Which organs are at the greatest risk for permanent damage during drowning?

The brain and heart are indeed at the greatest risk for permanent damage during drowning incidents. When a person is submerged underwater, the body's ability to absorb oxygen is compromised, which can lead to hypoxia—an insufficient supply of oxygen to the tissues. The brain is particularly vulnerable because it requires a continuous supply of oxygen to function properly. Even a short period without oxygen can result in irreversible brain damage, potentially leading to cognitive deficits, coma, or death.

The heart is also at high risk during drowning due to the stress placed on it from changes in oxygen levels and the physical strain of attempting to breathe. If the heart does not receive adequate oxygen, it can suffer from arrhythmias or other life-threatening complications.

In terms of the other options, while the lungs are directly impacted during drowning—experiencing fluid inhalation—it is the brain and heart that face the most severe consequences in terms of permanent damage. Organs like the stomach, liver, skin, and muscles are less susceptible to immediate irreversible harm from drowning when compared to the vital functions of the brain and heart.