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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 -
Experimental Physiology Nov 2017What is the topic of this review? This is the first review to look across the broad field of 'cold water immersion' and to determine the threats and benefits associated... (Review)
Review
What is the topic of this review? This is the first review to look across the broad field of 'cold water immersion' and to determine the threats and benefits associated with it as both a hazard and a treatment. What advances does it highlight? The level of evidence supporting each of the areas reviewed is assessed. Like other environmental constituents, such as pressure, heat and oxygen, cold water can be either good or bad, threat or treatment, depending on circumstance. Given the current increase in the popularly of open cold water swimming, it is timely to review the various human responses to cold water immersion (CWI) and consider the strength of the claims made for the effects of CWI. As a consequence, in this review we look at the history of CWI and examine CWI as a precursor to drowning, cardiac arrest and hypothermia. We also assess its role in prolonged survival underwater, extending exercise time in the heat and treating hyperthermic casualties. More recent uses, such as in the prevention of inflammation and treatment of inflammation-related conditions, are also considered. It is concluded that the evidence base for the different claims made for CWI are varied, and although in most instances there seems to be a credible rationale for the benefits or otherwise of CWI, in some instances the supporting data remain at the level of anecdotal speculation. Clear directions and requirements for future research are indicated by this review.
Topics: Adaptation, Physiological; Animals; Body Temperature Regulation; Cold Temperature; Cryotherapy; Drowning; Exercise Tolerance; History, 18th Century; History, 19th Century; History, 20th Century; History, 21st Century; History, Ancient; Humans; Hydrotherapy; Immersion; Risk Assessment; Risk Factors; Swimming; Water
PubMed: 28833689
DOI: 10.1113/EP086283 -
Physiology (Bethesda, Md.) Mar 2016Drowning physiology relates to two different events: immersion (upper airway above water) and submersion (upper airway under water). Immersion involves integrated... (Review)
Review
Drowning physiology relates to two different events: immersion (upper airway above water) and submersion (upper airway under water). Immersion involves integrated cardiorespiratory responses to skin and deep body temperature, including cold shock, physical incapacitation, and hypovolemia, as precursors of collapse and submersion. The physiology of submersion includes fear of drowning, diving response, autonomic conflict, upper airway reflexes, water aspiration and swallowing, emesis, and electrolyte disorders. Submersion outcome is determined by cardiac, pulmonary, and neurological injury. Knowledge of drowning physiology is scarce. Better understanding may identify methods to improve survival, particularly related to hot-water immersion, cold shock, cold-induced physical incapacitation, and fear of drowning.
Topics: Animals; Cold Temperature; Diving; Drowning; Heart; Humans; Reflex; Water
PubMed: 26889019
DOI: 10.1152/physiol.00002.2015 -
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 -
Ugeskrift For Laeger Oct 2023According to the International Life Saving Federation (ILS), integrating lifeguards in the local or regional emergency medical service (EMS) is a necessity to prevent... (Review)
Review
According to the International Life Saving Federation (ILS), integrating lifeguards in the local or regional emergency medical service (EMS) is a necessity to prevent drowning and improve prehospital treatment in selected situations. This review describes the organisation of lifeguards in Denmark, focusing on essential skills and equipment to assist prehospital EMS in drowning, out-of-hospital cardiac arrest, and search and rescue operations. Standardised requirements for the medical education of lifeguards are warranted to improve prehospital treatment and integration in the EMS.
Topics: Humans; Drowning; Emergency Medical Services; Cardiopulmonary Resuscitation; Out-of-Hospital Cardiac Arrest; Denmark
PubMed: 37873984
DOI: No ID Found -
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 -
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 -
Current Biology : CB Jun 2021Interview with Dori Derdikman, who studies spatial memory and navigation at the Technion - Israel Institute of Technology.
Interview with Dori Derdikman, who studies spatial memory and navigation at the Technion - Israel Institute of Technology.
Topics: Animals; Drowning; History, 20th Century; History, 21st Century; Humans; Israel; Male; Neurosciences; Research Personnel; Spatial Memory; Spatial Navigation
PubMed: 34102112
DOI: 10.1016/j.cub.2021.04.058 -
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 -
Annals of the Royal College of Surgeons... Sep 2022The National Confidential Enquiry into Perioperative Deaths (NCEPOD) report recommended that 'fluid prescribing be given the same value as drug prescribing', yet fluid...
INTRODUCTION
The National Confidential Enquiry into Perioperative Deaths (NCEPOD) report recommended that 'fluid prescribing be given the same value as drug prescribing', yet fluid prescription is commonly delegated to junior doctors despite being a notoriously challenging topic. When antibiotics are given as an infusion they are diluted in 100ml of fluid, which is often unaccounted for when thinking about a patient's fluid requirements. This closed-loop audit aimed to assess first, intravenous (IV) fluid therapy and second, electrolyte prescribing compliance with National Institute for Health and Care Excellence (NICE) guidelines, with and without the additional fluid given with antibiotic administration.
METHODS
Two retrospective audits were performed. Total fluid and electrolyte volume received with and without antibiotic fluids was correlated with recommendations in the NICE guidelines. Between cycles 1 and 2, potassium chloride with sodium chloride and glucose (PSG) was introduced as an alternative to IV maintenance fluid, and bolusing of antibiotics was mandatory.
RESULTS
When analysing total fluid volume input per day, 10.4% and 7.45% of patients met their fluid requirement accurately in the first and second cycles, respectively. Within cycle 1, the mean total additional fluid that was given over 3 days with antibiotics was 1,572.73ml. In cycle 2, this decreased to 469.44ml when antibiotics were given as a bolus.
CONCLUSIONS
In this closed-loop audit we noted that patients receiving IV fluids and IV antibiotics received too much additional fluid when the antibiotic dilution fluid was taken into account. Additional fluid was reduced alongside the proportion of electrolyte complications when bolusing of antibiotics was introduced. We recommend that that all nurses are trained to give antibiotics as a bolus because it can help to reduce fluid-related complications.
Topics: Anti-Bacterial Agents; Drowning; Electrolytes; Fluid Therapy; Humans; Retrospective Studies
PubMed: 35639453
DOI: 10.1308/rcsann.2022.0043