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drowning
This document discusses submersion injuries and drowning. It defines drowning and near drowning and notes that drowning is the 3rd leading cause of unintentional injury death worldwide. The highest risk groups are children ages 1-4 and teenage males. Drowning victims often struggle, swallow water, and vomit or aspirate liquid. Prognosis depends on factors like age, submersion time, water temperature, resuscitation time, and neurological status. Pre-hospital management focuses on CPR, oxygen, and stabilizing the victim, while hospital management addresses issues like acidosis, hypothermia, and fluid/electrolyte balance. Prevention strategies include pool fencing, education, not swimming alone
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drowning
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- 2. INTRODUCTION Submersion injury isalso known as the “SILENT EVENT”. It is the second leading cause of accidental death in children (National SAFE KIDS Campaign 2005.b) One of the most important nursing responsibilities is related to drowning is prevention of injury, including water safety education and training, drowning prevention measures and teaching CPR.
- 3. DEFINITION Drowning is submersionthat results in asphyxia and death within 24 hours. If the child survives longer than 24 hour after submersion, the event is referred to as near drowning.
- 4. INCIDENCE Drowning isthe 3rd leading cause of unintentional injury death worldwide, accounting for 7% of all injury- related deaths. There are an estimated 372 000 annual drowning deaths worldwide. Global estimates may significantly underestimate the actual public health problem related to drowning.
- 5. ETIOLOGY Most drownings happenin residential swimmimg pools.
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- 9. Open watersites, such as lakes, rivers and oceans are more likely to be the site of accident among teenagers.
- 10. EPIDEMIOLOGY Children between 1-4years are mostly affected. In teenagers males are mostly affected than females.
- 11. PATHOPHYSIOLOGY When drowning occur Drowningvictims becomes panic, struggle and attempt to hold their breathe Victim begin to swallow water Vomited or aspirated Laryngospasm Seizures, hypoxia, death(dry drowning)
- 12. If the childbecomes unconscious before Laryngospasm hypoxia causes loss of airway reflexes and aspiration of large amounts of water Wet drowning As hypoxia increases and acidosis increases Cardiopulmonary arrest occurs
- 13. MANIFESTATIONS The child’s conditionafter near drowning varies with the extent of injury. Five factors contribute to the child’s eventual prognosis: i. Age ii. Submersion time and iii. water temperature. iv. Elapsed time before resuscitation efforts are instituted v. Neurologic status vi. Arterial blood gas measurements(especially pH)
- 14. The childwith the poorest prognosis is younger than 3 years, has been submerged longer than 5 minutes is comatose and has an arterial ph less than 7.10 and has not resuscitate within the first 10 minutes.
- 15. The childwho is conscious with adequate respirations might have mild hypothermia, show slight pulmonary changes on radiography.
- 16. Children whoare unconscious demonstrate the consequences related to whether respiration are present or absent. If the respirations are adequate, the child may have mild to moderate hypothermia, respiratory distress abnormal chest radiography and arterial blood gas results
- 17. The childwho has resuscitative efforts is in markedly poor conditions with altered mental status, metabolic acidosis and altered blood gas abnormalities, electrolytes imbalances, shock,disseminated intravascular coagulation leads to death.
- 19. THERAPEUTIC MANAGEMENT I. Pre-hospitalmanagement II. Hospital management
- 20. Pre-hospital Management ii) Rescuethe victim and removed from the water iii) Prompt initiation of CPR and activation of emergency medical system
- 21. conti… iv)The goal ofpre-hospital care is to maintained adequate oxygenation and circulation, minimize secondary organ damage and take proper precautions to stabilize cervical spine injuries. V) The child’s airway is opened, the nurse begins to suction to remove mucus and fluid and delivers oxygen by mask or by bag valve mask
- 22. conti… VI) Over-inflation ofthe lungs must be avoided to prevent pneumothorax VII) Elevating the head of the bed to 30 degree may help lower intracranial pressure but should not be done in spinal injury
- 23. conti…. VIII) Intubation shouldbe considered for unconscious child IX) A cardiac monitor is used for ongoing assessment of the heart rate and rhythm
- 24. conti…. X) Warm thechild and removed the wet clothes XI) I/V lines should be started immediately in critically ill children.
- 25. Hospital management Continue thepre-hospital goals of maintaining adequate oxygenation and circulation and initiates other treatment on the basis of laboratory and radiologic findings. Arterial blood gases may indicate the need to correct acidosis with sodium bicarbonate. Hypothermia is initiated of warm blankets, oxygen Fluid and electrolyte correction can be instituted The child is admitted to the hospital for the observation even if in stable condition after initial rescue and emergency treatment
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- 29. Prevention: Education &Warnings
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- 31. Prevention: Do notswim alone
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- 35. PREVENTION Infants Parental vigilance Toddler Pool fencing Adolescent/Young Adult Control Alcohol/Drug Use Swimming lessons