Presentation
Near drowning can be divided into three stages: stage 1: acute laryngospasm that occurs after inhalation of a small amount of water stage 2: the victim still usually presents with laryngospasm but may begin to swallow water into the stomach stage 3 10 [radiopaedia.org]
If two or more people are present with the victim, one should start CPR, while the other calls 911. If only one person is present with the victim, CPR should be done for one minute before calling 911. [healthline.com]
Patients requiring CPR will often present with CPR still in progress or in the peri-resuscitation stages. [saem.org]
The clinical presentation, laboratory data, modes of therapy and outcome of 34 cases of near-drowning in children under the age of 14 years were reviewed. [pediatrics.aappublications.org]
Re-warming is undertaken when hypothermia is present. People may arrive requiring treatment for cardiac arrest or cardiac dysrhythmias. Comatose patients present a special problem. [encyclopedia.com]
Entire Body System
- Disability
Of these patients, 35 to 60 percent die in the emergency department, while almost all of those who survive have permanent disabilities. [healthofchildren.com]
When various disabilities and student needs were thrown into the mix, I felt trapped because I simply couldn’t keep up. My mind constantly felt like it was running at 100 miles per hour. [ednetggr.org]
The possible outcomes of drowning are classified as death, morbidity (the development of disability or injury), and no morbidity. This simple definition was agreed upon at the 2002 World Congress of Drowning held in Amsterdam. [medicinenet.com]
"Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015". [en.wikipedia.org]
It is a major cause of disability and death, particularly in children. [emedicine.medscape.com]
- Swelling
Acute respiratory distress syndrome (ARDS) is a sudden and very serious condition that occurs when the lungs swell and fill with liquid. This condition causes severe shortness of breath and may lead to respiratory failure. [drugs.com]
Other symptoms include: cold or bluish skin abdominal swelling chest pain cough shortness or lack of breath vomiting Near-drowning most often occurs when no lifeguard or medical professional is present. [healthline.com]
A person who is suffering from anaphylaxis may develop shortness of breath, wheezing, a swelling of lips or joints and/or an itchy rash all over the body. [netcare.co.za]
Fresh water is hypotonic; water is drawn into erythrocytes that swell and burst releasing potassium. This induces hyperkalaemia that can stop the heart. [patient.info]
Determination of the osmotic potential for swelling of cat brain in vitro. Exp Neurol. 1979 Jul; 65 (1):66–70. [ PubMed ] [ Google Scholar ] Nugent SK, Rogers MC. Resuscitation and intensive care monitoring following immersion hypothermia. [ncbi.nlm.nih.gov]
Respiratoric
- Sputum
[…] children unattended around bathtubs or pools Symptoms Symptoms can vary, but may include: Abdominal distention (swollen belly) Bluish skin of the face, especially around the lips Chest pain Cold skin and pale appearance Confusion Cough with pink, frothy sputum [mountsinai.org]
Bluish skin ( cyanosis ), coughing, and frothy pink sputum (material expelled from the respiratory tract by coughing) are often observed. [encyclopedia.com]
Bluish skin (cyanosis), coughing, vomiting, and frothy pink sputum (material expelled from the respiratory tract by coughing) are often observed. [healthofchildren.com]
Cardiovascular
- Irregular Heart Rhythm
Other traumatic injuries may be present, and irregular heart rhythms can occur. [medlineplus.gov]
The heart muscle needs oxygen to function and deadly, irregular heart rhythms may occur with oxygen deprivation. Young victims in cold water drowning may be spared this sequence because of the mammalian diving reflex. [emedicinehealth.com]
Psychiatrical
- Distractibility
Although the girl's mother was seated on a nearby platform to keep an eye on her daughter, she too became distracted by her phone and when she turned to speak to other people. [straitstimes.com]
The most common occurrence was that the supervising adult knew the child was in or near the water but was distracted long enough for the child to drown. A reduced concentration of oxygen in the blood (hypoxemia) is common to all near-drownings. [healthofchildren.com]
Try to be within arms' reach of small children and do not be distracted by other activities. Watch for anyone who seems to be swimming ineffectively or are bobbing in the water in an uncoordinated way, and whose head drops underwater. [medicinenet.com]
