Drowning

A 28-year-old male is brought to the mortuary after being recovered from a river. External examination reveals frothy fluid at the mouth and nostrils, and the body appears bloated. The investigating officer requests the most specific investigation to confirm drowning as the cause of death. Which of the following is the investigation of choice?

Which of the following is the primary mechanism of death in freshwater drowning?

A 5-year-old boy is found floating face-down in a swimming pool. Rescue personnel initiate resuscitation immediately. At the hospital, he is pronounced dead 2 hours later despite aggressive cardiopulmonary resuscitation. At autopsy, the lungs are heavy, waterlogged, and pale; the stomach is distended with water; and there is foam (frothy fluid) in the mouth and nostrils. The heart chambers show no evidence of blood clotting. Which of the following findings is MOST specific for drowning as the cause of death?

A 35-year-old man is retrieved from a river after 45 minutes of submersion in cold water (8°C). He is apnoeic and pulseless. Core body temperature is 28°C. Rescuers have initiated CPR. What is the most appropriate next step in management?

Which feature best distinguishes fresh water drowning from salt water drowning in terms of pathophysiological mechanism?