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  1. 1. Drowning
  2. 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. 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. 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. 5. Predisposing Factors • Coma, seizures • Alcohol/Drugs • Exhaustion • Hyperventilation • Rapidly moving water
  6. 6. Predisposing Factors • Poor swimming ability • Exhaustion • Panic • Hypothermia • Trauma
  7. 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. 8. Profound hypoxia Respiratory acidosis, ARDS Cardiovascular collapse Neuronal injury …. Death End Organ Effect
  9. 9. Dry-drowning • 10-20% of submersions • Laryngospasm • Hypoxia • Loss of consciousness
  10. 10. Wet-drowning • Aspiration of water • Dilution of surfactant • Diminished gas transfer • Atelectasis • Ventilation perfusion mismatch
  11. 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. 12. Prevention f
  13. 13. Prevention: Pool Fencing
  14. 14. Prevention: Education & Warnings Buckets
  15. 15. Prevention: Education & Warnings
  16. 16. Prevention: Targeted Education
  17. 17. Prevention: Swimming & CPR
  18. 18. Good Prognostic Factors • Older child or young adult • Cold water • Adequate CPR/on scene ACLS/BLS • Conscious • Short submersion • Healthy