Tips to prevent drowning are Infants should never be left in the bathtub alone, even for a few seconds, and the caregiver should not be distracted by other tasks or chores. [emedicinehealth.com]
Lifeguards may be unaware of a drowning due to "failure to recognize the struggle, the intrusion of non-lifeguard duties upon lifeguards' primary task-preventive lifeguarding, and the distraction from surveillance duties". [45] Pool alarms have poor evidence [en.wikipedia.org]
Neurologic
- Confusion
Those who arrive at an emergency department awake and alert usually survive with brain function intact, as do about 90% of those who arrive mentally impaired (lethargic or confused) but not comatose. [encyclopedia.com]
Swollen abdomen, nausea, or vomiting Bluish skin Confusion, trouble thinking or remembering, or loss of consciousness Coughing, increased breathing, shortness of breath, or wheezing Fast or slow heartbeat Weak or absent pulse What health problems can [drugs.com]
When the young Calgarian woke up, he was very disoriented and confused. “When I came back, when I wake up, there was a lot of people around me and I was like ‘oh man, what happened? I was really surprised,” he said. [langleyadvancetimes.com]
For the past 40 years, multiple entities and authors have tried to define the medical phenomena that follow a submersion injury. 1 A publication by the International Liaison Committee on Resuscitation (ILCOR) highlighted this as they discussed confusion [reliasmedia.com]
[…] to swim too far Leaving small children unattended around bathtubs or pools Symptoms Symptoms can vary, but may include: Abdominal distention (swollen belly) Bluish skin of the face, especially around the lips Chest pain Cold skin and pale appearance Confusion [mountsinai.org]
- Stroke
Stroke. 1977 Sep-Oct; 8 (5):558–564. [ PubMed ] [ Google Scholar ] Marshall LF, Smith RW, Shapiro HM. The outcome with aggressive treatment in severe head injuries. [ncbi.nlm.nih.gov]
[…] non-fatal drowning: the drowning process is interrupted and the person survives fatal drowning: the person dies during the drowning process (at any stage) CAUSES misadventure inadequate supervision of small children neurological event e.g. epilepsy, stroke [litfl.com]
Neurological (stroke, cerebral hypoxia, cerebral oedema). Acute kidney injury. Haematological (haemolysis). Metabolic (hyperkalaemia, acidosis). Infective (pneumonia, septicaemia). [patient.info]
This includes victims who experience a heart attack, stroke or seizure in the water. It also includes open water drowning victims who sustain an animal bite or sting. Fatigue or exhaustion when swimming. [emedicinehealth.com]
This causes an elevation in sensed circulatory volume that results in increased myocardial stretch, increased pulmonary artery pressure, and an increase in stroke volume, leading to increased cardiac output. 23 In patients with pre-existing illness, such [reliasmedia.com]
- Neglect
Child abuse or neglect The following are drowning risks in teenagers and adults: Alcohol consumption. Alcohol use is a factor in half of all teenage and adult drowning deaths. Inability to swim Medical emergency in the water. [emedicinehealth.com]
- Lethargy
[…] around bathtubs or pools Symptoms Symptoms can vary, but may include: Abdominal distention (swollen belly) Bluish skin of the face, especially around the lips Chest pain Cold skin and pale appearance Confusion Cough with pink, frothy sputum Irritability Lethargy [mountsinai.org]
Workup
[…] are ingested), while long-term infectious complications are primarily related to whether the victim was submersed in a natural or a man-made body of water. [8] Immediate threats include effects on the central nervous and cardiovascular systems (see Workup [emedicine.medscape.com]
Treatment
Your care team will watch you closely and make any needed changes in treatment right away. How is it treated? Treatment may include: Help with breathing. A machine called a ventilator will gently push air into your lungs. [myhealth.alberta.ca]
Treatment Treatment begins with removing the victim from the water and performing cardiopulmonary resuscitation ( CPR ). One purpose of CPR is to bring oxygen to the lungs, heart, brain, and other organs by breathing into a person's mouth. [encyclopedia.com]
Treatment for drowning begins with recognizing when victims are in trouble, and assessing whether they are awake and breathing. [medicinenet.com]
It is not intended as medical advice for individual conditions or treatments. [drugs.com]
Oxygen recompression therapy is definitive treatment for symptom resolution and avoiding recurrence, even if delayed 1 or 2 days. [accessmedicine.mhmedical.com]
