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Near Drowning

Near Drowning. R. Hernandez. Near Drowning. Suffocation and death as a result of submersion in liquid. Near drowning: Liquid submersion survival Dry drowning: Glottis spasm Wet drowning Glottis relaxes Water floods tracheobronchial tree / alveoli.

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Near Drowning

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  1. Near Drowning R. Hernandez

  2. Near Drowning • Suffocation and death as a result of submersion in liquid. • Near drowning: • Liquid submersion survival • Dry drowning: • Glottis spasm • Wet drowning • Glottis relaxes • Water floods tracheobronchial tree / alveoli

  3. Pulmonary pathologic and structure changes • Laryngospasm and bronchial constriction • Interstitial edema • Decreased pulmonary surfactant • Increased surface tension of alveolar fluid • Atelectasis • Pulmonary edema

  4. Drowning or Near Drowning Sequence • Panic and violent struggle • Period of calmness and apnea • Swallowing of large amounts of fluid, followed by vomiting • Gasping inspirations and aspirations • Convulsions • Coma • Death

  5. Favorable Prognostic FactorsCold Water Drowning • Age • Submersion time • Water temperature • Water Quality • Other injuries • Amount of struggle • CPR • Suicidal attempt

  6. Near Wet Drowning • Tachypnea or apnea • Tachycardia, hypertensive • Cyanosis • Frothy pink sputum • Crackles / decrease aeration • Acute ventilatory failure with hypoxemia • Neurologic Status • Dilated pupils • Pain response

  7. X-Ray • Fluffy infiltrates • Opacities of atelectasis • Hypovolemia • Hypervolemia

  8. Treatment • Normalize Temperature • Hyperoxia • Pa02 > 100 torr • PEEP • Hyperventilation • pH> 7.45 • PaC02 25-30 torr

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