DROWNING
• form of suffocation where
respiratory tree is obstructed
with fluid
• mode of death is systematic anoxia
which almost affects the brain
• recovery from drowning depends on
:
the amount of time the brain is
deprived of oxygen and the degree of
permanent brain damage.
Within minutes: Brain cells start to die.
3-5 minutes: Significant brain damage becomes more likely.
10 minutes: Survival becomes less likely, and severe brain damage is highly probable.
Factors:
• Alcohol Ingestion
• Inability to swim
• Diving Injuries
• Hypothermia
• Exhaustion
:
NONFATAL DROWNING
• Survival for at least 24h after
submersion that caused a respiratory
arrest
• MC consequence: Hypoxemia
• Highest risk: < 5 & > 85 y/o
DROWNING SYNDROME
• Range from minimal aspiration
of water with good survival to
severe pulmonary injury with
:
death.
DRY WET
GASP FOR AIR
LARYNGOSPASM ASPIRATION
REFLEX
CESSATION BREATHING
BLOCK AIRWAY
ASPHYXATION LARYNGOSPASM
CARDIAC ARREST
RELAXATION LUNG
AIRWAY
NEAR DROWNING
:
• Submersion with survival
• Submersion incident is a more
neutral term to describe a person
who is adversely by being
submerged in water.
SEA WATER�Hypertonic
plasma
Alveoli
Hypovolemic Shock
:
FRESH WATER�Hypotonic
Plasma
RBC
Rupture Cells
Arrhythmias
K release
What can the victim experience
• Initial gasping • Cardiac Arrest
• hyperventilation • Hypoxemia
• possible aspiration • Cessation of
• Relaxation of respiratory effort
:
airway • Cardiac arrest
• Permits lungs to fill • No fluid aspiration
with water (wet • (dry drowning)
drowning) • CNS ischemia
• Tight laryngospasm • Asphyxia
• Voluntary cessation
GOAL
“ SURVIVAL”
Early
resuscitation
WHAT TO DO!!!!!!
:
• Rescue from
H2O
• Assess ABC
• AR or CPR
• Assess for
cause
• Warm patient
:
Initial Hospital Nursing
Management
• Transfer patient to a high acuity
area
:
• Check ABC
• Immobilize head
• Five 100% oxygen
• Resuscitate patient
• Establish IV line and draw blood
for FBC, urea / electrolytes /
creatinine and ABG
Secondary Survey
Physical Examination
• Altered sensorium - alcohol and drug
• Head injury - scalp and face
• Cervical spine injury
• Epilepsy
• Cardiac dysrrthythmias - ECG
• Perform serial GCS assessment
:
Causes of Drowning at
home
PREVENTION
:
:
Ah..uhmmm
:
:
