Transcript Submersion Injuries PPT

Submersion Injuries
Mandi Stone, MD
Orlando Health Emergency Medicine
• No disclosures
Vocabulary
Vocabulary
• Drowning vs near-drowning?
• Wet vs dry?
• Primary vs secondary?
Vocabulary
• Drowning vs near-drowning?
• Wet vs dry?
• Primary vs secondary?
Vocabulary
• Drowning vs near-drowning?
• Wet vs dry?
• Primary vs secondary?
• “A process resulting in primary
respiratory impairment from
submersion/immersion in a liquid
medium.”
Epidemiology
• Estimated 500,000 deaths per year,
worldwide
Pathophysiology
Submersion
Breathholding
Air hunger
Reflex gasping
Aspiration
Salt vs Fresh water?
Salt vs Fresh water?
• Surfactant washout
• Atelectasis
• VQ mismatch
• Pulmonary edema
• ARDS
H+
O2
Management
Pre-hospital
ED Management
•A
•B
•C
•D
•E
ED Management
• Cause of drowning?
• Trauma
• Seizure
• Hypoglycemia
• Arrhythmia
• Suicide attempt
• Abuse or neglect
Immersion syndrome
• Syncope secondary to cardiac
dysrhythmia due to sudden contact with
cold water
• ASSOCIATED WITH CONGENITAL
PROLONGED QT SYNDROME
• Caused by V.fib/Asystole secondary to
catecholamine release in response to
quick temperature change
CXR
• Routine steroids or antibiotics NOT
recommended
Disposition
• Symptomatic patients - admit for
observation, supplemental O2
• Asymptomatic - observe for 4-8 hours
Prevention
• Fences around pools
• Swimming lessons
• Close monitoring of infants/children
• Avoiding alcohol/drug use while
swimming
Thank you!