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Free access to water: Effective barriers prevent young children from gaining access to the water Ineffective supervision: Drowning can occur anywhere there is water, and even in the presence of lifeguards. Physiological responses to even small quantities include the extrusion of liquid into the lungs ( pulmonary edema ) over the following hours, but this reduces the ability to exchange air and can lead to a person "drowning in their own body fluid". The lungs may be over inflated and waterlogged, filling the thoracic cavity, and the surface may have a marbled appearance, with darker areas associated with collapsed alveoli interspersed with paler aerated areas. Hypotension remaining after oxygenation may be treated by rapid crystalloid infusion. "Chapter 14: Reflections on Lifeguard surveillance programs". Committee on injury, violence, and poison prevention (2010). Archived from the original on Retrieved b c Schmidt, AC; Sempsrott JR; Hawkins SC (2016). Thus, the level of oxygen in the blood decreases, and the level of carbon dioxide increases. Ventricular fibrillation is more likely to be associated with complications of pre-existing coronary artery disease, severe hypothermia, or the use of epinephrine or norepinephrine.