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Respiratory > Respiratory: Immersion and drowning > Flashcards

Respiratory: Immersion and drowning Flashcards

1
Q

A high % of drowning deaths involve who?

A

Men and children

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2
Q

Many of the swimmers are ** swimmers and die within ** metres of safety

A

Competent

10

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3
Q

Define drowning.

A

Process resulting in primary respiratory impairment from submersion/immersion in a liquid medium.

Person is prevented from breathing air due to liquid at the entrance of the airway.

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4
Q

Does drowning infer the patient is dead?

A

No.

Drowning does not infer the patient is dead.

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5
Q

Define immersion.

A

Being covered in a liquid medium.

Doesn’t mean the water has entered airways.

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6
Q

What are the problems associated with immersion?

A

Problems: hypothermia and cardiovascular collapse from hydrostatic pressure on lower limbs

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7
Q

Define submersion.

A

The entire body including the airway being under the liquid medium.

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8
Q

What are the problems associated with submersion?

A

Problems:
Asphyxia
Hypoxia
Hypercapnia

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9
Q

What exacerbation factors could there be with drowning?

A

Intoxication of alcohol or drugs.

A medical condition

Mental health

Injuries

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10
Q

Pathophysiology (progress) of drowning? (4)

A

Patient initially tries to hold their breath.
May develop laryngospasm as water irritates the vocal chords.
May aspirate large quantities of water.
Both result in rapid hypoxia and hypercapnia.

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11
Q

What is hypercapnia?

A

High CO2 levels.

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12
Q

What happens if rescue is not made in drowning?

A

The patient will aspirate water into the lungs exacerbating hypoxia

Bradycardia will ensue followed by cardiac arrest.

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13
Q

What happens in 10-15% of patients where the laryngospasm is so intense?

A

None of the liquid medium enters the lungs known as dry drowning.

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14
Q

What happens when rescue in drowning is made if the patient is pulled out vertically?

A

If the patient is raised vertically from the water their blood pressure will fall ‘after drop’

This may lead to cardio vascular collapse.

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15
Q

What must we always attempt to ensure when pulling a patient out of water?

A

Always attempt to maintain the patient flat and avoid vertical removal from the water.

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16
Q

What is the Rescue procedure? (3)

A

Carry out a dynamic risk assessment
Assess Number of patients
Drag out of water.

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17
Q

What do you do if neck or back trauma is suspected?

A

Wait until patient has been rescued before applying immobilisation.
Limit neck extension and flexion.

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18
Q

What are the 5 main types of drowning?

A 
Near
Dry
Fresh water
Salt water
Secondary
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19
Q

Describe near drowning.

A

A patient who has been rescued before the point of deathly if there is temporary survival.

20
Q

Describe dry drowning.

A

Stimulation of the reflex action of the larynx and epiglottis causing them to seal off the trachea diverts the water to the stomachs.

21
Q

How does the patient drown with dry drowning?

A

Due to acute hypoxia the patient will have died of asphyxiation long before water enters the lung.

22
Q

What % of drowning incidents are the type ‘dry drowning’?

A

10%

23
Q

Describe fresh drowning and what happens when fresh water enters the lungs. (5)

A

Fresh water entering the lungs;
Interferes with the normal process of respiration.
Removes the surfactant lining of the alveoli.
Prevents gaseous exchange
Creates dilution of the blood
May cause cardiac arrest.

24
Q

What is the surfactant lining of the alveoli?

A

The grease lining which keeps the alveoli inflated.

25
Q

How long after rescue in fresh water drowning can the patient go into cardiac arrest?

A

2-4minutes

26
Q

What happens if a sufficient amount of salt water enters the lungs?

A

Causes water to be drawn into the alveoli from the bloodstream.

27
Q

Why does water get drawn into he alveoli from the blood stream I. Salt water drowning?

A

Because salt sucks the water out of the blood

28
Q

How long after rescue may you still go into cardiac arrest from salt water drowning?

A

12 minutes

29
Q

How long after rescue from primary drowning could you go into secondary drowning?

A

Up to 24 hours later

30
Q

What continues to be absorbed into the bloodstream causing a distortion of Ph levels with secondary drowning?

A

Water

31
Q

What are the common problems with secondary drowning?

A 
ARDS (Acute Respiratory Distress Syndrome
Cerebral oedema
Renal failure
Infection
Disturbance of - 
Electrolytes
Acid base balance
Lung function
32
Q

Complications of drowning

A

Alcohol
Hypothermia
Prolonged immersion
Mammalian diving reflex

33
Q

What is mammalian divine reflex?

A

suddenly immersed head first into icy cold water, everything shuts down - suspended animation

The following systems shut down:
Respiratory systems
Circulatory systems
Nervous systems

34
Q

How is alcohol a complication of drowning?

A

…

35
Q

List the management of drowning. (11)

A 
Assess ABCDE
Airway
Ventilation
Oxygen
Heart rate
Concomitant injuries
ECG
Pain
Position
Transfer to further care
Discontinuation of resuscitation efforts.
36
Q

When administering Oxygen due to drowning, what saturation % do we aim for in adults?

A

94-98%

37
Q

Define secondary drowning

A

…

38
Q

What are the problems with secondary drowning?

A

…

39
Q

How is hypothermia a complication of drowning?

A

…

40
Q

How is prolonged immersion s complication of drowning?

A

….

41
Q

What must we not do if a patient is a victim of a sub-Aqua accident?

A

We must not tamper with any valves on any part of the equipment.

42
Q

We must always consider he possibility of decompression sickness. Why?

A

..

43
Q

How many deaths by drowning in 2009 in England and Wales?

A

205

44
Q

How would we prevent further heat loss for the patient?

A

…

45
Q

What do we never do when dealing with a drowning victim?

A

Give up

46
Q

What should we do if we suspect a c-spine injury on a drowning patient?

A

…..

47
Q

What can drowning, immersion and hypothermia mimic?

A

…

Respiratory (18 decks)

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