Near Drowning

Question 1

What happens in fresh water drowning?

Answer 1

readily destroys surfactant

May be open to pneumonitis is in muddy or dirty water

Question 2

What happens in Salt water drowning?

Answer 2

Causes fluid from the blood to enter the lung (pulmonary edema) Salt gradient

Alveoli collapse as surfactant is washed out

Sodium level may be high

Question 3

What would you see in an near drowning patient’s ABG?

Answer 3

hypoxemia, hypercapnea,

low bicarb because its used to buffer the increased Pac02

Question 4

How do you treat a near drowning patient?

Answer 4

Obtain ABG
Oxygen administration, PEEP
CXR, Spinal film if suspect injury

Bronchodilators for bronchospasm
Sputum culture

Correct electrolyte or acid base abnormality

Infection should be watched for and treated appropriately (no proph antibiotics)

Overnight observation for spont breathing patients

Question 5

How should you treat a near drowning patient at the scene?

Answer 5

No chest thrust, no head down
Airway, Breathing, Circulation (VS CAB)
Give 5 initial breaths