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