submersion

SUBMERSIONCLINICAL SERIES

Dr.Raihana

DROWNING IS:A. Death within 24h of suffocation from

submersion in liquids.

B. Victims who survived at least 24h post event regardless of outcome.

C. Process of experiencing resp. impairment from submersion/immersion in liquids.

D. Syncope resulting from cardiac dysrhythmias on sudden contact with water.

DROWNING IS:A. Death within 24h of suffocation from

submersion in liquids.

B. Victims who survived at least 24h post event regardless of outcome.

C. Process of experiencing resp. impairment from submersion/immersion in liquids.

D. Syncope resulting from cardiac dysrhythmias on sudden contact with water.

Definitions Drowning :death within 24h : OLD. Near-Drowning: survival after more than

24h : OLD. Drowning outcome should be classified

as: Death. morbidity. no morbidity. Immersion syndrome: syncope resulting

from cardiac arrhythmias after immersion in water at least 5C less than body T.

A major risk factor 4 drowning

A. Ethanol consumption in proximity to water.

B. Swimming ability.

C. Medical conditions. e.g. seizure.

D. Prolonged QT.

A major risk factor 4 drowning

A. Ethanol consumption in proximity to water.

B. Swimming ability.

C. Medical conditions. e.g. seizure.

D. Prolonged QT.

In pathophysiology: what determines subseq. Pulmonary derangement:

A. Aspirating fresh water.

B. Aspirating salt water.

C. Aspirating 1-3ml/Kg.

D. Aspirating 11ml/Kg.

In pathophysiology: what determines subseq. Pulmonary derangement:

A. Aspirating fresh water.

B. Aspirating salt water.

C. Aspirating 1-3ml/Kg.

D. Aspirating 11ml/Kg.

pathophysiology

Submersion> breath-holding> struggle to surface> hypoxia and air hunger.

As breath-holding overcome, gasps results in aspiration.

The QAUNTITY rather than composition determines subsequent pul. derangem.

Salt or fresh water and electrolyte imbalance based on animal studies.

Pathophysiology

Significant CVS abnormalities do not occur until the aspirated water > 11ml/Kg

Autopsy showed most victims aspirated less than 4ml/Kg.

Aspiration of 1-3ml/Kg of fresh or salt water destroys the integrity of surfactant>alveolar collapse > noncardiogenid edema>V/P mismatch> hypoxia>acidosis>CVS collapse> death.

TRUE OR FALSE

10-15% OF DROWNING IS DRY DROWNING

TRUE OR FALSE

10-15% OF DROWNING IS DRY DROWNING X

List five prognostic factors

Prognostic factors

Age. (less than 3y) Duration( immersion more than 5m) CPR initiated more than 10mnt of rescue Hypothermia Severe acidosis Unreactive pupils GCS of 3 Need of ongoing CPR.

What is Diving Reflex?

Diving reflex

Activated by fear or immersion of the face in cold water.

Shunts blood centrally to heart and brain Apnea and bradycardia ensue Prolonging the duration of submersion

tolerated without CNS damage.

The first step to be done after rescuing a victim from drowning:

A. Apply C –collar.

B. Heimlich maneuver to get water out of chest.

C. Give 2 recue breaths if not breathing.

D. Cover victim with warm cloths.

The first step to be done after rescuing a victim from drowning:

A. Apply C –collar.

B. Heimlich maneuver to get water out of chest.

C. Give 2 recue breaths if not breathing.

D. Cover victim with warm cloths.

EMS brought 16y old boy after submersion, he is conscious and oriented and breathing in his own.

What u want to know?

What u want to Do?

Where and when to dispose?

Which of following improve outcome after water submersion

A. Hyperventilation.

B. Steroids.

C. Dehydration.

D. Barbiturate coma.

E. None of above.

Which of following improve outcome after water submersion

A. Hyperventilation.

B. Steroids.

C. Dehydration.

D. Barbiturate coma.

E. None of above.

THANK U