chapter 25 Submersion Incidents

Question 1

is an incident in which someone is submerged or immersed in a liquid that results I a primary respiratory impairment

Answer 1

drowning

Question 2

refers to medical conditions resulting from changes in ambient pressure. Various activities are associated with pressure changes. Scuba diving is the most frequently cited example, but pressure changes also affect people who work in other pressurized environments (for example, caisson workers), and people who move between different altitudes.

Answer 2

dysbarism

Question 3

is bloating of the stomach when air is pumped into it.

Answer 3

gastric distention

Question 4

The mammalian diving reflex is a reflex in mammals which optimizes respiration to allow staying underwater for extended periods of time.

Answer 4

mammalian diving reflex

Question 5

is a lipoprotein that lines the inner surface of the alveoli. it maintains a surface tension that keeps the alveoli from completely collapsing

Answer 5

surfactant

Question 6

The most significant determining factor for patient survival in a drowning are

Answer 6

duration and the severity of hypoxia a patient suffers

Question 7

Why is ALS non effective in patients with body core temp less than 86 degrees

Answer 7

you can only use the AED once on a patient with body core temp less than 85 degrees, their BCT must be above 86 for shockrythem to be effective.

Question 8

how does mammalian diving reflex work

Answer 8

1. Heart rate slows (Bradycardia)
2. Blood flow to extremities constricted (peripheral vasoconstriction)
3. Blood and water allowed to pass through organs and circulatory walls to chest cavity (blood shift)

Question 9

what do you do if a drowning patient is suspected of being hypothermic

Answer 9

access pulse for 10 seconds
if pulseless begin chest compressions
apply AED

Question 10

• water enters lungs and at same time gasping occurs. Laryngeal spasm may follow
• airway resistance increased, reflex pulmonary vasoconstriction occurs, surfactant is diminished and lung compliance is decreased
• water shifts from alveoli into circulation
• swallowing, vomiting and aspiration of vomit is likely
• phase of secondary apnoea occurs followed by further involuntary gasping and loss of consciousness
• respiratory arrest and cardiac arrhythmias occur several minutes later

This is known as

Answer 10

the pathology of drowning

Question 11

10-20% of drowned patients

• little or no fluid found in lungs
• death probably due to profound laryngospasm. This is followed immediately by outpouring of thick mucus, which with bronchospasm, may prevent entry of water when spasm relaxes shortly before death by asphyxiation occurs
• more common in adults
• lung reflexes facilitated by raised blood alcohol levels

This is known as

Answer 11

Dry drowning

Question 12

drowning have a tendency to washout________causing atelectasis

Answer 12

surfactant

Question 13

an acute injury to the lungs that results in alveolar flooding, atelectasis and a severe oxygenation defect, but is not due to heart failure. In its early stages, it can cause shortness of breath (dyspnea), increased rate of breathing (tachypnea), and low oxygen saturation (hypoxemia).[

Answer 13

Acute respiratory distress syndrome (ARDS),

Question 14

emergenct for drowning patient

Answer 14

(patient with respiratory distress)
positive pressure ventilation with highest supplement oxygen

(patient breathing sponatuosly no distress)
use CPAP
or nonrebreather mask 15 lpm

Question 15

what are the four laws of physics that play a major role in adverse conditions and emergencies by divers

Answer 15

Boyle law
Daltons law
Henry law
Charles LAW

Question 16

“the pressure exerted by a mixture of gases is equal to the sum of the pressures that would be exerted by the gases individually”.

Answer 16

Daltons law

Question 17

How does Dolton’s law affect scuba divers

Answer 17

This is relevant to scuba diving with regard to the individual gases in a mix that will compress equally as outside pressure increases.

Read more: http://www.ehow.com/about_6692411do-laws-relate-scuba-diving.html#ixzz2ildkIhAw

Question 18

“At a constant temperature, the amount of a given gas that dissolves in a given type and volume of liquid is directly proportional to the partial pressure of that gas in equilibrium with that liquid.” This is known as

Answer 18

Henry’s law

Question 19

How does Henry’s law affect scuba divers

Answer 19

This essentially says that as pressure increases then our bodies will absorb more gas. Thus at greater depths the amount of gas absorbed into our body will be greater. This means that deeper dives have to be calculated shorter to allow for this, or risk the possibility of decompression sickness.

Question 20

As pressure increases, volume decreases. As pressure decreases, volume increases.

Answer 20

Boyles law

Question 21

How does Boyles law effect scuba divers

Answer 21

This is relevant to scuba diving in the context of depth and water pressure. Pressure increases with depth, and thus volume will be decreased as a descent is made and will increase upon ascent. This means that every air space on the diver, both dead air space (such as the mask) and live air spaces (such as the lungs), must be paid attention to avoid problems such as decompression sickness and lung over-expansion injuries. Therefore breathing techniques, equalizing air spaces and never holding your breath are affected by Boyle’s law. In addition buoyancy can be affected too, with wetsuit material being compressed and thus becoming less buoyant.

Question 22

cooling a gas decreases the volume of the gas. If the volume does not change then pressure must decrease.

Answer 22

Charles law

Question 23

How does Charles law effect scuba divers

Answer 23

This means that if a scuba tank is heated then the pressure will increase, which accounts for accidents that have happened with scuba tanks being left in hot environments.

Question 24

also known as divers’ disease, the bends or caisson disease describes a condition arising from dissolved gases coming out of solution into bubbles inside the body on depressurisation.

Answer 24

Decompression sickness (DCS)

Question 25

what are the effects of the bubbles on the body

Answer 25

1. act as emboli and cause obstruction in the circulation

2. they compress or stretch the blood vessels and nerves

Question 26

What are the types on Decompression sickness

Answer 26

Type I (‘simple’)” for symptoms involving only the skin, musculoskeletal system, or lymphatic system,”

Type II (‘serious’)” for symptoms where other organs (such as the central nervous system) are involved.

Type II DCS is considered more serious and usually has worse outcomes.

Question 27

what are the predisposing factors of DCS

Answer 27

Ascent from depth

Leaving a high-pressure environment