Near Drowning

Question 1

Nonfatal drowning generally is defined as …..

Answer 1

survival, at least temporarily, after suffocation by submersion in a liquid medium

Question 2

What factors increase the risk of drowning

Answer 2

(a) Inadequate adult supervision.
(b) Inability to swim or overestimation of swimming capabilities.
(c) Risk-taking behavior
(d) Use of alcohol and illicit drugs
(e) Hypothermia
(f) Concomitant trauma, stroke, or myocardial infarction.
(g) Seizure disorder or developmental/behavioral disorders in children

Question 3

more than 50 percent of adult drowning deaths are
believed to be ______ related

Answer 3

Alcohol

Question 4

Approximately ____ percent of nonfatal drowning victims sustain neurologic damage, limiting functional recovery despite successful cardiopulmonary
resuscitation.

Answer 4

20

Question 5

Management of drowning victims can be divided into three phases:

Answer 5

-prehospital care,
-emergency department (ED) care,
-inpatient care.

Question 6

Acute interventions for Near drowning

Answer 6

(a) Rescue and immediate resuscitation by bystanders improve the outcome of drowning victims
(b) The need for (CPR) is determined as soon as possible without compromising the safety of the rescuer or delaying the removal of the victim from the water.

Question 7

True/False
The you should delay rescue breathing to perform Heimlich maneuver or other postural drainage techniques to remove water from the lungs.

Answer 7

FALSE
Heimlich maneuver or other postural drainage techniques are of no proven value

Question 8

Cervical spinal cord injury is uncommon in nonfatal drowning victims, UNLESS what?

Answer 8

there are clinical signs of injury or a concerning mechanism
(e.g., dive into shallow water)

Question 9

Clinical Management:
In the symptomatic patient, indications for intubation include what:

Answer 9

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

Question 10

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

Answer 10

94

Question 11

Clinical Management near drowning

Answer 11

(a) Prehospital resuscitative efforts should be continued, and the airway secured as indicated
(b) maintain the SpO2 above 94 percent
(c) Wet clothing should be removed, and rewarming initiated in hypothermic
patients.
(d) Symptomatic patients require hospitalization for supportive care and treatment of organ-specific complications

Question 12

True/False
Immersion in water regardless of temperature puts a patient at high risk for hypothermia.

Answer 12

true

Question 13

The following factors at presentation have been associated with a poor prognosis:
a) Duration of submersion _____ minutes (most critical factor)
b) Time to effective basic life support ____ minutes
c) Resuscitation duration ____ minutes
d) Age____ years
e) Glascgow coma scale ____
f) Persistent apnea requirement of cardiopulmonary resuscitation in the emergency department.
g) Arterial blood pH __ upon presentation

Answer 13

a) > 5
b) > 10
c) > 25
d) > 14
e) <5
g) <7.1

Question 14

What is the most critical factor for poor prognosis with near drowning

Answer 14

Duration of submersion > 5 minutes