peds

1. Drowning

2. • Drowning is death from suffocation caused by a liquid
entering the lungs and preventing the absorption of
oxygen leading to cerebral hypoxia and myocardial
infarction.
• Near drowning is the survival of the drowning event
involving unconsciousness or water inhalation and can
lead to serious secondary complication, including death,
after the event.
• Drowning: die within 24 hours of a submersion incident
• Near Drowning: survive at least 24 hrs. after a
submersion incident

3. Drowning Risk Situation:
• Most drownings occur in water, 90% in freshwater
(rivers,lakes and pools) 10% in seawater, drownings in
other fluids are rare and often industrial accidents.
• common conditions and risk factors that may lead to
drowning include but are not limited to:
• Males are more likely to drown than females, especially
in the 18-24 age.
• Risk taking behaviour
• Co morbidity: trauma, seizure, CVA, cardiac

4. • lack of supervision of young children (less than 5 years
old)
• water conditions exceed the swimmer's ability-turbulent
or fast water, water out of depth.
• Entrapment- physically unable to get out of the situation
because of a lack of an escape route, snagging or by
being hampered by clothing or equipment.
• misguided children's play.
• swimming after dark.
small children may drown in baths , buckets and toilets.

5. Predisposing Factors
• Coma, seizures
• Alcohol/Drugs
• Exhaustion
• Hyperventilation
• Rapidly moving water

6. Predisposing Factors
• Poor swimming ability
• Exhaustion
• Panic
• Hypothermia
• Trauma

7. Pathophysiology
Aspiration of 1-3 mL/kg destroys integrity
of pulmonary surfactant
( lung compliance)
Alveolar collapse, atelectasis,
Non-cardiogenic pulmonary edema (ARDS),
Intrapulmonary shunting,
V/Q mismatch

8. Profound hypoxia
Respiratory acidosis, ARDS
Cardiovascular collapse
Neuronal injury
…. Death
End Organ Effect

9. Dry-drowning
• 10-20% of submersions
• Laryngospasm
• Hypoxia
• Loss of consciousness

10. Wet-drowning
• Aspiration of water
• Dilution of surfactant
• Diminished gas transfer
• Atelectasis
• Ventilation perfusion mismatch

11. Rescue and Treatment:
• Remove the victim from the water. Conscious victims
may panic and thus hinder rescue efforts.
Signs or behaviours associated with drowning and near
drowning:
• head low in the water , mouth at water level
• Head tilted back with mouth open
• Eyes glassy and empty, unable to focus.
• Eyes open, with fear evident on the face.
• hair over forehead or eyes.
• hyperventilating or gasping.

12. Prevention
f

13. Prevention: Pool Fencing

14. Prevention: Education &
Warnings
Buckets

15. Prevention: Education &
Warnings

16. Prevention: Targeted
Education

17. Prevention: Swimming &
CPR

18. Good Prognostic Factors
• Older child or young adult
• Cold water
• Adequate CPR/on scene ACLS/BLS
• Conscious
• Short submersion
• Healthy