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Drowning in Salt Water

Drowning Salt Water


Presentation

  • Secondly, the amount of fresh water presented into each shoreline will have to be excluded and expounded upon withdrawing the effect out of the over concentration of salt.[sites.google.com]
  • So my diagnosis was of a (likely viral) myocarditis as a subacute process over the last weeks, with a superimposed pneumonia causing the acute deterioration and presentation to ED.[thinkingcriticalcare.com]
  • Near drowning can be divided into three stages: stage 1: acute laryngospasm that occurs after inhalation of a small amount of water stage 2: the victim still usually presents with laryngospasm but may begin to swallow water into the stomach stage 3 10[radiopaedia.org]
  • […] in bodies of water; theoretically should never be present in a human unless they inhaled water Look for diatoms in bone marrow Validity questionable because diatoms are present in soil and atmosphere, and samples are easily contaminated Absence of diatoms[pathologyoutlines.com]
  • Secondary drowning commonly presents 5–8 hours after the initial incident.[parentmap.com]
Sepsis
  • الصفحة 137 - Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. ‏[books.google.com]
  • Bottom Line: I think the learning point in this case is that, without POCUS, this could easily have been treated as severe sepsis with multiple organ failure (potentially rationalizing away the BP of 140 as a “relatively low” BP due to untreated hypertension[thinkingcriticalcare.com]
  • […] alveoli, resulting in hemoconcentration and increased blood electrolyte levels Near drowning : when a submerged individual survives greater than 24 hours after rescue May show pulmonary edema, hemoglobinuria, cardiac arrhythmia, pneumonitis, fever, sepsis[pathologyoutlines.com]
  • A risk in using hypothermia as a therapy is the possibility of internal infection (sepsis), probably caused by the fact that cold suppresses the body's immune system.[thedoctorwillseeyounow.com]
  • 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]
Cough
  • #2534524 grad1980 - 11/29/11 22:25 @4usmlee, michaeericksens: remember she coughs n breaths on rescue, read the question properly.[usmleforum.com]
  • Others continue with severe cough and bronchospasm and require assistance. Patients with minimal symptoms (eg, coughing) and normal oxygen saturation should be observed for 24 hours; nearly all recover spontaneously within a few hours.[scuba-doc.com]
  • Secondary drowning symptoms Most symptoms involve irregular breathing: trouble catching one’s breath, feeling winded without exertion, breathing too quickly or panting and excessive coughing.[parentmap.com]
  • So here’s what happens: When people swallow water into their lungs, it can cause the vocal cord to close even though the natural response is coughing.[sheknows.com]
  • If you see them come out of the water coughing, keep an eye on them for as long as you can after they’re done swimming .[freerangekids.com]
Pleural Effusion
  • Usumoto Y, Sameshima N, Hikiji W et al (2009) Electrolyte analysis of pleural effusion as an indicator of drowning in seawater and freshwater.[link.springer.com]
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]

Workup

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]
Pseudomonas
  • Abstract Pseudomonas putrefaciens, a marine organism infrequently found in human culture material, was repeatedly isolated from the sputum of a patient with pneumonia during a three-week period following a salt-water drowning accident.[ncbi.nlm.nih.gov]
Pleural Effusion
  • Usumoto Y, Sameshima N, Hikiji W et al (2009) Electrolyte analysis of pleural effusion as an indicator of drowning in seawater and freshwater.[link.springer.com]

Treatment

  • This would have been the polar opposite of the necessary treatment. The scarier thought is that he may have then progressed to “ARDS,” been intubated and then the debate between keeping him dry and giving fluids for the kidneys may have ensued.[thinkingcriticalcare.com]
  • A randomized, controlled trial of methylprednisolone or naloxone in the treatment of acute spinal cord injury: results of the Second National Acute Spinal Cord Injury Study. ‏[books.google.com]
  • 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

  • […] those with liver disease and hematologic malignancies Aspergillus (see Aspergillus , [[Aspergillus]])): common fungal contaminant of natural bodies of water, especially those polluted with sewage) Invasive Aspergillosis cases have been reported Rare etiology[mdnxs.com]

Epidemiology

  • Epidemiology Definition of Near Drowning : defined as submersion in water severe enough to require medical attention WHO Definition of Drowning : “the process of experiencing respiratory impairment from immersion/immersion in liquid” Mortality Rates Associated[mdnxs.com]
  • 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]
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]
  • Drowning can further be classified as warm-water ( 20 C) or cold-water ( Drowning pathophysiology The drowning process begins with the victim’s airway submerged beneath the surface of the water.[ems1.com]
  • Pathophysiologic changes and pulmonary injury depend on the type of fluid (fresh or salt water) and the volume aspirated. Fresh water aspiration results in a loss of surfactant, leading to an inability to expand the lungs.[nursingcenter.com]
  • […] 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]
  • The pathophysiology of drowning [ edit ] The body's reaction to submersion [ edit ] Submerging the face in water triggers the mammalian diving reflex . This is found in all mammals , and especially in marine mammals such as whales and seals .[en.wikibooks.org]

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]
  • 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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