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Drowning in Fresh Water

Drowning Fresh Water


Presentation

  • We present a case of a young man who was submerged in a swimming pool and was transported to our hospital in cardiac arrest.[keio.pure.elsevier.com]
  • Abstract The interpretation of the level of strontium (Sr) in blood has been demonstrated to be useful in the diagnosis of death by drowning occurred in sea water, but its use in fresh water drownings is not so evident because of the low Sr concentration present[ncbi.nlm.nih.gov]
  • The presented findings are typical for freshwater drowning. The combination of fluid levels in the paranasal sinuses, in the nasal cavity as well as in the trachea and main bronchi indicates drowning.[radiopaedia.org]
  • Research Briefs boxes present abstracts of selected research studies and emphasize the use of evidence to guide care recommendations. NANDA-approved diagnoses are marked with an icon to familiarize you with NANDA terminology.[books.google.de]
  • Presented in clear and concise format, this text will prove invaluable to students and field providers alike.[books.google.de]
Swelling
  • @usmleburger, doc499, always know that fresh water drowning leads to water moving into RBCs swelling rupture. the concept of osmosis![usmleforum.com]
  • Freshwater Drowning: Freshwater - Time it takes: Five to 20 minutes In freshwater, the water filling a person's lungs can enter the bloodstream quickly causing blood cells to swell and burst.[kidzworld.com]
  • When water enters the cells, it causes them to swell. Some of the lung cells may burst. Because capillaries in your lungs are exposed to the fresh water, water enters the bloodstream, diluting your blood.[thoughtco.com]
  • When water enters cells, it swells them. Cells may burst. Lung capillaries are exposed to freshwater, water enters bloodstream. This dilutes blood. Blood cells burst (hemolysis).[gkenhancer.blogspot.com]
  • This causes the red blood cells to swell up and eventually burst. Also, and more obviously, the fluid filling a person’s lungs will prevent the body from taking in enough air.[zidbits.com]
Cough
  • #2534524 grad1980 - 11/29/11 22:25 @4usmlee, michaeericksens: remember she coughs n breaths on rescue, read the question properly.[usmleforum.com]
  • Bluish skin (cyanosis), coughing, vomiting, and frothy pink sputum (material expelled from the respiratory tract by coughing) are often observed.[healthofchildren.com]
  • […] enters the mouth when no longer able to be kept clear voluntarily spat out or swallowed at first next conscious response is to hold one’s breath, lasts 1 minute, until inspiratory drive is too high to resist water is aspirated into the airways, and coughing[lifeinthefastlane.com]
  • The reaction to water inhalation [ edit ] If water enters the airways of a conscious victim the victim will try to cough up the water or swallow it thus inhaling more water involuntarily.[en.wikibooks.org]
  • A continuous cough may indicate pulmonary injury due to aspiration. Any abnormal respiratory sounds may reflect aspiration, pulmonary edema or atelectasis.[rescuediver.org]
Flushing
  • […] in salt water drowning, water moves out from the cells in accumulates in the lungs to balance the salty water there, flushing the surfactant ARDS. the answer is C, since she was in a swimming pool. hypotonic. Report Abuse[usmleforum.com]
  • Hyperventilation before any dive, deep or shallow, flushes out carbon dioxide in the blood resulting in a dive commencing with an abnormally low carbon dioxide level; a potentially dangerous condition known as hypocapnia.[en.wikibooks.org]
Renal Insufficiency
  • Sepsis and disseminated intravascular coagulation are possible complications during the first 72 hours after resuscitation. 27 Renal insufficiency or failure is rare but can occur as a result of anoxia, shock, myoglobinuria, or hemoglobinuria. 53 The[nejm.org]
  • Disseminated intravascular coagulation (DIC), hepatic and renal insufficiency, metabolic acidosis, and GI injuries must be considered and appropriately managed.[emedicine.medscape.com]
Renal Impairment
  • Acute renal impairment after immersion and near drowning. J Am Soc Nephrol 1999 ;10: 382 - 386 54. Eich C, Brauer A, Timmermann A, et al.[nejm.org]

Workup

  • […] are ingested), while long-term infectious complications are primarily related to whether the victim was submersed in a natural or a man-made body of water. [6] Immediate threats include effects on the central nervous and cardiovascular systems (see Workup[emedicine.medscape.com]
Hemoglobin Increased
  • Hematocrit values, serum sodium concentrations, and osmolality decreased while serum potassium concentrations, catecholamines, and free hemoglobin increased. All measured biochemical data (except PaO2) remained at viable levels.[ncbi.nlm.nih.gov]

