DROWNING, NEAR- |
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DROWNING, NEAR-
GENERAL INFORMATlON
DEFINITION--The immediate aftereffects of prolonged submersion under water. This may occur with or without aspirating water into the lungs. Approximately 10% to 15% of all drownings or near-drownings occur without aspiration. There have been a few reports of survival following submersion up to 40 minutes when the water was very cold. Submersion in warm or hot water results in more rapid death. Drowning accounts for approximately 10,000 deaths in North America each year.
SIGNS & SYMPTOMS
Confusion or unconsciousness.
Little or no breathing or heartbeat.
Bluish-white paleness.
CAUSES & RISK FACTORSSubmersion under water, resulting in either of the following:
Spasm of the larynx (the tube from the throat to the lungs). After rescue, this spasm prevents oxygen from reaching the lungs unless air is forced through the spasm by a respirator or CPR procedures.
Water in the lungs, causing life-threatening changes in the circulating blood.
HOW TO PREVENT
Learn cardiopulmonary resuscitation (CPR).
Encourage all family members--including infants--to learn to swim. Never leave a child, even one who can swim, alone near the water.
Never swim alone.
Don't drink alcohol and swim.
WHAT TO EXPECT
DIAGNOSTIC MEASURES
Your own observation of symptoms.
Medical history and physical exam by a doctor.
Laboratory blood tests.
SURGERYNot necessary nor useful for this disorder.
N0RMAL COURSE OF ILLNESS
Depends on the length of time under water. With early rescue and treatment, full recovery is possible. Special body mechanisms may permit full recovery from near-drowning in icy water.
POSSIBLE COMPLICATIONS
Pulmonary edema (body fluid in the lungs) followed by acute respiratory failure.
Permanent brain damage.
Lung infection.
Heart irregularities, including cardiac arrest and death.
HOW TO TREAT
NOTE -- Follow your doctor's instructions. These instructions are supplemental.
FIRST AID
If the victim is unconscious and not breathing, yell for help. Don't leave the victim.
Begin mouth-to-mouth breathing immediately.
If there is no heartbeat, give external cardiac massage.
Have someone call 0 (operator) or 911 (emergency) for an ambulance or medical help.
Don't stop CPR until help arrives.
The near-drowning victim should be taken to the nearest hospital for intensive care--even if the victim has regained consciousness. Complications or death due to heart-rhythm disturbances may occur 24 to 48 hours after the accident.
Remain with a recovering patient to provide support and reassurance. Near-drowning is a traumatic experience.
MEDICAL TREATMENT
Immediate cardiopulmonary resuscitation (CPR).
Hospitalization (sometimes) to lower body temperature, to induce coma with medicines and to monitor spinal-fluid pressure.
Hospitalization for observation for delayed, serious reactions.
HOME TREATMENTNone appropriate.
MEDICATIONYour doctor may prescribe:
Oxygen.
Cortisone drugs to prevent or treat lung inflammation.
Antibiotics to prevent lung infection.
Bronchodilators to enable oxygen to enter the lungs.
ACTIVITYComplete bed rest is necessary until activity is permitted by the doctor.
DIETIntravenous nutrients, if the victim is unconscious upon hospitalization. After recovery, no special diet is necessary.
CALL YOUR DOCTOR IF
Someone appears to have drowned. Call for emergency help immediately!
Signs of infection (fever, cough, muscle aches and fatigue) appear after apparent recovery.
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