Struggling to survive: Post-traumatic stress disorder following nonfatal drowning in a professional rescuer with no other neurologic morbidity - A case report

Struggling to survive: Post-traumatic stress disorder following nonfatal drowning in a professional rescuer with no other neurologic morbidity - A case report

Context
Psychiatric sequelae, including Post-Traumatic Stress Disorder (PTSD), have been described for survivors of traumatic, life-threatenineg events. While the experience of drowning can be terrifying and a frequently lethal event, the available literature regarding nonfatal drowning survivors has largely overlooked the psychiatric sequelae that may occur in this population.

Case Presentation
An American, middle-aged, white male career firefighter with extensive aquatics rescue training drowned during a routine ice diving training exercise. He was revived on scene and subsequent medical evaluation determined that he had suffered no neurologic morbidity. He did however experience a variety of psychiatric symptoms beginning with the evening of his drowning and culminating in a presumptive diagnosis of PTSD years after this event.

Discussion
There is a gap in the current drowning literature regarding the psychiatric sequelae in nonfatal drowning survivors. Medical post-drowning assessments and intellectual frameworks currently fail to account for this type of morbidity, typically measuring neurological outcome using the cerebral performance category scale. This case adds to the emerging evidence on the psychiatric morbidity associated with survivors of drowning and highlights the need for psychiatric follow-up even if medical issues have been resolved.

Conclusion
Researchers, academicians, and practitioners would be wise to include psychiatric symptomatology when addressing sequelae of nonfatal drowning events. To this end, further research is needed to identify and characterize the incidence and prevalence of psychiatric morbidity in this population. Likewise, medical evaluations and long-term care should include a psychiatric component after nonfatal drowning.