Submersion/Drowning

EMT

What is the incidence of drowning?

* children less than 1 year of age, bathtub most common drowning location
* 40% of deaths are of children younger than 5 years old
* second-highest incidence among teenagers
* 85% drowning are males
* alcohol frequently involved

What is the pathophysiology of drowning?

* submersion results in aspiration of water or laryngeal spasms, leading to suffocation
* hypoxia and acidosis lead to brain damage and death
* surfactant maintains surface tension in the alveoli to keep them from collapsing
* water in the lungs washes out the surfactant
* when it’s washed out, alveoli collapse
* acute respiratory distress syndrome results

When do you suspect spinal injury?

* diving accident
* pt may have been struck by a skier, surfboard, other
* swimmer was using a water slide
* suspicion of intoxication
* evidence of traumatic injury

What do you classify drowning pts as?

* asymptomatic (mild to no water inhalation)
* symptomatic (moderate water inhalation)
* cardiac arrest
* dead

What is the treatment for drowning?

* if no spinal injury, place pt on the left side
* be prepared to suction
* for absent or inadequate breathing, establish an airway and begin ventilations with supplemental oxygen

What is decompression sickness?

occurs as the result of bubbles formed by the expansion of nitrogen in the blood and tissues

bubbles:

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

s/s: tachycardia, SOB, pain, rash, bloody sputum, edema in lungs

Development of concerning symptoms after scuba diving should be considered decompression sickness

What is the treatment for decompression sickness?

administer oxygen, non-rebreather 10-15L/min, assist ventilations if needed