Drowning

for nursing student

1. NEAR DROWNING PRAGYANSHREE NANDA. PG-NEUROSCIENCE , LECTURE Dept. Of Medical-Surgical Nursing. KINS / KIIT-DU

2. A process resulting in primary respiratory impairment from submersion in a liquid medium . "Near drowning" means a person almost died from not being able to breathe (suffocating) under water. DEFINITION

3. TYPES OF DROWNING DRY DROWNING The airway closes up due to spasms caused by the presence of water. WET DROWNING The persone inhaled water which interferes with respiration and causes the circulatory system collapse.

4. The majority of near-drowning cases are attributed to accidents that occur near or in the water. Inability to swim Panic in the water Leaving children unattended near bodies of water Falling through thin ice Alcohol consumption while swimming or on a boat Seizure, or heart attack while in water Suicide attempt etc. CAUSES

5. Cold or bluish skin Abdominal swelling Chest pain Cough Shortness or lack of breath Vomiting Rhonchi An abnormal lung sound SIGNS & SYMPTOMS

6. PATHOPHYSIOLOGY INVOLUNTARY SUBMERSION ( Voluntary apnea, hypoxia, hypercarbia ) INVOLUNTARY INSPIRATION (arterial hypoxemia, tissue hypoxia, tissue acidosis, and tachycardia) WATER ENTERS LUNGS ( Increased peripheral airway resistance, pulmonary vessel vasoconstriction/hypertension, decreased lung compliance, decreased surfactant)

7. DECOMPENSATION (gasping with further inhalation -swallowing with emesis -loss of consciousness) NEURONAL DYSFUNCTION ( blood brain barrier breaks down ) CARDIAC DYSFUNCTION ( bradycardia , arrhythmias, asystole ) BRAIN DEATH

8. MANAGEMENT Laboratory Studies Blood gas analysis with co- oximetry CBC count. Serum electrolytes (with glucose) Liver enzymes Renal function tests Continuous pulse oximetry cardiorespiratory monitoring (may be needed) Chest radiography Head CT and cervical spine imaging if trauma suspected Extremity, abdominal, pelvic imaging if clinically indicated Echocardiography

9. Monitoring cardiac output and related hemodynamic parameters . General assessment. Et intubation if unconscious . 100% o2 by face mask Treat hypothermia, hypoglycaemia , seizures, hypovolaemia and hypotension, if they occur . If the patient is awake and alert, observe for at least six hours. Pulmonary oedema may develop late . Removal of vomit Nasogastric tube . Urinary catheter.

10. THANK YOU