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Near Drowning R. Hernandez. Near Drowning Suffocation and death as a result of submersion in liquid. – Near drowning: Liquid submersion survival – Dry.

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Presentation on theme: "Near Drowning R. Hernandez. Near Drowning Suffocation and death as a result of submersion in liquid. – Near drowning: Liquid submersion survival – Dry."— Presentation transcript:

1 Near Drowning R. Hernandez

2 Near Drowning Suffocation and death as a result of submersion in liquid. – Near drowning: Liquid submersion survival – Dry drowning: Glottis spasm – Wet drowning Glottis relaxes – Water floods tracheobronchial tree / alveoli

3 Pulmonary pathologic and structure changes Laryngospasm and bronchial constriction Interstitial edema Decreased pulmonary surfactant Increased surface tension of alveolar fluid Atelectasis Pulmonary edema

4

5 Drowning or Near Drowning Sequence Panic and violent struggle Period of calmness and apnea Swallowing of large amounts of fluid, followed by vomiting Gasping inspirations and aspirations Convulsions Coma Death

6 Favorable Prognostic Factors Cold Water Drowning Age Submersion time Water temperature Water Quality Other injuries Amount of struggle CPR Suicidal attempt

7 Near Wet Drowning Tachypnea or apnea Tachycardia, hypertensive Cyanosis Frothy pink sputum Crackles / decrease aeration Acute ventilatory failure with hypoxemia Neurologic Status – Dilated pupils – Pain response

8 X-Ray Fluffy infiltrates Opacities of atelectasis Hypovolemia Hypervolemia

9 Treatment Normalize Temperature Hyperoxia – Pa02 > 100 torr – PEEP Hyperventilation – pH> 7.45 – PaC torr


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