Which of the following is more likely to occur in salt water, rather than fresh water drowning?

Correct Answer: Faster death
Description: Salt water drowning results in faster death than fresh water drowning. Salt water causes an osmotic shift of water into the alveolar spaces, with subsequent impaired oxygenation/ventilation and death (usually within 6 to 7 minutes). Patients have hypovolemia from these osmotic movements of fluid, and hemolysis is not a significant feature. As it enters the lungs, fresh water destroys surfactant activity, leading to alveolar collapse and intrapulmonary shunting (perfusion without ventilation). Water is reabsorbed into the vascular system, producing volume overload with subsequent hyponatremia and hemolysis of red blood cells. Ref: Krishnan vij Textbook of Forensic Medicine and Toxicology; 5th ed; Page no: 137
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