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Chest Apr 2021Drowning is "the process of experiencing respiratory impairment from submersion or immersion in liquid." According to the World Health Organization, drowning claims the... (Review)
Review
Drowning is "the process of experiencing respiratory impairment from submersion or immersion in liquid." According to the World Health Organization, drowning claims the lives of > 40 people every hour of every day. Drowning involves some physiological principles and medical interventions that are unique. It occurs in a deceptively hostile environment that involves an underestimation of the dangers or an overestimation of water competency. It has been estimated that > 90% of drownings are preventable. When water is aspirated into the airways, coughing is the initial reflex response. The acute lung injury alters the exchange of oxygen in different proportions. The combined effects of fluid in the lungs, loss of surfactant, and increased capillary-alveolar permeability result in decreased lung compliance, increased right-to-left shunting in the lungs, atelectasis, and alveolitis, a noncardiogenic pulmonary edema. Salt and fresh water aspirations cause similar pathology. If the person is not rescued, aspiration continues, and hypoxemia leads to loss of consciousness and apnea in seconds to minutes. As a consequence, hypoxic cardiac arrest occurs. The decision to admit to an ICU should consider the patient's drowning severity and comorbid or premorbid conditions. Ventilation therapy should achieve an intrapulmonary shunt ≤ 20% or Pao:Fio ≥ 250. Premature ventilatory weaning may cause the return of pulmonary edema with the need for re-intubation and an anticipation of prolonged hospital stays and further morbidity. This review includes all the essential steps from the first call to action until the best practice at the prehospital, ED, and hospitalization.
Topics: Combined Modality Therapy; Drowning; Emergency Service, Hospital; Emergency Treatment; Hospitalization; Humans; Near Drowning; Pulmonary Edema; Resuscitation
PubMed: 33065105
DOI: 10.1016/j.chest.2020.10.007 -
Emergencias : Revista de La Sociedad...This narrative review discusses the evidence relevant to key aspects of drowning, which is defined by the World Health Organization as the process of respiratory... (Review)
Review
This narrative review discusses the evidence relevant to key aspects of drowning, which is defined by the World Health Organization as the process of respiratory difficulty caused by submersion/immersion in liquid. The length of time the victim is submerged is a key factor in survival and neurologic damage. Although respiratory distress and hypoxia are the main events, other complications affecting various systems and organs may develop. Drowning is one of the main causes of accidental death worldwide, yet deaths from drowning are underestimated and morbidity is unknown. Prevention is essential for reducing both mortality and morbidity, but if prevention fails, the speed of access to and the quality of prehospital and hospital care will determine the prognosis. It is therefore essential to understand the factors and mechanisms involved in these emergencies.
Topics: Age Factors; Cardiopulmonary Resuscitation; Cause of Death; Drowning; Emergencies; Female; Hospitalization; Humans; Immersion; International Classification of Diseases; Male; Prognosis; Risk Factors; Sex Factors; Survivors; Time Factors
PubMed: 31347808
DOI: No ID Found -
BMC Pediatrics Sep 2021We looked at existing recommendations for preventing unintentional injuries in children under five years of age, and we attempted to identify the main sources used as... (Review)
Review
We looked at existing recommendations for preventing unintentional injuries in children under five years of age, and we attempted to identify the main sources used as evidence for formulating these recommendations.We conducted a literature search up to the 18th October 2019 by using key terms and manual search in selected sources. We summarized the recommendations and source of the evidence in tables for each of five areas of unintentional injuries: road traffic injuries, drowning, poisoning, thermal injuries, falls.In 2008, the World Health Organization (WHO) published a comprehensive report with strategies for child injury prevention for the European region. More recently, the WHO published several guidance documents focused on one area such as drowning, usually with a global focus. The PrevInfad workgroup (Spanish Association of Primary Care Pediatrics) updated their document on road safety in April 2019, providing recommendations and a summary of the existing evidence. Preventive strategies for injuries in childhood are mainly based on surveillance data and the identification of risk factors. The key strategies for preventing unintentional injuries are a combination of environmental and behaviour modification, that can be achieved through engineering, enforcement and education. Consequently, for this kind of strategies, it is important to evaluate the effectiveness of both the intervention itself, and the way the intervention is advised to parents and caretakers so that there is good compliance of the recommendation.
Topics: Accidental Falls; Accidental Injuries; Accidents, Traffic; Burns; Child; Child, Preschool; Drowning; Humans; Infant; Risk Factors; Wounds and Injuries
PubMed: 34496772
DOI: 10.1186/s12887-021-02517-2 -
Military Medicine Sep 2018Highly skilled swimmers and aquatically adaptable service members such as U.S. Navy Divers, Sea, Air and Land (SEAL) Teams, and Explosive Ordnance Disposal (EOD)...