Prognosis
Links: associated injuries aetiology resuscitation in the field further management prognosis [gpnotebook.co.uk]
His current condition and prognosis are unknown, but please keep this family in your thoughts and prayers. As I said before, water play can quickly have life-changing consequences. [1043wowcountry.com]
LAS is often difficult to treat and has to be distinguished from myoclonic status epilepticus, which usually occurs within the first 24 hours after hypoxia and which is associated with a very poor prognosis. [thieme-connect.com]
Prognosis is ultimately related directly to the duration and magnitude of hypoxia. The most significant impact on morbidity and mortality occurs before arrival at hospital. [patient.info]
Etiology
Near drowning pulmonary edema is considered an etiological subtype of non cardiogenic pulmonary edema. It can occur with both salt water and fresh water near-drowning. [radiopaedia.org]
This is especially important if the patient may have had a medical etiology for drowning. [saem.org]
Etiology Drowning may be a primary event or may be secondary to events such as the following: Seizures Head or spine trauma Cardiac arrhythmias Hypothermia Alcohol and drug ingestion Syncope Apnea Hyperventilation Suicide Hypoglycemia Causes tend to vary [emedicine.medscape.com]
Epidemiology
We also detail the microbiological causes of this entity and provide important clinical and epidemiological information associated with specific pathogens. [academic.oup.com]
Epidemiology Because reporting of near-drowning incidents is incomplete, most of the available epidemiologic information focuses on drowning deaths, which number more than 6500 per year in the United States. [pedsinreview.aappublications.org]
Epidemiology Drowning accounts for more than 500,000 deaths worldwide each year. [reliasmedia.com]
Epidemiology Worldwide, drowning is the fourth most common injury after road traffic accidents, self-inflicted injuries and violence. It is more common than war deaths. [patient.info]
The distinction between submersion fluid type is primarily academic and mostly connotes epidemiologic significance. [emedicine.medscape.com]
Pathophysiology
Herein, we review the epidemiology and pathophysiology associated with near-drowning, discuss the potential mechanisms of infection, and describe the likely risk factors for pneumonia related to near-drowning. [academic.oup.com]
Pathophysiologic changes and pulmonary injury depend on the type of fluid (fresh or salt water) and the volume aspirated. Fresh water aspiration results in a loss of surfactant, leading to an inability to expand the lungs. [nursingcenter.com]
[…] drowning process (at any stage) CAUSES misadventure inadequate supervision of small children neurological event e.g. epilepsy, stroke cardiac event e,g, MI, HCM, dysrhythmia, long QT, short QT impaired judgement e.g. intoxication trauma overdose foul play PATHOPHYSIOLOGY [litfl.com]
Pathophysiology After an initial gasp, with possible aspiration, or a period of breath holding, apnoea eventually exceeds breaking point and stimulates hyperventilation, causing aspiration and a variable degree of laryngospasm. [patient.info]
This article will review risk factors for drowning, pathophysiology of drowning, and management guidelines. We will present a systematic approach for both prehospital care and definitive care once the patient arrives in the emergency department. [reliasmedia.com]
Prevention
Prevention in children Drowning is the leading cause of unintentional injury related death in children 1-4 years old. Preventing near-drowning in children requires extra precautions. [healthline.com]
Prevention Prevention depends on educating parents, other adults, and teenagers about water safety. Parents must realize that young children who are left in or near water without adult supervision, even for a short time, can easily get into trouble. [encyclopedia.com]
Drowning facts and prevention The best treatment for drowning is prevention of causes. Drowning is defined by the World Health Organization (WHO) as "...the process of experiencing respiratory impairment from submersion or immersion in liquid." [medicinenet.com]
Nasogastric intubation may be ordered to decompress the stomach and prevent aspiration of gastric contents. Because of submersion, Mr. Taylor will most likely be hypothermic. [nursingcenter.com]
The Centers for Disease Control and Prevention says formal swimming lessons reduce the risk of drowning in children 1 to 4 years old. [eu.indystar.com]