NEAR DROWNING Flashcards
_______________ generally is defined as survival, at least temporarily,after suffocation by submersion in a liquid medium.
Nonfatal Drowning
Drowning:
Most authors include the _____________ while submerged as a criterion for the syndrome.
loss of consciousness
What factors increase the risk of drowning?
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.
____ percent of adult drowning deaths are believed to be alcohol-related
50%
If somebody was in a Nonfatal drowning and experienced a cardiac arrhythmia, what is most likely the cause?
Hypothermia
Drowning:
Hypoxemia affects every organ system, with the major component of morbidity and mortality being related to _______________
Cerebral hypoxia
What is a Pulmonary Hypoxemia finding when salt water and fresh water wash out SURFACTANT for a drowning patient?
1) Pulmonary Edema
2) Acute Respiratory Distress Syndrome (ARDS)
What are signs and symptoms of Pulmonary Hypoxemia?
Shortness of breath, Crackles, and Wheezing
What imaging for a nonfatal drowning patient can be used to look for evidence of localized, peripheral, or diffuse pulmonary edema?
x-ray or CT
Approximately _____ percent of nonfatal drowning victims sustain neurologic damage
20%
Arrhythmias secondary to ________ and _________ are often observed in nonfatal drowning victims
Hypothermia and Hypoxemia
What are the INITIAL arrhythmias observed in nonfatal drowning victims?
1) Sinus Tachycardia
2) Sinus Bradycardia
3) A-Fib
What are the 3 phases of management of drowning victims?
1) Pre-Hospital Care
2) Emergency Department Care
3) Inpatient Care
What are the Acute Interventions for drowning victims?
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
What should NOT be done when determining the need for CPR for a drowning victim?
1) Do not compromise the safety of the rescuer
2) Do not delay removal of victim from the water
What postural drainage technique is NOT useful in removing water from the lungs of a drowning victim?
The Heimlich maneuver
When is C-spine warranted in the Acute Interventions for a Drowning Victim?
If they dove into shallow water
What are the indications to intubate a drowning victim?
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)
Drowning victim:
PaCO2 above ____mmHg indicates intubation
50 mmHg
Drowning victim:
Inability to maintain oxygen saturation (SpO2) above ____% despite high-flow supplemental oxygen indicated intubation
90 %
Drowning victim:
Inability to maintain a PaO2 above __ mmHg indicates intubation
60 mmHg
Drowning victim:
In symptomatic patients who do not require immediate intubation,supplemental oxygen should be provided to maintain the SpO2 above ___ percent.
94 %
What is the most critical factor at presentation of a drowning victim that has been associated with poor prognosis?
Duration of submersion >5 minutes
Arterial blood pH ____ upon presentation has been associated with poor prognosis for drowning victims.
Less than 7.1
