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Flashcards in Environment Deck (6)
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1

Drowning definitions

Submersion - entire body including airway under water

Immersion - covered in water

2

Drowning causes

Alcohol 25-50%
Seizures
Syncope
Dementia
Cardiac
Trauma
Deliberate -nai in children
Second most common cause accidental death kids

Water <10 if rapid may confer some benefit
No difference salt vs fresh for electrolytes.
Fresh has more bugs gram -ve, staph, algae, fungi

3

Drowning assessment

Immersion/submersion
Time in, time removed, temp, type
Precipitating event
Other injuries
Airway
Oxygenation/ventilation
Cardiac rhythm
Temp
Electrolytes

Conn and Modell 2 hours post
A-awake
B-conscious but obtunded
C-comatose 1-flexion to pain, 2-extension to pain, 3-flaccid

4

Drowning treatment

Support abc, reward, prevent secondary brain injury

Awake - supportive, 6 hours observation at least, if o2 required needs longer/admit

O2, CPAP, intubation, salbutamol if spasm
IVF (care re oedema)
Rewarm
Abx if gross contamination/pool kids

5

Drowning prognosis

Submersion <6 mins 85% good outcome, > 10 mins poor

GCS < 5 poor but good if improving first 2-6 hours

First breath <15-30 mins < 10% poor
First breath > 60-120 50-80% poor

Orlowski scale (<3 90% recovery, >3 5% recovery)
Age < 3
Submersion > 5 mins
No resus attempt first 10 mins
Coma on arrival to ED
pH < 7.1

6

When to stop CPR in drowning

Blood frozen
K > 11
Asystole after 1 hour CPR (warmed)
Water temp > 6 and immersion for > 30 mins
Water temp < 6 and immersion for > 90 mins
Submersion > 10 mins without hypothermia