Mod D Tech 9 Drowning and Near-drowning

Question 1

Compounding Factors of water

Answer 1

•Thermal conduction of water is 25 to 30 times that of air

•

•Physical exertion increases heat loss up to 50% faster

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•A significant risk of hypothermia usually develops were the water temperature is less than 25ºC

Question 2

Management

History is often incomplete at the scene, both relating to the incident and the casualty. Try to obtain:

Answer 2

• time of accident
• time of rescue
• start time of C.P.R.
• duration of Immersion
• water temperature
• type of water

Question 3

Primary Survey and Resus

Answer 3

• Hazards; PPE; pt. position; response;
• Airway clearance; adjuncts; ventilation priority
• Suction equipment available
• Breathing: IPPV at 12-20 if <10 or >30
• Admin. high concentration oxygen to ensure

SpO² of 94 – 98 % (except COPD)

• Circulation: bradycardia ? Hypothermia
• Consider paramedic for ET; IV & Drugs

Cardiac arrest:

If hypothermic defibrillation is likely to be unsuccessful

• At 28°c ventricles spontaneously fibrillate
• Core temp. needs to rise to 30-32°
• Give max. of 3 shocks (Resus Guidelines)
• Continuous CPR (30:2) DO NOT STOP CPR in the field
• Rapid transfer with Pre-alert (ATMIST)
• Consider c-spine follow ETLS protocols

Question 4

Management

(non time critical)

Answer 4

• Perform a thorough patient assessment
• Brief Secondary Survey
• C -spine, ok, recovery position
• C-spine not ok, long board with tilt (only if pt. vomits)
• Keep suction to hand
• Cover to prevent heat loss
• Consider paramedic for IV access
• Transport with pre-alert (ATMIST)

Question 5

Secondary Drowning

what is it

Answer 5

Definition:

• Occurs within 4 hours of near-drowning
• Can prove fatal

Question 6

Common problems of secondary drowning

Answer 6

• ARDS: Acute Respiratory Distress Syndrome
• Cerebral oedema
• Renal failure
• Infection
• Electrolyte & acid base imbalance