Drowning Flashcards
What is the definition of drowning?
A process resulting in primary respiratory impairment from submersion/immersion in a liquid medium.
What is the 11th most frequent cause of death in the 0–4 years age group?
Drowning.
What is the 3rd most frequent cause of death in children aged 5 to 14 years?
Drowning.
What is the 2nd leading cause of injury-related death in childhood?
Drowning.
Where does the majority of drowning deaths occur?
In non-Western countries.
What is the male preponderance in drowning events?
Majority of drowning victims are male.
In children under 4 years, where do most drowning events occur?
Swimming pools, usually the child’s home pool.
In older children, where do most drowning events occur?
Open water.
What are the first two steps in the drowning sequence?
- Immediate struggle
- Suspension of movement with frequent swallowing.
What is the last step in the drowning sequence?
Death.
What are the pulmonary sequelae of drowning?
- Majority aspirate water (salt or fresh)
- Laryngospasm in about 10% of cases prevents water entry
- Local insult arises from infection, surfactant depletion, aspiration of debris.
What is the most common finding in radiological pulmonary edema after drowning?
Radiological pulmonary edema.
How does seawater aspiration affect the lungs?
Results in an osmotic gradient with fluid shifts into the alveolar spaces, less injurious compared to freshwater.
What is the effect of freshwater aspiration on the lungs?
Rapidly absorbed into the systemic circulation and causes rapid inactivation of surfactant.
What is the impact of chlorine at 1-2 ppm in freshwater on pulmonary injury?
Does not affect the pulmonary injury.
What may cause pulmonary edema secondary to drowning?
- Neurogenic causes
- Forced inspiration against a closed glottis
- Altered surfactant.
- Altered pulmonary capillary permeability.
What is the most common pathological finding in drowning victims?
Presence of reactive edema with hyperinflation and increase in lung weight.
What are the nonpulmonary sequelae of drowning?
- Hypothermia
- Electrolyte imbalances
- Trauma
- Hypoxic-Ischemic damage.
How does hypothermia affect drowning victims?
Core temp < 35°C leads to muscular incoordination and weakness.
What happens to the heart at core temp < 30°C?
Unconsciousness; myocardium becomes irritable.
What are the electrolyte imbalances in freshwater immersion victims?
Decreased serum sodium.
What are the electrolyte imbalances in saltwater immersion victims?
Elevated serum sodium and chloride levels.
What type of injuries are critical to consider in drowning?
Cervical spine injuries.
What is the most susceptible organ to hypoxic-ischemic damage?
Brain.