Highly skilled swimmers and aquatically adaptable service members such as U.S. Navy Divers, Sea, Air and Land (SEAL) Teams, and Explosive Ordnance Disposal (EOD) technicians, die every year from drowning. Drowning is the cause of over 500,000 deaths annually across the globe. This Clinical Practice Guideline (CPG) provides an overview of drowning and associated conditions based on the best available current medical evidence. Unlike basic life support and advanced cardiac life support protocols, rescue breathing should be initiated prior to chest compressions to re-expand water-filled alveoli. These guidelines should be used as a standardized framework to guide first responders, prehospital emergency medical service personnel, and medical department personnel in evaluating, diagnosing, and managing common in water pathologies.
Topics: Disease Management; Drowning; Emergency Medical Services; Guidelines as Topic; Humans; Pulmonary Edema; Resuscitation; Swimming; Water
PubMed: 30189074
DOI: 10.1093/milmed/usy136 -
The Medico-legal Journal Mar 2022Internationally, drowning is a leading cause of accidental death that features in many legal cases. In these cases, possible mitigations and the 'pain and suffering' in...
Internationally, drowning is a leading cause of accidental death that features in many legal cases. In these cases, possible mitigations and the 'pain and suffering' in terms of the duration and subjective experience of drowning are often pivotal in determining levels of compensation and outcome. As a result, there is a requirement to understand the stages of the drowning process, and the duration and physiological and subjective responses associated with each stage. In this short review we focus on these issues.
Topics: Drowning; Humans
PubMed: 34791956
DOI: 10.1177/00258172211053127 -
Pediatrics in Review Apr 2019
Topics: Child, Preschool; Drowning; Humans; Infant; Safety; Swimming Pools; Water
PubMed: 30936404
DOI: 10.1542/pir.2017-0240 -
Pediatric Annals Mar 2018Drowning contributes significantly to morbidity and mortality in the pediatric population but it is largely preventable through judicious use of safety measures. To... (Review)
Review
Drowning contributes significantly to morbidity and mortality in the pediatric population but it is largely preventable through judicious use of safety measures. To affect outcomes surrounding drowning, pediatricians need to understand the most updated terminology, the basic resuscitation protocols, and the assessment and management of a drowning victim. Most importantly, pediatricians must appreciate the importance of properly counseling patients and families about drowning prevention. Effective preventive measures supported by the literature include constant and reliable adult supervision, swim instruction for most children older than age 4 years, pool isolation fencing, and the proper use of personal floatation devices. [Pediatr Ann. 2018;47(3):e112-e117.].
Topics: Accident Prevention; Child; Directive Counseling; Drowning; Humans; Pediatrics; Physician's Role; Resuscitation; Risk Factors
PubMed: 29538784
DOI: 10.3928/19382359-20180220-02 -
Cleveland Clinic Journal of Medicine Jul 2018Drowning is a common and often preventable cause of death, especially in children. The mass media often propagate misinformation about "dry" and "secondary" drowning,... (Review)
Review
Drowning is a common and often preventable cause of death, especially in children. The mass media often propagate misinformation about "dry" and "secondary" drowning, diverting attention from appropriate efforts to prevent drowning and rescue and treat those who do drown.
Topics: Adolescent; Cardiopulmonary Resuscitation; Child; Child, Preschool; Drowning; Humans; Infant; Public Health
PubMed: 30004377
DOI: 10.3949/ccjm.85a.17070 -
American Family Physician Apr 2016Nearly 4,000 drowning deaths occur annually in the United States, with drowning representing the most common injury-related cause of death in children one to four years... (Review)
Review
Nearly 4,000 drowning deaths occur annually in the United States, with drowning representing the most common injury-related cause of death in children one to four years of age. Drowning is a process that runs the spectrum from brief entry of liquid into the airways with subsequent clearance and only minor temporary injury, to the prolonged presence of fluid in the lungs leading to lung dysfunction, hypoxia, neurologic and cardiac abnormalities, and death. The World Health Organization has defined drowning as "the process of experiencing respiratory impairment from submersion/immersion in liquid." Terms such as near, wet, dry, passive, active, secondary, and silent drowning should no longer be used because they are confusing and hinder proper categorization and management. The American Heart Association's Revised Utstein Drowning Form and treatment guidelines are important in guiding care, disposition, and prognosis. Prompt resuscitation at the scene after a shorter duration of submersion is associated with better outcomes. Because cardiac arrhythmias due to drowning are almost exclusively caused by hypoxia, the resuscitation order prioritizes airway and breathing before compressions. Prevention remains the best treatment. Education, swimming and water safety lessons, and proper pool fencing are the interventions with the highest level of current evidence, especially in children two to four years of age. Alcohol use during water activities dramatically increases the risk of drowning; therefore, abstinence is recommended for all participants and supervisors.
Topics: Accident Prevention; Child; Drowning; Humans; Risk; Swimming; United States
PubMed: 27035042
DOI: No ID Found -
Families, Systems & Health : the... Mar 2020Presents a brief story about the drowning death of a two year old child, the grief of the parents, and subsequent organ donation. (PsycInfo Database Record (c) 2020 APA,...
Presents a brief story about the drowning death of a two year old child, the grief of the parents, and subsequent organ donation. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Topics: Child, Preschool; Critical Illness; Drowning; Humans; Tissue and Organ Procurement
PubMed: 32202841
DOI: 10.1037/fsh0000455