What is pathophysio of submersion injuries?

Begins with panic, loss of normal breathing, breath holding, air hunger, struggle to stay above water. Aspiration and reflex laryngospasm occurs for inspiratory efforts. Hypoxemia -> multiorgan failure Distinct salt and fresh water, aspirate 11ml/kg body weight for volume change and 22 for electrolyte change (but no longer important to distinguish the two) Cause decreased lung compliance, vent-perfusion mismatch ,intrapulmonary shunt, hypoxemia