Drowning: Three Chances to Die - @ JEMS.com


Drowning: Three Chances to Die

 

 
 
 

Greg Friese, MS, NREMT-P, WEMT | | Sunday, June 15, 2008


I've received several e-mails about a child who died from a drowning several hours after his submersion event. The event is being called a parking lot or secondary drowning. With drowning in general, a patient has three chances to die.

First, to drown means death after submersion and a loss of consciousness. Since you can't breathe underwater, your only chance of survival after you lose consciousness and stop breathing is rapid extrication followed by outstanding BLS and ALS care. If you aren't successfully resuscitated, you have drowned (cause of death #1).

Even if you're successfully resuscitated after a loss of consciousness underwater, you aren't in the clear yet. Patients who had water flow into their lower airway passages and through the alveoli can experience a rapid and worsening onset of pulmonary edema. The accumulation of edema obstructs oxygenation of red blood cells. This is sometimes known as a parking lot, or secondary, drowning. The patient's condition could rapidly deteriorate over several hours, eventually leading to death (cause of death #2).

If you survive the submersion and the edema, your prognosis is still as murky as a barnyard puddle. The infection likely to proceed from water and emesis aspiration -- assume all patients will vomit during resuscitation -- is high. Death can result from the ensuing infection (cause of death #3).

Our best defense against drowning is prevention. The following are simple rules for drowning prevention.

  • Know your limits.
  • Learn to swim.
  • Swim with a buddy.
  • Do not mix swimming and boating with drugs and alcohol.
  • Wear a personal flotation device when using small boats.
  • Monitor children in or near water.
  • Block child access to pools.
  • Do not play breath-holding games.

If a patient has lost consciousness after submersion, they need rapid extrication, outstanding BLS, rapid ALS interventions on scene, transport to a hospital equipped to deal with the immediate, short-term, and long-term complications, and a lot of luck. Remember, patients who don't have a pulse back by the time they reach the emergency department don't survive.

To learn more, visit

http://circ.ahajournals.org/cgi/content/full/112/24_suppl/IV-133

http://www.emedicinehealth.com/drowning/article_em.htm

http://lifesaving.com/interest/index.html




Connect: Have a thought or feedback about this? Add your comment now
Related Topics: Airway and Respiratory, Medical Emergencies

 
What's Your Take? Comment Now ...

Buyer's Guide Featured Companies

Featured Careers & Jobs in EMS

Get JEMS in Your Inbox

 

Fire EMS Blogs


Blogger Browser

Today's Featured Posts

 

EMS Airway Clinic

Improving Survival from Cardiac Arrest Using ACD-CPR + ITD

Using active compression-decompression CPR with an ITD has been shown to improve 1-year survival from cardiac arrest by 33%.
More >

Multimedia Thumb

FDNY Rescues Boy on Frozen River

Video captures rescue on the Bronx River.
Watch It >


Multimedia Thumb

Three Injured in Philadelphia Collapse

Parapet wall falls through roof of store.
Watch It >


Multimedia Thumb

Explosion Shakes Mexico Hospital

Rescuers search ruins of children’s hospital.
More >


Multimedia Thumb

Hands On February 2015

Here’s a look at this month’s product hands on.
More >


Multimedia Thumb

Nightwatch Series Premiere Party

JEMS Editor-in-Chief A.J. Heightman attends the series premiere of A&E's new reality show, "Nightwatch."
More >


Multimedia Thumb

Braun Ambulances' EZ Door Forward

Helps to create a safer ambulance module.
Watch It >


Multimedia Thumb

The AmbuBus®, Bus Stretcher Conversion Kit - EMS Today 2013

AmbuBus®, Bus Stretcher all-hazards preparedness & response tool
Watch It >


Multimedia Thumb

VividTrac offered by Vivid Medical - EMS Today 2013

VividTrac, affordable high performance video intubation device.
Watch It >


More Product Videos >