Submersion injury 8.9 Flashcards Preview

Emergency Medicine and Surgical Care > Submersion injury 8.9 > Flashcards

Flashcards in Submersion injury 8.9 Deck (9)
Loading flashcards...
1

Shallow water blackout

hyperventilation-->decreased CO2 upon submersion-->O2 metabolized to CO2 but its not high enough to trigger breath-->swimmer loses consciousness

2

Pre-hospital care

Immediate CPR, ventilation first with 2 rescue breaths. NO maneuvers to remove water, high flow oxygen and intubate apneic patients

3

ED care

resuscitative efforts in hypothermic patients until 35C, in non-hypothermic resuscitative efforts no more than 30 mins. high flow O2, inhaled beta-adrenergic agonists, CPAP/BiPAP, rewarming, glucose, opioid intoxication-->naloxone, monitor cardiac telemetry, continous and end tidal CO2, vital signs, neuro checks

4

ED indications for Orogastric intubation

inability to protect airway/neurologic deterioration, PaO2 50mmHg

5

ED diagnostic tests

ECG, chest radiograph, Serum electrolytes, BUN/Cr, EtOH/drug screen, CBC, PT/PTT, ABG/VBG, cardiac markers as indicated, imaging studies as indicated

6

Pulmonary drowning complications

bronchospasm, pneumonia, ARDS

7

Neurologic considerations

elevate head of bed, cautious use of diuretics if hypervolemic, tight seizure control with non-sedating anti-convulsants, avoid neuromuscular blocking agents, tight glycemic control, avoid hyperthermia,

8

Asymptomatic patients

observe for 8hrs, if all vitals, clinical state and CXR are normal may discharge

9

Poor Prognosis

submersion > 5mins, delay to BLS >10 mins, duration of resuscitation >25 mins, age >14 yrs, Glasgow coma Scale