EAC Immersion Incidents Flashcards
define:
Immersion
Being covered in a liquid medium
define:
submersion
The entire body, including the airway being under the liquid medium
define:
Drowning
Process resulting in primary respiratory impairment from submersion/immersion in a liquid medium
Thus the person is prevented from breathing air due to liquid medium at the entrance of the airway
Drowning does not infer that the pt has died
five types of drowning
Near
Dry
Fresh water
Salt water
Secondary
define:
Near drowning
pt who is rescued before the point of death or if there is temporary survival
define:
Dry drowning
Occurs when stimulation of the reflex action of the Larynx and Epiglottis causes them to seal the trachea and divert the water to the stomach
Due to acute hypoxia, the pt will have died of asphyxiation long before water enters the lungs
This accounts for 10% of all incidents
define:
Fresh Water drowning
If a sufficient volume of water enters the lungs, it will:
- Interfere with the normal process of respiration
- Remove the surfactant lining of the alveoli
- Prevent gaseous exchange
- Creates dilution of the blood effecting pH
- May cause cardiac arrest within 2-4mins after rescue
define:
Salt Water drowning
If a sufficient volume of salt water enters the lungs, it will
- Cause water to be drawn into the alveoli form the bloodstream due to high solute nature of salt
- Increase in blood viscosity that will cause severe bradycardia and death
- Increased fluid in the lungs causes pt to drown in their own body fluid
- May cause cardiac arrest up to 12mins after their rescue
define:
Secondary drowning
Should a drowning victim be successfully rescued and resuscitated they may appear to have fully recovered.
HOWEVER water in the stomach will continue to be absorbed into the bloodstream causing a distortion in the pH of the blood
Death may occur up to 24 hours after rescue
infection
additional complications of drowning
hypothermia
Alcohol
Mammalian diving reflex
prolonged immersion
If neck/back trauma is suspected wait until pt has been rescued before applying immobilisation but; limit neck extension and flexion
complications of drowning:
Alcohol
Speeds onset of hypothermia
Slows reactions
Increases risk of vomiting increasing the risk of compromised airway
complications of drowning:
Hypothermia
Must be considered in all cases of near drowning, submersion or immersion
This is a serious complication of drowning which itself can mimic many signs of cardiac arrest
complications of drowning:
Prolonged immersion
Most victims, if they survive hypothermia, float vertically in the water
While in this position the water exerts pressure on the legs which massages the veins ensuring adequate venous return
Upon removal form the water this pressure is removed, resulting in syncope or sudden death
Cardiovascular collapse from hydrostatic pressure on lower limbs if pt removed from liquid vertically
complications of drowning:
Mammalian Diving Reflex
A primitive reflex action that activates when the victim is suddenly immersed in icy cold water, face first
It immediately results in the shutdown of the respiratory, circulatory and nervous systems to a point of suspended animation and apparent death
management of:
drowning, submersion and immersion incidents
DRABC - any present = time critical transfer
assisted ventilations if:
SpO2 30
Expansion is inadequate
Supplemental oxygen:
Children high %
Adults aim for 94-98%
Heart rate - consider compressions. bradycardia often responds to improved ventilations and O2
?accompanying injuries - neck? back? immobilise
ECG
Pain management
Position - if time critical removal from water takes precedence over method of removal
Transfer to further care - transfer all pt’s
If neck and back injuries not suspected/present transport In recovery position
If pt is immobilised prepare to side-tilt
Consider warming
Pre-alert
Continue treatment