Treatment

  • A possible cause of hemolysis is proposed and treatment based on th epathophysiology of pulmonary aspiration of fresh water is discussed.[keio.pure.elsevier.com]
  • Principles of ALS Care provides a succinct and comprehensive review of essentials concepts in ALS assessment and treatment.[books.google.de]
  • Treatment for drowning begins with recognizing that the victim is in trouble, and assessing whether they are awake and breathing.[rxlist.com]
  • Brain damage is the major long-term concern in the treatment of near-drowning victims.[healthofchildren.com]

Prognosis

  • Surf immersion, cold water, short immersion times, skilled administration of CPR are favourable factors - prognosis good if first gasp within 30 min of rescue and there is continuing improvement, especially in children - mortality related to level of[aic.cuhk.edu.hk]
  • Prognosis is better if the immersion time is shorter; the water is cleaner and colder. Prognosis also is better for younger individuals compared with the elderly. Debunking Summer Health Myths As children, most of us heard lots of health advice.[medicinenet.com]
  • Prognosis is ultimately related directly to the duration and magnitude of hypoxia. The most significant impact on morbidity and mortality occurs before arrival at hospital.[patient.info]
  • The rescue team should get the water temperature or an estimate there of, since hypothermia influences prognosis.[rescuediver.org]

Etiology

  • Etiology Drowning may be a primary event or may be secondary to events such as the following: Seizures Head or spine trauma Cardiac arrhythmias Hypothermia Alcohol and drug ingestion Syncope Apnea Hyperventilation Suicide Hypoglycemia Causes tend to vary[emedicine.medscape.com]

Epidemiology

  • EPIDEMIOLOGY Approximately 8,000 deaths due to drowning occur each year in the United States, and approximately 40% of the victims are less than 4 years of age.[pedsinreview.aappublications.org]
  • Epidemiology Worldwide, drowning is the fourth most common injury after road traffic accidents, self-inflicted injuries and violence. It is more common than war deaths.[patient.info]
  • The distinction between submersion fluid type is primarily academic and mostly connotes epidemiologic significance.[emedicine.medscape.com]
  • "Drowning: Epidemiology". Drugs & Diseases - Emergency Medicine. Medscape. Archived from the original on 4 February 2017. Retrieved 3 February 2017.[en.wikipedia.org]
Sex distribution
Age distribution

Pathophysiology

  • OBJECTIVE: To compare the pathophysiologic changes occurring during drowning in cold fresh water and cold salt water with reference to viability. DESIGN: Randomized, prospective, controlled submersion experiments in two contrasting cold liquids.[ncbi.nlm.nih.gov]
  • Award-winning clinical nurse specialist Marianne Baird separates the content first by body system and then by disorder, with each disorder including a brief description of pathophysiology, assessment, diagnostic testing, collaborative management, nursing[books.google.de]
  • Despite increasing understanding of the pathophysiology of drowning and continuing advances in cardiopulmonary resuscitation and support, efforts at cerebral resuscitation have been less successful, and it is estimated that only about half of the children[pedsinreview.aappublications.org]
  • […] and vagal cardiac effects (ie "immersion") rather than true drowning with aspiration of fluid - can occur in very shallow water and volume inhaled may be relatively small - def: at least temporary survival following asphyxia while immersed in liquid Pathophysiology[aic.cuhk.edu.hk]
  • Pathophysiology of drowning The mechanism of death in true drowning is not one of simple hypoxia but differ according to the type of water: hypotonic or hypertonic.[medicinembbs.blogspot.com]

Prevention

  • Salt, the first lifeguard You may not think so by looking at the salt shaker in your kitchen, but salt can actually prevent (or at least slow down) drownings.[lifeguardmiami.com]
  • This not only prevents oxygen from entering the bloodstream, but also causes the victim to essentially drown in their own fluids.[curiositycomplex.wordpress.com]
  • Bariatric Considerations section added to assessment sections to help you assess, and prevent complications and improve care in, overweight and obese patients. NEW![books.google.de]
  • Also, the fluid filling the person's lungs will prevent the body from taking in enough air. This leads to cardiac arrest (when the heart stops cuz it doesn't have enough oxygen.)[kidzworld.com]
  • You don't even need to breathe in the water for this occur, but if you do inhale salt water, the high salt concentration will prevent the water from crossing into your lung tissue.[thoughtco.com]

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