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  • Submersion Injuries: Mandi Stone, MD Orlando Health Emergency Medicine

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    Drowning is defined as a process resulting in primary respiratory impairment from submersion or immersion in a liquid medium. It is estimated to cause 500,000 deaths worldwide each year. The pathophysiology of submersion injuries involves breath holding, air hunger, reflex gasping and aspiration of liquid into the lungs, which can lead to complications like surfactant washout, atelectasis, VQ mismatch, pulmonary edema and ARDS. In the ED, management involves assessing and treating the cause of drowning, looking for trauma, seizures, hypoglycemia, arrhythmias or signs of abuse or neglect. Symptomatic patients should be admitted for observation and supplemental oxygen while asymptomatic patients can be observed for 4-

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    Drowning is defined as a process resulting in primary respiratory impairment from submersion or immersion in a liquid medium. It is estimated to cause 500,000 deaths worldwide each year. The pathophysiology of submersion injuries involves breath holding, air hunger, reflex gasping and aspiration of liquid into the lungs, which can lead to complications like surfactant washout, atelectasis, VQ mismatch, pulmonary edema and ARDS. In the ED, management involves assessing and treating the cause of drowning, looking for trauma, seizures, hypoglycemia, arrhythmias or signs of abuse or neglect. Symptomatic patients should be admitted for observation and supplemental oxygen while asymptomatic patients can be observed for 4-

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    34 views31 pages

    Submersion Injuries: Mandi Stone, MD Orlando Health Emergency Medicine

    Uploaded by

    وهج القصيد
    Drowning is defined as a process resulting in primary respiratory impairment from submersion or immersion in a liquid medium. It is estimated to cause 500,000 deaths worldwide each year. The pathophysiology of submersion injuries involves breath holding, air hunger, reflex gasping and aspiration of liquid into the lungs, which can lead to complications like surfactant washout, atelectasis, VQ mismatch, pulmonary edema and ARDS. In the ED, management involves assessing and treating the cause of drowning, looking for trauma, seizures, hypoglycemia, arrhythmias or signs of abuse or neglect. Symptomatic patients should be admitted for observation and supplemental oxygen while asymptomatic patients can be observed for 4-

    Copyright:

    © All Rights Reserved
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    of 31

    Submersion

    Injuries
    Mandi Stone, MD
    Orlando Health Emergency Medicine

    No disclosures

    Vocabulary

    Vocabulary
    Drowning vs near-drowning?
    Wet vs dry?
    Primary vs secondary?

    Vocabulary
    Drowning vs near-drowning?
    Wet vs dry?
    Primary vs secondary?

    Vocabulary
    Drowning vs near-drowning?
    Wet vs dry?
    Primary vs secondary?

    A process resulting in primary

    respiratory impairment from


    submersion/immersion in a liquid
    medium.

    Epidemiology
    Estimated 500,000 deaths per
    year, worldwide

    Pathophysiology

    Submersion
    Breathholding
    Air hunger
    Reflex gasping
    Aspiration

    Salt vs Fresh
    water?

    Salt vs Fresh
    water?

    Surfactant washout
    Atelectasis
    VQ mismatch
    Pulmonary edema
    ARDS

    H+
    O2

    Management

    Pre-hospital

    ED Management
    A
    B
    C
    D
    E

    ED Management
    Cause of drowning?
    Trauma
    Seizure
    Hypoglycemia
    Arrhythmia
    Suicide attempt
    Abuse or neglect

    Immersion
    syndrome

    Syncope secondary to cardiac

    dysrhythmia due to sudden contact


    with cold water

    ASSOCIATED WITH CONGENITAL


    PROLONGED QT SYNDROME

    Caused by V.fib/Asystole secondary

    to catecholamine release in response


    to quick temperature change

    CXR

    Routine steroids or antibiotics NOT


    recommended

    Disposition
    Symptomatic patients - admit for
    observation, supplemental O2

    Asymptomatic - observe for 4-8


    hours

    Prevention
    Fences around pools
    Swimming lessons
    Close monitoring of
    infants/children

    Avoiding alcohol/drug use while


    swimming

    Thank you!

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