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Near Drowning


Presentation

  • 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]
  • If two or more people are present with the victim, one should start CPR, while the other calls 911. If only one person is present with the victim, CPR should be done for one minute before calling 911.[healthline.com]
  • The clinical presentation, laboratory data, modes of therapy and outcome of 34 cases of near-drowning in children under the age of 14 years were reviewed.[pediatrics.aappublications.org]
  • Re-warming is undertaken when hypothermia is present. People may arrive requiring treatment for cardiac arrest or cardiac dysrhythmias. Comatose patients present a special problem.[encyclopedia.com]
  • The following remarks pertain to the near-drowning victim who presents for acute medical management.[pedsinreview.aappublications.org]
Pathologist
  • Rehabilitation - Relearning How To Use His Body On this particular Wednesday, after breakfast, Pablo’s morning routine began with senior speech pathologist Donna Minkler, MA, CCC-SLP.[childrenshospitaloakland.org]
Nightmare
  • Water can go from fun to a full-blown nightmare situation in a matter of minutes. A 4-year-old boy is fighting for his life this morning after a near drowning accident at a pool in Meridian.[1043wowcountry.com]
Camping
  • Jones, an operations manager for a scaffolding company in Calgary, just happened to be in the Fernie area that weekend camping with friends.[langleyadvancetimes.com]
Movement Disorder
  • Children’s is one of a handful of spasticity centers in Northern California, providing diagnosis, treatment, and management for children with movement disorders like Pablo’s, through collaboration between our Neurosurgery and Rehabilitation Medicine departments[childrenshospitaloakland.org]
Sputum
  • […] children unattended around bathtubs or pools Symptoms Symptoms can vary, but may include: Abdominal distention (swollen belly) Bluish skin of the face, especially around the lips Chest pain Cold skin and pale appearance Confusion Cough with pink, frothy sputum[mountsinai.org]
  • Bluish skin (cyanosis), coughing, vomiting, and frothy pink sputum (material expelled from the respiratory tract by coughing) are often observed.[healthofchildren.com]
  • Bluish skin ( cyanosis ), coughing, and frothy pink sputum (material expelled from the respiratory tract by coughing) are often observed.[encyclopedia.com]
Painful Cough
  • Other symptoms include: cold or bluish skin abdominal swelling chest pain cough shortness or lack of breath vomiting Near-drowning most often occurs when no lifeguard or medical professional is present.[healthline.com]
Regurgitation
  • Individuals who are close to drowning can also regurgitate their stomach contents and breathe these into the lungs.[healthofchildren.com]
Weak Pulse
  • Taylor had a weak pulse and was breathing on his own. They tell you that they don't know how long Mr. Taylor was in the water before they found him and that they didn't see anyone else at the lake before or after finding him.[nursingcenter.com]
Fracture
  • For example, cervical spine fractures (broken neck) due to diving injuries may result in breathing problems and subsequent drowning.[medicinenet.com]
Mild Cognitive Impairment
  • She works as a Special Education Teacher for students with Mild Cognitive Impairments at Kenowa Hills High School.[ednetggr.org]
Myoclonic Jerking
  • Myoclonic jerks were not registered during rest, but were easily provoked by motor activities (action myoclonus).[thieme-connect.com]

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. [8] Immediate threats include effects on the central nervous and cardiovascular systems (see Workup[emedicine.medscape.com]

Treatment

  • Your care team will watch you closely and make any needed changes in treatment right away. How is it treated? Treatment may include: Help with breathing. A machine called a ventilator will gently push air into your lungs.[myhealth.alberta.ca]
  • Treatment Treatment begins with removing the victim from the water and performing cardiopulmonary resuscitation ( CPR ). One purpose of CPR is to bring oxygen to the lungs, heart, brain, and other organs by breathing into a person's mouth.[encyclopedia.com]
  • Treatment for drowning begins with recognizing when victims are in trouble, and assessing whether they are awake and breathing.[medicinenet.com]
  • Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only.[drugs.com]
  • Oxygen recompression therapy is definitive treatment for symptom resolution and avoiding recurrence, even if delayed 1 or 2 days.[accessmedicine.mhmedical.com]

Prognosis

  • Links: associated injuries aetiology resuscitation in the field further management prognosis[gpnotebook.co.uk]
  • LAS is often difficult to treat and has to be distinguished from myoclonic status epilepticus, which usually occurs within the first 24 hours after hypoxia and which is associated with a very poor prognosis.[thieme-connect.com]
  • His current condition and prognosis are unknown, but please keep this family in your thoughts and prayers. As I said before, water play can quickly have life-changing consequences.[1043wowcountry.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]

Etiology

  • Near drowning pulmonary edema is considered an etiological subtype of non cardiogenic pulmonary edema. It can occur with both salt water and fresh water near-drowning.[radiopaedia.org]
  • This is especially important if the patient may have had a medical etiology for drowning.[saem.org]
  • 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 Because reporting of near-drowning incidents is incomplete, most of the available epidemiologic information focuses on drowning deaths, which number more than 6500 per year in the United States.[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]
  • Epidemiology Drowning accounts for more than 500,000 deaths worldwide each year.[reliasmedia.com]
  • 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

  • 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]
  • Pathophysiology After an initial gasp, with possible aspiration, or a period of breath holding, apnoea eventually exceeds breaking point and stimulates hyperventilation, causing aspiration and a variable degree of laryngospasm.[patient.info]
  • Pathophysiology of drowning. Med J Aust. 1985 May 27; 142 (11):586–588. [ PubMed ] [ Google Scholar ] Fraser-Darling A. Electrocution, drowning, and burns.[ncbi.nlm.nih.gov]
  • […] drowning process (at any stage) CAUSES misadventure inadequate supervision of small children neurological event e.g. epilepsy, stroke cardiac event e,g, MI, HCM, dysrhythmia, long QT, short QT impaired judgement e.g. intoxication trauma overdose foul play PATHOPHYSIOLOGY[litfl.com]
  • This article will review risk factors for drowning, pathophysiology of drowning, and management guidelines. We will present a systematic approach for both prehospital care and definitive care once the patient arrives in the emergency department.[reliasmedia.com]

Prevention

  • Prevention in children Drowning is the leading cause of unintentional injury related death in children 1-4 years old. Preventing near-drowning in children requires extra precautions.[healthline.com]
  • Prevention Prevention depends on educating parents, other adults, and teenagers about water safety. Parents must realize that young children who are left in or near water without adult supervision, even for a short time, can easily get into trouble.[encyclopedia.com]
  • Drowning facts and prevention The best treatment for drowning is prevention of causes. Drowning is defined by the World Health Organization (WHO) as "...the process of experiencing respiratory impairment from submersion or immersion in liquid."[medicinenet.com]
  • The Centers for Disease Control and Prevention says formal swimming lessons reduce the risk of drowning in children 1 to 4 years old.[eu.indystar.com]
  • Nasogastric intubation may be ordered to decompress the stomach and prevent aspiration of gastric contents. Because of submersion, Mr. Taylor will most likely be hypothermic.[nursingcenter.com]

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