In brief: The outcome of a near drowning depends on the patient's physical condition before the accident, the duration of submersion, the temperature of the water, and how much water entered the lungs and stomach. Dr. Podolsky describes the pathophysiology of drowning, a practical action plan for treating victims, and preventive measures. The key to successful management is shortening the duration and extent of hypoxemia. In addition, patients should be monitored in intensive care units for at least 24 hours, because potentially fatal complications may develop. Preventive measures include restricting access to unguarded pools and teaching the public basic cardiopulmonary resuscitation techniques.