Drowning

Drowning

Drowning is defined as
respiratory impairment
as a result of being in
or under a liquid
Machanism of drowning
Being under a liquid Hold your breath

Use oxygen in red blood cell

𝑜2 𝐶𝑂2
Inhalation of water Vagus nerve in brain

Swelling water into stomach Autonomic Respiration

Happen for minutes….Apnea….Unconscious
 Signs and symptoms

• Unconscious • Vomiting
• Not breathing • Extreme fatigue
• Cardiac arrest • low body temperature
• Confuse (Hypothermia)
• shortness of breath, difficulty breathing
• Coughing
Drowning in fresh water
 alveoli
Inhalation of Fresh water(hypotonic solution)

fresh water Osmosis vascular

Into the vascular

system from the
alveolar
Hypervolemia and Hemodilution

•Weakness.
•Dizziness.
Hemolysis •Confusion
•Abnormal paleness
•Dark-colored urine.
Normal
Hyponatremia
•Nausea and vomiting
in intracellular K > Na •Headache
•Confusion
in extracellular Na > K •fatigue
•Restlessness
Na in extracellular •Muscle weakness
Fresh water •Seizures
Hypervolemia
Hyperkaliemia
Hemolysis •weakness.
•a feeling of numbness or tingling.
•nausea or vomiting.
K in extracellular
•trouble breathing.
•irregular heartbeats.
Drowning in sea waters
 alveoli Sea water(hypertonic solution)
Pulmonary
edema vascular

Air don’t exchange

because alveoli have
Hemoconcentration and Hypovolemia
plasma fluid
•Rapid heartbeat.
•Quick, shallow breathing.
• Dyspnea • Cough •Feeling weak.
•Confusion
• Wheezing • Pallor
•Little or no pee.
• Orthopnea • Cyanosis •Low blood pressure.
• Fatigue •Cool skin
Alveoli damage

Hypoxia

Severe hypoxia

Brain anoxia
 Hypovolemia

Hypernatriemia Hyperchloremia

•High blood pressure

•Lethargy Irritability •muscle weakness
•Ataxia, tremor •irregular heart rate
•Hyperreflexia •Confusion
•Seizures •numbness or tingling
•seizures
 First aid drowning
1. Get Help
Notify a lifeguard, if one is close.
If not, ask someone to call 1669 and asked AED.
If you are alone, follow the steps below.
2. Move the Person
Take the person out of the water.
If conscious
First aid drowning
1.Tell them to
• Clam down
• Take a deep breath
2. Lateral recovery position
3.Keep warm
4.Refer to hospital for observe signs and symptoms
because occasionally symptoms may not appear
until up to six hours afterwards
If unconscious but breathing
First aid drowning
1. Lateral recovery position
2.Keep warm
3.Refer to hospital for observe
signs and symptoms because occasionally
symptoms may not appear until up to six hours afterwards
If unconscious ,not breathing ,cardiac arrest
First aid drowning
Check the person's pulse for 10 seconds.
- Pulse
1. Clear airway (keep in mild C-spine protection)
2. Give breath every 5-6 second ( keep respiratory rate 10-12
Times/min)
3.Keep warm
4.Refer to hospital
If unconscious ,not breathing ,cardiac arrest
First aid drowning
Check the person's pulse for 10 seconds.
- Pulseless
1.Start CPR
-basic life support
- Chest compression, Airway,
Breathing) Until life support team
arrive or person conscious or person starts breathing .
 Care in the Emergency Department
Group A: Awake
- Conscious
- Best verbal response
Classify group - Glasgow Coma Scale (GCS) = 14-15
- Normal ABG , normal CXR

- Observe signs and symptoms in ER

- Give oxygen
- Keep warm
Care in the Emergency Department
Group B: Blunted conscious , GCS = 8-13
- Mild , moderate hypoxemia
- Congest lung

- Observe signs and symptoms in ICU

- Give oxygen
- Treat acidosis
- Cough and Breath stimulation
- Monitoring
Care in the Emergency Department
• Group C : Comatose
- Severe hypoxemia
- Pulmonary infiltration

- ICU
- ET tube, Ventilation
- IVF ,NaHCO
- Hypertherapy
- Aggressive monitor
 References
Acta,M. (2011). Pathology, prevention and treatment of drowning syndrome. Retrieved from
http://www.actamedicamediterranea.com/archive/2011/medica-1/pathophysiology-prevention-and-t
reatment-of-drowing-syndrome/pdf?fbclid
วรนุช เกียรติพงษ์ถาวร. การพยาบาลผู้ป่วยจมนา้ . [ออนไลน์] สื บค้นวันที่ 3 มิถุนายน 2562 จากเว็บไซต์
http://www.elearning.ns.mahidol.ac.th/Km/data/kmsurgicalnursing/drown.pdf?fbclid=IwAR2XH
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