DROWNING, NEARDROWNING, AND DIVING EMERGENCIES

1
DROWNING, NEAR-DROWNING, AND DIVING EMERGENCIES
2
WATER-RELATED INJURIES

• Drownings are responsible for only 1 in 20
  water-related deaths.
• Most are caused by diving and deep-water
  exploration, boating, and water skiing.
  Water-related deaths may also result from motor
  vehicle accidents.
• An adult can drown in a few inches an infant in
  even less.
• 1/4 of all infants who drown do so in 5-gallon
  buckets, bathtubs, and toilets.

3
COULD WATER RELATED ACCIDENTS BE PREVENTED?
YES!

• Statistics show that wearing personal flotation
  devices could prevent many of the deaths.
• Proper supervision of swimming pools
• Locked fences around pools
• Prompt and proper application of basic life
  support could also reduce deaths.

4
NEAR-DROWNING AND DROWNING

• Near-drowning is defined as survival, at least 24
  hours, from near-suffocation due to submersion.
• Drowning is defined as death from suffocation due
  to submersion.
• Drowning is the third leading cause of accidental
  death in the U.S.
• Drowning is the leading cause of accidental death
  for children under 5.

5
CAUSES OF DROWNING

• Becoming exhausted in the water
• Losing control and getting swept into water that
  is too deep
• Losing a support---sinking a boat
• Getting trapped or tangled while in the water
• Drugs or alcohol
• Seizures
• Poor judgement in the water
• Hypothermia
• Trauma
• Diving accident

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SIGNS AND SYMPTOMS OF THE WATER-RELATED
EMERGENCY PATIENT

• Airway obstruction
• Absent or inadequate breathing
• Pulselessness
• Spinal injury or head injury
• Soft tissue injuries
• Musculoskeletal injuries

• External or internal injuries
• Shock
• Hypothermia
• Alcohol or drug abuse
• Drowning/near-drowning

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DIVING AND WATER-RELATED EMERGENCIES

• Always assume that a diver has sustained neck and
  spine injuries.
• Never go out into the water to attempt a rescue
  unless you meet certain requirements.
• Responsive patient reach, throw, row, go
  strategy
• Unresponsive patient row or swim to the patient.

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EMERGENCY CARENEAR-DROWNING

• Remove the patient from the water as quickly and
  safely as you can.
• If you do not suspect spine injury, place the
  patient on his left side so that water, vomitus,
  and secretions can drain from the upper airway.
• Suction as needed.
• Establish an airway.
• Gastric distention---if ventilation gets
  difficult, with suction available, apply pressure
  to the epigastric area.
• Transport patient.

9
AIR EMBOLISM

• Often appears 15 minutes after the diver surfaces.

10
SIGNS AND SYMPTOMS OFAN AIR EMBOLISM

• Itchy, blotchy, or mottled skin
• Difficulty in breathing
• Dizziness
• Chest pain
• Deep aching pain in the muscles
• Blurred or distorted vision
• Partial deafness, distortion of senses
• Nausea and vomiting

• Numbness or paralysis
• Staggering gait or lack of coordination
• Frothy blood in the nose or mouth
• Swelling of crepitus in the neck
• Loss of memory
• Cardiac or respiratory arrest
• Behavioral changes

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DECOMPRESSION SICKNESS AND BAROTRAUMA

• Decompression Sickness (Bends) usually occurs
  when the diver ascends too quickly from a deep,
  prolonged dive. S/S usually occur about 12-24
  hours after the dive.
• Barotrauma called the squeeze during ascent or
  descent when the air pressure in the bodys air
  cavities (such as the sinuses or the middle ear)
  becomes too great.