Week 11: Drowning
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Define drowning
Is a type of suffocation induced by the immersion of the mouth and nose in a liquid
Define submersion
The airway being occluded by liquid, the remainder of the body does not have to be below the surface of the liquid
Define immersion
partial coverage, the head remains above water, usually with a clear airway but potential aspiration of water splashes
What are the affects of freshwater drowning?
• sufficient volume interferes with normal external respiration (passage of gasses between alveoli and capillaries) • haemodilution occurs in bloodstream • cardiac arrest may occur 2-4 minutes after rescue
What are the affects of salt water drowning?
• opposite to that of freshwater • salt water is more solute than blood, so water is drawn from bloodstream into alveoli, increasing volume of fluid in lungs • blood becomes viscous and slows heart to point of arrest • may occur up to 12 mins after rescue
What are examples of complications of drowning?
• hypothermia • alcohol • mammalian diving reflex • prolonged immersion
Define how hypothermia is a complication of drowning
It is considered in all cases of near drowning and can mimic signs of cardiac arrest
Define how alcohol is a complication of drowning
Alcohol speeds the onset of hypothermia, slows reactions and risks of vomiting
Define how mammalian diving reflex is a complication of drowning
Suddenly plunged into icy water first, near total shutdown of systems “suspended animation”
Define how prolonged immersion is a complication of drowning
Assuming survival of hypothermia, the water exerts pressure on legs and massive veins, this maintains venous return, when rescued pressure lost and gravity prevents blood returning to heart. leading to syncope or death
How long is an adult rescue?
0-60 minutes from time of call
How long is an adult rescue in temperatures below 6 degrees?
0-90 minutes from call
How long is a child rescue or someone who has a small weight:surface area?
0-90 minutes from call
What will submersion result in?
Hypoxia
How do you restore cardiac activity when hypoxic due to drowning?
5 initial ventilations
Should you start CPR on a boat?
No, this is ineffective
If ventilation on patients back is impossible, what should you do?
Roll patient onto side
What should you expect to see from patients airway?
Large amounts of foam
What may be considered if patients heart rate is extremely slow?
External compressions
Is there a difference between salt water and freshwater drowning management?
No
Is palpatation of pulse in a drowning scenario a good recognition for cardiac arrest?
No
How does hypothermia impact on cardiac drugs
Hypothermia is less responsive to cardiac drugs
If patients temp is between 30-35 degrees you should…
Double intervals between drugs
If temp is under 30 degrees you should…
Give no drugs until temp increases above 30 degrees, if shockable rhythm only give 3 shocks