Submersion/drowning

incidence of drowning

* in __**children

pathophysiology of drowning

* __submersion__ results in **aspirations of water** or **laryngeal spasms**, leading to suffocation
* ==**hypoxia** and **acidosis**== leads to ==brain damage and death==
* %%**surfactant** maintains **surface tension** in **alveoli**%% to keep them from collapsing
* water in lungs WASHES out surfactant
* when surfactant is washed out the alveoli COLLAPSES
* **Acute respiratory distress syndrome (ARDS)** results

drowning/diving injuries

* **head/spine** injuries
* fractures of **extremities and ribs**
* assume neck and spine injuries in diving emergencies

suspect spinal injury if

* there was a **diving accident**
* pt. may have been struck by **skier, surfboard**, or other object
* swimmer was using **water slide**
* there is signs of **intoxication**
* there is evidence of **traumatic injury**

drowning treatment

* if pt has no spinal injury, **place pt on his left side** (if pt. is breathing and has pulse)
* be **prepared to suction**
* for absent or inadequate oxygen, establish an **airway** and **begin ventilations** with supplemental oxygen

Decompression sickness occurs

* result of %%**bubbles**%% as an %%**expansion of nitrogen**%% in the blood and tissues

Bubbles (which causes decompression sickness) has TWO primary effects on the body

* they act as ==**emboli**== and cause obstruction in the ==**circulation**==
* **compress or stretch** the **blood vessels** and **nerves**

decompression sickness signs and symptoms

* tachycardia
* shortness of breath
* pain
* rash
* bloody sputum
* edema in lungs

decompression symptoms treatment

administer oxygen

* NRB 10-15 L/min
* assist ventilations if needed