Week 10

Question 1

Who does drowning mostly effect

Answer 1

Youth under 5
Males with drug or alcohol intoxication
Disorders that cause LOC ex seizures

Question 2

What is the time line of drowning (patho)

Answer 2

1. Holding breath: victims lose consciousness at 2 mins due to hypercapnia ETC02 >55mmgh
2. Gasping and swallowing: this causing swallowing large amounts of water
3. Laryngospasm: water entering the airway
4. Brain damage: occurs 4-6 mins after LOC
5. Cardiac progression: tachy - Brady - PEA - asystole

Question 3

Difference between salt water and freshwater drowning

Answer 3

Hemolysis will happen with freshwater not salt
(RBC break down)

Question 4

Aspiration of Fluid

Answer 4

Decreases Lung Compliance
•Initial Presentation: Non-cardiogenic pulmonary edema (fluid overload).
•Later Stages: Acute Respiratory Distress Syndrome (ARDS) due to surfactant washout.

Question 5

Cold Water Drowning

Answer 5

Cold Water Drowning
•Activates the Mammalian Diving Reflex, causing:
•Bradycardia: Slowed heart rate.
•Peripheral Vasoconstriction.
•Reduced Oxygen Demand.

Question 6

Pediatric Considerations to drowning

Answer 6

•Reflex is stronger in children.
•Children have greater oxygen-carrying capacity.
•Children cool more quickly due to larger body surface area.

Question 7

ARDS: What Happens?

Answer 7

•Blood vessels in the lungs leak fluid into the air spaces.
•This causes non-cardiogenic pulmonary edema (not related to the heart).
•Less surfactant is made, leading to collapsed lungs (atelectasis).

Question 8

ARDS: Why It’s Dangerous

Answer 8

•Lungs lose capacity to hold air.
•Blood flows to areas with no oxygen, causing hypoxia.
•One lung might still get blood but no air, worsening oxygen levels

Question 9

Boyles law

Answer 9

The pressure of a gas increases as its volume decreases assuming constant mass and temperature

Question 10

Henrys law

Answer 10

Henry’s Law- at constant temperature, the amount of gas dissolved in a liquid is proportional to the partial pressure of gas above the liquid

Question 11

Barotrauma- can occur in any gas filled space, but often occurs in

Answer 11

middle ear, sinuses,
GI system or
lungs.

Question 12

Symptoms of barotrauma

Answer 12

1. Tympanic membrane rupture: The eardrum bursts due to pressure differences.
   
   2. Tinnitus: Ringing or buzzing in the ear caused by damage to inner ear structures.
   3. Vertigo: A spinning sensation caused by pressure affecting the inner ear’s balance organs.
   4. Nausea and vomiting: These often accompany vertigo due to the inner ear’s role in balance and spatial orientation.

Question 13

When a diver makes his ascent there can be air trapped within the lungs from?

Answer 13

1. breath holding,
2. bronchospasm or
3. mucus plugs,
   Can cause alveolar rupture. Clinically, patient can present with dyspnea, pleuritic pain, sub-q emphysema, or pneumothorax.

Question 14

What is decompression sickness (the bends)

Answer 14

It occurs when nitrogen that is compressed in tissues/blood from increase pressure when diving turns back into gas bubbles when surfacing (Henry’s Law)

Question 15

Nitrogen narcosis what is it?

Answer 15

Due to increased pressures, normally with deeper dive (75-100 ft) nitrogen becomes dissolved in blood and passes the blood brain barrier
Nitrogen acts similar to alcohol cause the diver to make poor decisions during the dive. This can cause injury or death if impairment is enough to remove respirator

Question 16

Where is the Thermoregulatory Center and what does it do

Answer 16

1. Located in the anterior hypothalamus, it monitors temperature through both peripheral and central receptors. Normal Core Temperature: 37°C
2. Types of Thermoreceptors:
   - Cold Receptors
   - Warmth Receptors
   - Peripheral Receptors:3. Found in the skin, muscles, and mucous membranes. There are more cold receptors than warmth receptors in these areas.
3. Central Receptors:Found in the great veins, spinal cord, hypothalamus, and viscera. These receptors have a higher number of warm receptors than cold ones.

Question 17

What is Thermogenesis

Answer 17

Thermogenesis is the production of heat through the sympathetic nervous system.