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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.
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Submersion Injuries • Mandi Stone, MD • Orlando Health Emergency Medicine
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
Submersion Breathholding Air hunger Reflex gasping Aspiration
Surfactant washout • Atelectasis • VQ mismatch • Pulmonary edema • ARDS
H+ O2
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
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