Drowning — Accidental, Suicidal & Homicidal

Sudden collapse from coronary or cerebrovascular disease may cause loss of consciousness leading to immersion of the head and death. Epilepsy or a fall causing disabling head injury may also result in drowning. Other causes include CO poisoning, alcohol or drug intoxication, and electrocution.

It must be determined whether the head was submerged and if water was inhaled. Collect bath and tap water samples. Head bruising may be present. Grip marks on limbs suggest forcible immersion.

Natural disease should be excluded during autopsy and viscera preserved for chemical analysis.

In precipitate labour, the baby may fall into a lavatory pan or bucket and die. Microscopy of lungs and examination of fluid in the air-passages are important. Foreign material inhaled into the lungs can be compared with samples from the bucket or pan.

Chemical analysis of airway fluid—e.g., soap or disinfectant—is useful.

Common in non-swimmers; swimming, bathing in rivers or sea; women falling into wells; children in ponds or lakes while playing.

Adults with epilepsy, intoxication, coronary artery disease, or dizziness may drown in shallow water.

Diving accidents may cause forehead impact on the pool floor → hyperextension of neck → loss of consciousness → drowning.

Haemorrhages in deep neck muscles around C1–C2 may appear, with or without vertebral fractures.

Swimmers may hyperventilate before diving to prolong underwater time. CO₂ tension becomes abnormally low, delaying respiratory drive. Sudden unconsciousness leads to drowning.

Hazards include equipment failure, environmental conditions, exhaustion, panic, disease, or misuse of gear. Risks include drowning, barotrauma, bends, pulmonary oedema, emphysema, pneumothorax, and air embolism.

Air trapped in lungs during ascent may expand → alveolar rupture → emphysema, pneumothorax, or air embolism.

Common in India, especially among women. Bodies often fully dressed. Suicides may remove outer clothing or shoes.

Naked non-swimmer suggests suicide. Drowning may occur in shallow water or containers.

If weights are attached: could be suicide or homicide (in children → homicide). Examine ligature knots carefully.

Rare except in infants/children. Pushing into water or assault beforehand may occur.

Marks of throttling, head injuries, or bruises strongly indicate homicide.

Before immersion: accidental, suicidal, or homicidal wounds.

During immersion: impact with rocks or hard objects.

After immersion: abrasions, propeller injuries, and aquatic animal bites producing punched-out lesions.

Body heat is lost twice as fast in water; equalizes in ~14 hours.

Floatation time:

• India: 12–18 hours (summer); 18–36 hours (winter).
• Cold countries: 2 days to 1 week or more.

Epidermis loosens in 2–4 days; advanced decomposition causes body to浮 belly-up.