Near drowning in the Dead Sea

Seven cases of submersion in the Dead Sea are described. The clinical picture varied in severity and consisted of signs of pulmonary edema, chemical bronchitis, hypermagnesemia and hemoconcentration. Two of the patients died of hypotension and cardiac arrhythmia. The clinical findings were similar to those found in cases of drowning in seawater, but the presence of hypermagnesemia is unique to this entity. The amount of aspirated water causing severe clinical signs seemed to be much smaller than is seen with ordinary seawater. Therapeutic guidelines, including assisted respiration, infusion of hypotonic solutions and corticosteroid therapy, are suggested.