submersion

22
SUBMERSION CLINICAL SERIES Dr.Raihana

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By Dr Raihanna

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Page 1: Submersion

SUBMERSIONCLINICAL SERIES

Dr.Raihana

Page 2: Submersion

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.

Page 3: Submersion

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.

Page 4: Submersion

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.

Page 5: Submersion

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.

Page 6: Submersion

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.

Page 7: Submersion

In pathophysiology: what determines subseq. Pulmonary derangement:

A. Aspirating fresh water.

B. Aspirating salt water.

C. Aspirating 1-3ml/Kg.

D. Aspirating 11ml/Kg.

Page 8: Submersion

In pathophysiology: what determines subseq. Pulmonary derangement:

A. Aspirating fresh water.

B. Aspirating salt water.

C. Aspirating 1-3ml/Kg.

D. Aspirating 11ml/Kg.

Page 9: Submersion

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.

Page 10: Submersion

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.

Page 11: Submersion

TRUE OR FALSE

10-15% OF DROWNING IS DRY DROWNING

Page 12: Submersion

TRUE OR FALSE

10-15% OF DROWNING IS DRY DROWNING X

Page 13: Submersion

List five prognostic factors

Page 14: Submersion

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.

Page 15: Submersion

What is Diving Reflex?

Page 16: Submersion

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.

Page 17: Submersion

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.

Page 18: Submersion

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.

Page 19: Submersion

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?

Page 20: Submersion

Which of following improve outcome after water submersion

A. Hyperventilation.

B. Steroids.

C. Dehydration.

D. Barbiturate coma.

E. None of above.

Page 21: Submersion

Which of following improve outcome after water submersion

A. Hyperventilation.

B. Steroids.

C. Dehydration.

D. Barbiturate coma.

E. None of above.

Page 22: Submersion

THANK U