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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 -
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 -
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 -
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 -
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 -
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 -
Pediatrics Aug 2021Drowning is a leading cause of injury-related death in children. In 2018, almost 900 US children younger than 20 years died of drowning. A number of strategies are...
Drowning is a leading cause of injury-related death in children. In 2018, almost 900 US children younger than 20 years died of drowning. A number of strategies are available to prevent these tragedies. As educators and advocates, pediatricians can play an important role in prevention of drowning.
Topics: Adolescent; Child; Child, Preschool; Drowning; Humans; Infant
PubMed: 34253571
DOI: 10.1542/peds.2021-052227 -
Pediatric Emergency Medicine Practice Jun 2022Drowning and submersion injuries are highly prevalent, yet preventable, causes of pediatric mortality and morbidity. Prehospital care should focus on restoring normal... (Review)
Review
Drowning and submersion injuries are highly prevalent, yet preventable, causes of pediatric mortality and morbidity. Prehospital care should focus on restoring normal ventilation and circulation as quickly as possible to limit the extent of hypoxic insult. Diagnostic testing for symptomatic patients may include blood glucose level, arterial blood gas level, complete blood count, electrolyte levels, chest radiography, and cardiorespiratory monitoring with pulse oximetry and a rhythm strip. In this review, passive external, active external, and active internal rewarming techniques for treatment of hypothermic patients are discussed. A systematic approach to treatment and disposition of pediatric drowning victims is provided, and risk factors, caveats in pediatric care, and factors affecting prognosis are also discussed.
Topics: Child; Drowning; Emergency Medical Services; Humans; Immersion; Near Drowning; Resuscitation
PubMed: 35737684
DOI: No ID Found -
Fa Yi Xue Za Zhi Feb 2022To explore the application value of virtual autopsy to obtain key evidence information on drowned corpses and its application value of virtual autopsy in the diagnosis...
OBJECTIVES
To explore the application value of virtual autopsy to obtain key evidence information on drowned corpses and its application value of virtual autopsy in the diagnosis of drowning.
METHODS
In this study, 7 corpses were selected as the research objects. The image data of corpses were collected by computed tomography (CT) before conventional autopsy. The characteristics of corpses were observed through image reading, combined with virtual measurement indexes, and compared with 15 non-drowned corpses.
RESULTS
The postmortem CT of drowning showed the more fluid in respiratory tract than the non-drowning, and ground-glass opacities in the lung. The statistical volume of fluid in the sinus (maxillary sinus and sphenoid sinus) was (10.24±4.70) mL in drowning cases and (2.02±2.45) mL in non-drowning cases. The average CT value of fluid in the sinus, left atrial blood and gastric contents in drowning cases were (15.91±17.20), (52.57±9.24) and (10.33±12.81) HU, respectively, which were lower than those in non-drowning cases (<0.05).
CONCLUSIONS
The comprehensive consideration of multiple characteristic image manifestations and the virtual measurement indexes are helpful to the forensic pathological diagnosis of drowning. Virtual autopsy can be used as an auxiliary method in the forensic diagnosis of drowning.
Topics: Autopsy; Cadaver; Drowning; Forensic Pathology; Humans; Tomography, X-Ray Computed
PubMed: 35725704
DOI: 10.12116/j.issn.1004-5619.2021.410806 -
Emergency Medicine Clinics of North... Aug 2024Drowning is responsible for considerable morbidity and mortality worldwide, and it is estimated that 90% of drownings are preventable. Drowning is defined as "the... (Review)
Review
Drowning is responsible for considerable morbidity and mortality worldwide, and it is estimated that 90% of drownings are preventable. Drowning is defined as "the process of experiencing respiratory impairment from submersion/immersion in liquid." Emergency providers should focus on airway management and rapid delivery of oxygen to interrupt the drowning process and improve patient outcomes. Patients with minimal or no symptoms do not require any specific diagnostic workup, aside from physical examination and 4 to 6 hours of observation prior to discharge. Patients with more severe symptoms may present with rales and foamy secretions, and should be managed with high-concentration oxygen and positive airway pressure.
Topics: Humans; Drowning; Near Drowning; Emergency Service, Hospital
PubMed: 38925773
DOI: 10.1016/j.emc.2024.02.014