3. VocabularyVocabulary
Drowning – death within 24 hoursDrowning – death within 24 hours
Near-drowning – survival past 24 hoursNear-drowning – survival past 24 hours
6. EpidemiologyEpidemiology
500,000 submersion events annually500,000 submersion events annually
2nd cause of death – children under 152nd cause of death – children under 15
Injury rangesInjury ranges
TransientTransient
Profound neurological deficitProfound neurological deficit
16. Wet-drowningWet-drowning
Aspiration of waterAspiration of water
Dilution of surfactantDilution of surfactant
Diminished gas transferDiminished gas transfer
AtelectasisAtelectasis
Ventilation perfusion mismatchVentilation perfusion mismatch
17. Pulmonary InjuryPulmonary Injury
Contaminated foreign materialContaminated foreign material
Particulate matterParticulate matter
BacteriaBacteria
VomitusVomitus
Chemical irritantsChemical irritants
23. AirwayAirway
BreathingBreathing
High flow oxygen by facemaskHigh flow oxygen by facemask
Not BreathingNot Breathing
Bag valve maskBag valve mask
Endotracheal tubeEndotracheal tube
UnconsciousUnconscious
Protect from aspirationProtect from aspiration
24. Who to transport?Who to transport?
AmnesiaAmnesia
Loss or depressed consciousnessLoss or depressed consciousness
Period of apneaPeriod of apnea
Period of artificial respirationsPeriod of artificial respirations
Even if asymptomaticEven if asymptomatic
28. GCS > 12GCS > 12
Oxygen to keep sat > 95%Oxygen to keep sat > 95%
Observe 4-6 hoursObserve 4-6 hours
Pulmonary exam normalPulmonary exam normal
Saturation normalSaturation normal
Discharge homeDischarge home
No xray or labs neededNo xray or labs needed
29. GCS > 12GCS > 12
Oxygen to keep sat > 95%Oxygen to keep sat > 95%
Observe 4-6 hoursObserve 4-6 hours
Pulmonary exam abnormalPulmonary exam abnormal
Requires oxygenRequires oxygen
DeterioratesDeteriorates
Admit to Monitored bedAdmit to Monitored bed
30. GCS < 13GCS < 13
High flow oxygenHigh flow oxygen
Intubation for low PaO2Intubation for low PaO2
CXR, LabsCXR, Labs
Continuous cardiac monitoringContinuous cardiac monitoring
Frequent reassessmentsFrequent reassessments
32. ED ArrestED Arrest
Warm water drowningWarm water drowning
Recovery doubtfulRecovery doubtful
Consider early discontinuation of effortsConsider early discontinuation of efforts
Risk profound neurological handicapsRisk profound neurological handicaps
35. PrognosisPrognosis
No CPRNo CPR
Full recovery within 48 hoursFull recovery within 48 hours
May develop ARDSMay develop ARDS
Bystander CPRBystander CPR
Steady recoverySteady recovery
Steady declineSteady decline
ED CPRED CPR
Very poor prognosisVery poor prognosis
36. Pediatric Warm Water DrowningPediatric Warm Water Drowning
500 victims500 victims
100% received ED CPR100% received ED CPR
84% died84% died
16% severe hypoxic encephalopathy16% severe hypoxic encephalopathy
38. ICE water submersionICE water submersion
AsystoleAsystole
Children and AdultsChildren and Adults
Complete RecoveryComplete Recovery
RareRare
Resuscitate until normothermicResuscitate until normothermic
