Chapter 25 - Submersion Incidents: Drowning and Diving Emergencies

Question 1

an incident in which someone is submerged or immersed in a liquid that prevents the person from breathing air and that results in a primary respiratory impairment, whether the person lives or dies after this process

Answer 1

drowning

Question 2

the best chance for survival (drowning) is in a pt who has two or fewer of these characteristics. if three or more are present the chance of survival is only 5% ORLOWSKI predictors of poor survival are:
1
2
3
4
5

Answer 2

pt 3y/o or older
pt submerged > 5 min
resuscitation did not begin for more than 10min after rescue
pt is comatose on delivery to ED
pt arterial blood is very acidic (pH

Question 3

a substance responsible for maintaining surface tension in the alveoli to keep them from collapsing

Answer 3

surfactant

Question 4

never go out into the water to attempt a rescue unless you meet all of the following criteria:
1
2
3
4

Answer 4

good swimmer
specially trained in water rescue
wearing PFD
accompanied by other rescuers

Question 5

the body’s natural response to submersion in cold water in which breathing is inhibited, the heart rate decreases, and blood vessels constrict in order to maintain cerebral and cardiac blood flow

Answer 5

mammalian diving reflex

Question 6

S/S
airway obstruction
absent or inadequate breathing
pulselessness (cardiac arrest)
spinal injury or head injury
musculoskeletal injuries
external or internal bleeding
shock
hypothermia
alcohol or drug abuse
drowning or submersion

Answer 6

water-related emergency Pt

Question 7

condition in which the stomach fills with water, enlarging the abdomen to the point that it interferes with the ability to inflate the lungs can also be caused by air that is forced into the stomach during artificial ventilation

Answer 7

gastric distention

Question 8

a medical condition that results from pressure changes that occur when a person descends in water or ascends in altitude

Answer 8

dysbarism

Question 9

the concept that the volume of a gas is inversely proportionate to the pressure

Answer 9

boyles law

Question 10

rupture of the alveoli and other lung structures

Answer 10

barotrauma

Question 11

occurs as the result of the bubbles formed from the expansion of nitrogen in the blood and tissues as described in the henry law

Answer 11

decompression sickness (DCS)

Question 12

bubbles in blood vessels have two primary effects on the body:

Answer 12

act as emboli
compress and stretch vessels and nerves

may also cause coagulation to occur

Question 13

S/S:
pain
pruritus (itching) and burning feeling of skin
skin rash
skin has orange  peel appearance
painless pitting edema

Answer 13

type I decompression sickness

Question 14

S/S
fatigue 
s/s of shock
pupillary changes
pallor to the tongue
bloody sputum
nasal flaring, retraction of chest, accessory muscle use
tachypnea
crackles (rales)
vomiting
urinary bladder distention
seizure
uncoordinated movement, weakness, motor/sensory deficits
joint pain, decreased ROM
edema
cyanosis, apllor, itching, mottling, marbling

Answer 14

type II decompression sickness

Question 15

blocking of blood vessels by an air bubble or clusters of air bubbles

Answer 15

arterial gas embolism (AGE)

Question 16

S/S
itchy, blotchy, mottled skin
dyspnea
dizziness
chest pain
severe, deep aching pain in muscle, joints, tendons
blurred or distorted vision
partial deafness
N/V
numbness or paralysis
weakness or numbness on one side of the body
staggering gate or lack of coordination
frothy blood in the nose and mouth
swelling and crepitus in the neck
loss or distortion of memory
coma
cardiac or resp arrest 
behavioral changes (sometimes the only sign)

Answer 16

arterial gas embolism

Question 17

S/S
mild to severe pain in the affected area
clear or bloody discharge from the nose or ears
extreme dizziness
nausea
disorientation

Answer 17

barotrauma