Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Patho 2 (Path 311) > Mod 7 Drowning > Flashcards

Mod 7 Drowning Flashcards

1
Q

Define Drowning

A

Suffocation and death due to submersion in a liquid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Define Near-drowning

A

When a victim survives a liquid submersion, at least temporarily

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Define Dry drowning

  • when does this occur?
A

Due to involuntary laryngospasm, liquid does not enter the lungs

  • Lungs of near dry drowning victims are normal
  • 10-20% of victims maintain the laryngospasm until cardiac arrest
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Define Wet drowning

A

As O2 levels fall, the glottis relaxes and the liquid enters the lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What happens when you drown? (2)

A
  • Aquatic distress
  • Instinctive drowning response
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is Aquatic distress?

A

Classic pic of drowning

  • usually precedes drowning
  • visible, active/violent/abrupt movments
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the Instinctive drowning response

  • Key feature?
A

The more typical picture of drowning

  • Behaviors instinctively taken by someone drowning (or close to drowning)
  • Noiseless and subtle behaviors that are instinctive
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are typical responses/events that occur during drowning or near drowning sequences? (7)

A
  1. Panic/violent struggle to return to surface
  2. Period of calmness and apnea
  3. Swallowing large amounts of fluids, followed by vomiting
  4. Gasping inspirations and aspirations
  5. Convulsions
  6. Coma
  7. Death
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are 3 things to consider for Near drowning?

A
  1. Salt vs fresh water
  2. Cold vs warm water
  3. Clean vs unclean water
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why is salt water near drowning more concerning than in fresh water?

A

Salt water near drowning victims have more electrolyte disturbances

  • Pathologic changes are almost the same.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is considered warm vs cold water?

A
  • > 20 °C is warm
  • < 20°C cold
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Does colder or warmer water drowning yield better survival?

  • why?
A

Cold water slows metabolism; means they require less O2

  • cold water immersion will stimulate the diving reflex in young children (apnea, bradycardia, core-saving vasoconstriction)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What factors do you need to consider with unclean water near drowning?

A

May have aspirated pathogens and solid material

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What risks develop with unclean water near drownings?

  • Think pathologies
A

Risk of developing pneumonia and ARDS is much higher

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What factors increase survival prognosis in cold water near drownings? (8)

A
  1. Age
  2. Submersion time
  3. Water temperature
  4. Water quality
  5. Other injuries
  6. Amount of struggle
  7. CPR quality
  8. Suicidal intent
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the upper limit for cold water near drowning prognosis’s ?

A

60 mins is the upper limit for cold water drownings

  • The shorter, the better
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Pathophysiology of Wet Near Drowning? (8)

  • AKA what happens to the body as a result?
A
  • Laryngospasm
  • noncardiogenic pulmonary edema
  • Decreased surfactant
  • Alveolar shrinkage and atelectasis
  • Alveolar consolidation
  • Bronchospasm
  • Pulmonary hypertension
  • CNS damage
18
Q

What are the mechanisms of noncardiogenic pulmonary edema that’s involved with wet near drowning? (2)

A
  1. Interstitial edema; fluid moves into the capillaries into the perivascular and peribronchial spaces, alveolar walls, bronchi/bronchioles, and interstitial spaces
  2. Lymph vessels dilate w/increased flow through the lymph system
19
Q

What are the mechanisms of Pulmonary Hypertension that’s involved with wet near drowning?

A

Secondary hypoxemia or inflammatory mediator release

20
Q

Why does surfactant decrease with near drowning?

A

Surfactant mixes w/inhaled fluids creating frothy secretions.

  • Then we suction it out…
21
Q

What would cause injury to the CNS because of near drowning? (3)

  • Break up each cause into flash cards
A
  1. Primary injury involves prolonged hypoxemia during episode
  2. Secondary causes involve reperfusion injury, cerebral edema, seizures, arrhythmias
  3. May be concomitant head or spinal cord injury
22
Q

What do primary injuries that cause CNS damage during near drowning generally entail in terms of pathology/affect?

  • AKA What is the primary cause of injury that causes CNS damage
  • Need to edit the phrasing
A

Prolonged hypoxemia during episode

23
Q

What are secondary causes that may cause CNS damage in near drownings? (4)

A
  • Reperfusion injury
  • Cerebral edema
  • Seizures
  • Arrhthmias
24
Q

When does irreversible brain damage usually occur in near drowning events?

A

after 4-6 minutes after immersion

25
Q

When do children lose consciousness in immersion events?

A

Two minutes after immersion

26
Q

How is the heart affected by near drowning events?

A

Myocardial dysfunction

27
Q

How is blood volume affected by near drownings?

  • When do changes occur?
A

Hypovolemia can result due to fluid losses from increased capillary permeability.

  • occurs if more than 11ml/kg of water is aspirated
28
Q

When do electrolyte changes occur during near drowning events?

A

If more than 22ml/kg of water is aspirated

29
Q

Clinical Manifestations of drowning? (6)

A
  • Apnea or tachypnea
  • Increased HR and BP
  • Cyanosis
  • Cough w/frothy, white, or pink sputum
  • crackles on auscultation
  • Restrictive lung pathophysiology
30
Q

Clinical manifestations of drowning: What would you expect on a ABG?

A

Resp acidosis w/hypoxemia

OR

Metabolic acidosis if lactic acid present

31
Q

Clinical manifestations of drowning: What would you expect on a CxR?

A

Initial CXR may be normal; may deteriorate within the first 48-72 h

  • Pulmonary edema and atelctasis
  • Fluffy infiltrates; air bronchograms
32
Q

Left off @slide 14

A
33
Q

What are pre-hospital treatments of near drowning events?

A
  • Conserve heat/maintain body temperature (remove wet clothes/cover)
  • All drowning victims should get 100% O2
  • If in cardiac arrest; CPR; Establish airway
34
Q

What are hospital treatments of near drowning events if the patient is still spontaneously breathing?

A
  • Intubate and ventilate if PaO2 < 60mmHg on FiO2 > 0.50 or if resp acidosis present (<7.25)
  • NIPPV can be considered prior to intubation if awake and alert
35
Q

What are airway management strategies and treatments in the hospital for victims of near drowning events? (3)

A
  1. Intubate and vent (or NIPPV if spontaneously breathing)
  2. Follow Mech ventilation ARDS/lung protective strategies w/permissive hypercapnia as necessary
  3. Bronchodilators (if bronchospasm present)
36
Q

What are the primary treatments used for victims of near drowning to address drowning (not direct airway management treatments) (7)

A
  1. Warming of patient
  2. Address volume depletion
  3. Manage electrolyte imbalances
  4. Bronchoscopy
  5. ECO
  6. Surfactant therapy
  7. Prophylactic antibiotics or steroids
37
Q

What considerations need to be kept in mind when rewarming near drowning victims?

A

Rewarming may be balanced by a goal of permissive hypothermia for neuroprotection

38
Q

How is fluid volume depletion addressed?

A

Fluids and possibly inotropes

39
Q

What is the purpose of a Bronchoscopy in addressing near drowning victims?

A

To remove foreign material if present (debris or vomit)

40
Q

What can be used to rewarm a patient?

A

Warm IV solutions, heated lavage, Active humidity on the ventilator
Heating blankets (Bear hugger)

41
Q

What is the diving reflex?

A

physiological response that causes peripheral vasoconstriction to prioritize blood flow to vital organs.

Patho 2 (Path 311) (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions