NEAR DROWNING

Question 1

_______________ generally is defined as survival, at least temporarily,after suffocation by submersion in a liquid medium.

Answer 1

Nonfatal Drowning

Question 2

Drowning:

Most authors include the _____________ while submerged as a criterion for the syndrome.

Answer 2

loss of consciousness

Question 3

What factors increase the risk of drowning?

Answer 3

1) Inadequate adult supervision.

2 )Inability to swim or overestimation of swimming capabilities.

3) Risk-taking behavior.
4) Use of alcohol and illicit drugs
5) Hypothermia
6) Concomitant trauma, stroke, or myocardial infarction.
7) Seizure disorder or developmental/behavioral disorders in children.

Question 4

____ percent of adult drowning deaths are believed to be alcohol-related

Answer 4

50%

Question 5

If somebody was in a Nonfatal drowning and experienced a cardiac arrhythmia, what is most likely the cause?

Answer 5

Hypothermia

Question 6

Drowning:

Hypoxemia affects every organ system, with the major component of morbidity and mortality being related to _______________

Answer 6

Cerebral hypoxia

Question 7

What is a Pulmonary Hypoxemia finding when salt water and fresh water wash out SURFACTANT for a drowning patient?

Answer 7

1) Pulmonary Edema

2) Acute Respiratory Distress Syndrome (ARDS)

Question 8

What are signs and symptoms of Pulmonary Hypoxemia?

Answer 8

Shortness of breath, Crackles, and Wheezing

Question 9

What imaging for a nonfatal drowning patient can be used to look for evidence of localized, peripheral, or diffuse pulmonary edema?

Answer 9

x-ray or CT

Question 10

Approximately _____ percent of nonfatal drowning victims sustain neurologic damage

Answer 10

20%

Question 11

Arrhythmias secondary to ________ and _________ are often observed in nonfatal drowning victims

Answer 11

Hypothermia and Hypoxemia

Question 12

What are the INITIAL arrhythmias observed in nonfatal drowning victims?

Answer 12

1) Sinus Tachycardia
2) Sinus Bradycardia
3) A-Fib

Question 13

What are the 3 phases of management of drowning victims?

Answer 13

1) Pre-Hospital Care
2) Emergency Department Care
3) Inpatient Care

Question 14

What are the Acute Interventions for drowning victims?

Answer 14

1) Rescue and immediate resuscitation by bystanders
2) The need for CPR is determined
3) Rescue Breathing Initiated
4) C-Spine IF they dove into shallow water

Question 15

What should NOT be done when determining the need for CPR for a drowning victim?

Answer 15

1) Do not compromise the safety of the rescuer

2) Do not delay removal of victim from the water

Question 16

What postural drainage technique is NOT useful in removing water from the lungs of a drowning victim?

Answer 16

The Heimlich maneuver

Question 17

When is C-spine warranted in the Acute Interventions for a Drowning Victim?

Answer 17

If they dove into shallow water

Question 18

What are the indications to intubate a drowning victim?

Answer 18

1) Signs of neurologic deterioration or inability to protect the airway
2) Inability to maintain a PaO2 above 60 mmHg
3) Inability to maintain oxygen saturation (SpO2) above 90 percent despite high-flow supplemental oxygen
4) Their PaCO2 is above 50 mmHg

5)

Question 19

Drowning victim:

PaCO2 above ____mmHg indicates intubation

Answer 19

50 mmHg

Question 20

Drowning victim:

Inability to maintain oxygen saturation (SpO2) above ____% despite high-flow supplemental oxygen indicated intubation

Answer 20

90 %

Question 21

Drowning victim:

Inability to maintain a PaO2 above __ mmHg indicates intubation

Answer 21

60 mmHg

Question 22

Drowning victim:

In symptomatic patients who do not require immediate intubation,supplemental oxygen should be provided to maintain the SpO2 above ___ percent.

Answer 22

94 %

Question 23

What is the most critical factor at presentation of a drowning victim that has been associated with poor prognosis?

Answer 23

Duration of submersion >5 minutes

Question 24

Arterial blood pH ____ upon presentation has been associated with poor prognosis for drowning victims.

Answer 24

Less than 7.1