14. Drowning/Near Drowning/Diving/Scuba Accident -ABCDE

Question 1

Domestic Rescue

Answer 1

Person underwater in man-made structure intended for domestic use (i.e. hot tub, bathtub, swimming pool)

Question 2

Specialized Rescue

Answer 2

Person underwater or stranded in a natural setting or a man-made structure not intended for domestic use (i.e. lake, river, sea, canal, water tank)

Question 3

DIving

Answer 3

To jump or plunge into water from a height

Question 4

Scuba

Answer 4

Commonly used acronym for Self-Contained Underwater Breathing Apparatus, used to define problems occurring while using this device underwater

Question 5

Swift Water

Answer 5

Any body of water that is moving and has a visible current

Question 6

OBVIOUS DEATH (Submersion ≥ 6 hrs)

Answer 6

Local Medical Control must authorize the following condition before this determinant can be used:
* Submersion (≥ 6 hrs)

Question 7

Problem Suffixes

Answer 7

D: Diving injury (not underwater)
F: Floodwater rescue
I: Ice rescue
S: SCUBA accident (not underwater)
W: SWIFT water rescue

Question 8

Rule 1

Answer 8

The current location of a drowning patient (in water, underwater, out of water) should be determined on Case Entry during “Tell me exactly what happened”. This ensures proper used of ECHO coding for patients underwater or not breathing

Question 9

Rule 2

Answer 9

A submerged patient, regardless of time underwater (<6 hrs) is considered resuscitable by definition until proven otherwise, especially in cold-water situation

Question 10

Rule 3

Answer 10

Each year potential rescuers drown themselves attempting to save drowning people. The caller should be advised to attempt a rescue only if it is safe to do so.

Question 11

Rule 4

Answer 11

In diving accidents where there is any suspicion of neck injury, tilting the head or moving the patient should be avoided if at all possible

Question 12

Rule 5

Answer 12

The head-tilt is the only recognized method of airway control in the PAI dispatch environment. WHen presented with a TRAUMA patient described as not alert with INEFFECTIVE BREATHING, the EMD should protect life over limb and open the airway

Question 13

Rule 6

Answer 13

If a spinal injury is suspected in a breathing patient and PAIs are not necessary, PDIs may be enhanced by encouraging the patient not to move and by advising the rescuer to use her/his hands to stabilize the patient’s head and neck in position found

Question 14

Rule 7

Answer 14

The airway of an unconscious patient must be constantly maintained

Question 15

Axiom 1

Answer 15

Victims of cold-water drowning can remain underwater for long periods of time before death or brain damage occurs. An automatic body reflex called the “diving reflex” is triggered in cold water. Inhaled cold water may also lower blood and body temperature. The heart usually remains beating for a few minutes after submersion.

Question 16

Axiom 2

Answer 16

The “diving reflex” is more pronounced in children under four years of age possibly because of a similar reflex experienced during childbirth enabling the fetus to survive on limited oxygen.