21 Marked decomposition in a drowning victim who was recovered from a river approximately 4 weeks after he was witnessed jumping into the river. Note the extensive skin slippage, as well as river ‘‘slime’’ on the body surface.

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Fig.22 Decomposition with unusual color variation of the skin in another river drowning victim.

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Fig.23 A postmortem defect (skin split) on a decomposing river drowning victim. The defect may have been produced by a marine animal attempting to feed on the body. This is not evidence of an inflicted injury.

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Fig.24 A scene photograph of a drowning victim who has come to rest on the floor of the riverbed near the shoreline. Note how the victim is face-down, with the bloated body’s buttock region higher than the remainder of the body. This may result in injuries from dragging of the hands and feet along the riverbed.

One of the problems with drowning deaths is that victims have often been lost from sight and moved by the water, so it may take some time to find a body. This results in a range of postmortem changes that may complicate autopsy evaluation, ranging from marked putrefaction to injuries from animal feeding. Fish and crustaceans such as sea lice may devour significant portions of bodies, as well as creating defects in the skin that may be misinterpreted as wounds. Conversely, submersion may also alter the appearance of a genuine wound, with blood being leached out of the wound and the edges being modified by animal activity. The rate of decomposition may be slowed in colder climates; however, cold and wet conditions may predispose to skin splitting and the formation of adipocere (grave wax).

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Fig.25 The top of a drowning victim’s foot, including the bones, has been worn away due to dragging on a river bed.

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Fig.26 True antemortem (occurring before death) sharp force injuries on the chin and mouth of a homicide victim whose body was ‘‘dumped’’ into water after death.

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Fig.27 Additional examples of true antemortem (before death) sharp force injuries sustained prior to the homicide victim’s body being dumped in the water.

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Fig.28 Suicide victims who drown sometimes tie themselves to weights. In this case, a cement block has been tied to the body with plastic garbage bags. This has to be differentiated from situations where weights have been used to sink the body of a homicide victim.

The manner of death in most drowning cases is accidental, although suicidal drownings do occur in all locations, including domestic pools, baths, rivers, and the sea. Homicidal drownings tend to be rare.

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This post is for educational purposes only and is nonprofit. Under Section 107 of the US Copyright Act of 1976; Allowance is made for "Fair Use" for purposes such as criticism, comment, news reporting, teaching, scholarship, and research. OP is not a medical expert. No copyright infringement intended. This post does not encourage or glorify violence/harassment. Images might have been upscaled and enhanced. Text might have been shortened and simplified/reorganized for online view.
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Old 07-18-2021, 06:45 PM
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Identification must be next to impossible
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Old 07-18-2021, 10:01 PM
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Excellent thread as always, thank you.
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Old 07-18-2021, 11:54 PM
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Very informative. Thank you!
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Old 07-19-2021, 04:29 AM
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Fantastic informative post again. Thank you.
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Old 07-19-2021, 10:41 AM
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another great post, herman!
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Old 07-19-2021, 05:25 PM
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Originally Posted by Simone View Post
Excellent thread as always, thank you.
Agree! Reminds me of when I started to look at on-line death sites. I was in Yosemite Valley the day that the SE Asian tsunami hit and killed + 100,000s. I was looking for articles, and ran across Ogrish postings. Then Ogrish folded, and I ran across this DR site. Here I am, not much involved, but I cruise the postings sometimes. Appreciate Simone and the regular researchers and posters who contribute for all of us lazy people!
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Old 07-21-2021, 02:12 AM
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Identification must be next to impossible
there's dental records and dna
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