Near Drowning Lecture Notes

A set of vocabulary flashcards covering the definitions, physiology, etiology, and clinical management of near drowning based on lecture notes.

Near Drowning

A condition where the victim survives a liquid submersion at least temporarily; it is implied when victims are successfully resuscitated and survive at least $24\text{ hours}$.

Dry Drowning

A type of drowning occurring in 10\text{-}15\text{%} of victims where no fluid is aspirated into the lungs, and death results from acute asphyxia caused by laryngospasm.

Wet Drowning

A type of drowning where 85\text{-}90\text{%} of victims aspirate fluid into their lungs because the glottis relaxes.

Laryngospasm

A spasm of the glottis that prevents water from passing into the lungs during the initial stages of a dry drowning event.

Non cardiogenic pulmonary edema

A physiological response where fluid from pulmonary capillaries moves into the bronchioles and alveoli, causing swelling of alveolar walls and the interstitium.

Atelectasis

Alveolar shrinkage and collapse often caused by the washing out or destruction of pulmonary surfactant.

Fresh Water

A substance that is hypotonic to the blood and is rapidly absorbed into the blood stream, where it destroys pulmonary surfactant.

Frothy, pink stable bubbles

Specific sputum and cough production found in 85\text{-}95\text{%} of drowning victims, indicating secretions throughout the tracheobronchial tree.

Arterial Blood Gases (Near Drowning)

A laboratory finding typically showing decreased $pH$, increased $PaCO_2$, decreased $HCO_3$, and decreased $PaO_2$.

Metabolic Acidosis

A clinical occurrence in near drowning usually related to tissue hypoxia and the build-up of lactate.

Cold-Water Submersion Time

A prognostic factor where survival is possible for up to $60\text{ minutes}$ (the upper limit) in water temperatures ranging from $27^\text{o} \text{F}$ to $70^\text{o} \text{F}$.

Dilution

A decrease in hemoglobin, hematocrit, and electrolyte concentrations that may occur when large volumes of fresh water are aspirated.

Fluffy infiltrates

A common radiologic finding on a chest radiograph of a near drowning victim, often indicating a pulmonary edema pattern or ARDS.

PEEP

Positive End-Expiratory Pressure, a setting used during mechanical ventilation that most wet drowning victims require in the hospital.

Bronchospasm

A pathologic change where the bronchial walls constrict as a parasympathetic reflex when fluid is initially inhaled.