DROWNING

No pathognomonic findings: (circumstances plus non-specific anatmocal findings)
– white or hemorrhagic edema fluid in nostrils, mouth and airways
– pulmonary edema (non-specific)
– water in the stomach
– non-specific brain edema
– hemorrhage in petrous or mastoid bones
– “washerwoman” skin
– stones or vegetation in hands.
– bloodless antemortem wounds (cleaned out by action of water).
– 10-15% “dry” drowning: mechanism – sudden laryngeal spasm by vagus.

SCUBA complications: barotrauma, caisson disease, acute pulmonary emphysema, pneumonthorax, air embolism, asphyxia by exclusion of O2, CO (rare).
Caissons Disease “The Bends”
Bubbles: N2, CO2, O2 and H2O vapor
Death from decompression sickness is rare.
Autopsy: brain foci of ischemic necrosis. Lungs: hemorrhages, edema, atelectasis, emphysema
Acute Emphysema: small tears of alveolar walls with hemorrhages into lungs
CO: contamination by exhaust from SCUBA, faulty air tank, oil-contaminated air compressor used to fill tank