Random Case

Had a drowning today.

So, in my review of the literature (good resident, good resident!) there are a few things you tend to see in a drowning, none of which are specific and none of which are always there:Heavy lungs (80% of the time)Pleural effusions (40% of the time)Froth in the lower airways (also 40% of the time)And if there's a resuscitative effort-- no matter how brief-- it tends to blow away the froth.You can also see:water in the sphenoid sinus and, possibly, microscopic changes in the sinuseswhich I was all gung-ho to see but my tech is likety-split fast and closed the head about fifteen nanoseconds after showing me the pituitary. (I had informed everyone involved individually and more than once that I wanted to do the sinuses.) (... fail to see what I should have done short of flinging myself over the body and shouting "Wait! Wait!")

Also, be on the lookout for secondary causes of drowning, like heart attacks, strokes, seizure disorders, myocarditis (especially in kids: take micros!)

My guy had bad coronary disease, which sort of explains how when he got in over his head he couldn't manage to extricate himself.