Drowning and Near Drowning and Cognitive Functioning

Drowning will be defined as death resulting from suffocation, especially from submersion in water. Near drowning is a term reserved for those victims whose submersion was of sufficient severity to warrant emergency medical evaluation and treatment.

Approximately 15% of children will have experienced near drowning by middle-school age and 33% of adults have experienced near drowning (alcohol is involved in 40-50% of drownings). About 4,500 persons die from drowning each year in the United States. This makes it roughly the third leading cause of accidental death. Pool drownings are the most common, even in coastal areas. Bathtub drownings average one a day in the United States; 26% occur in children under 5 years of age. Approximately 16% of these victims had a history for seizures.

Peak incidence occurs in the teenage years and in children under 4 years of age (highest risk). More than 40% of drownings are in the under 4 age group. The occurrence of male drownings is 3:1 over females, outside the home. Alcohol use by older victims is also a factor. The association between drowning and neck (cervical) injuries, from shallow water diving, is well established.

REASONS FOR NEAR DROWNING

1. Inexperience

2. Hyperventilation

3. Hypothermia

4. Alcohol and drugs

5. Head trauma

6. Seizure

7. Myocardial infarction

The COMMON CAUSE of immediate death is lack of oxygen, (asphyxiation) either through the inhalation of large volumes of water into the lungs or via laryngospasm (muscle spasms of the throat and airway). In this situation, the victim suffocates with "dry lungs". These "dry drownings" account for approximately 10% of all drownings. Death from drowning can occur later (within 24 hours after injury) as a complication of drowning, known as POST IMMERSION SYNDROME. This refers to a delayed injury to the lungs that leads to an increase in fluid within the lung tissue. Due to these delayed effects, near drowning victims MUST be admitted to the hospital for close observation and treatment. Patients arriving at the hospital with breathing difficulty will usually "get worse before they get better." Early, aggressive airway support is needed, including assisted mechanical ventilation. In this case, a plastic tube is placed into the lungs (endotracheal intubation) to aid the patient's breathing efforts. Oxygen (in high concentrations) may be given using this modality and the airway is simultaneously protected from aspiration [of vomit] into the lungs. Victims who appear without symptoms are often observed in the hospital for 24 hours, to be certain they do not develop serious complications (post-immersion syndrome).

Outcome can be predicted on the basis of whether or not the patient required advanced resuscitation at the accident scene (CPR). Statistics show that almost all victims who require advanced resuscitative efforts will eventually die, or suffer severe brain damage. Young victims in COLD water drownings are an exception and have survived with return to normal function, after prolonged CPR. This has been explained by the rapid cooling of the brain that occurs when the cold water first enters the lungs. Studies show that rapid cooling appears to have a protective effect on the brain, allowing for the improved propect of survival. Factors which appear to be important in increasing survivorship include; age less than 2 years and water temperatures less than 20 degrees Celsius. ALL VICTIMS OF NEAR DROWNING REQUIRE PHYSICIAN EVALUATION.

Hope this article will provide you infomation about drowning and near drowning.


12 Hip Dislocation
12 Hip Fracture
12 Insect Stings and Spider Bites
12 Human and Animal Bites
12 Shoulder Injury Fracture
12 Toxic Inhalations and Carbon Monoxide Poisoning
12 Facial Injury Jaw Fracture and Dislocation
12 Kidney Injury
12 Knee Injury General Considerations
12 Knee Injury Contusion
12 Knee Injury Fracture
12 Knee Injury Sprain
12 Stab Wounds
12 Leg Injury Fractures and Contusions
12 Leg Injury Shin Splints
12 Lightning Injury
12 Oral and Tongue Injuries
12 Nasal Fracture or Contusion
12 Neck Injury General Considerations
12 Neck Injury Fracture
12 Neck Injury Spinal Cord Injury
12 Pelvic Bone Fracture
12 Puncture Wounds
12 Chest Injury Rib Fracture
12 Back Injury Sacrococcygeal Injury
12 Scorpion Bites
12 Abrasion Injuries
12 Shoulder Injury Clavicle Fracture
12 Shoulder Injury Strains and Sprains
12 Snakebite
12 Neck Injury Spinal Cord Injury
12 Abdominal Injury Ruptured Spleen
12 Foot Injury Toe Fracture and Sprain
12 Vaginal or Vulvar Injury
12 Drowning and Near Drowning

INJURIES

Abdominal Injury
Abdominal Injury: Contusion
Abrasion
Amputations
Animal Bites
Ankle Fracture
Ankle Injury
Ankle Injury: Contusion
Ankle Sprain
Back Injury
Back Injury : Sacrococcygeal Injury
Back Strain
Burns
Carbon Monoxide Poisoning
Chemical Burns
Chest Injuries
Chest Injury: Aortic Rupture
Chest Injury: Hemothorax
Chest Injury: Myocardial Contusion
Chest Injury : Pneumothorax
Chest Injury: Pulmonary Contusion
Chronic Back Pain
Clavicle Fracture
Compression Fractures
Contusions
Decompression Sickness
Disc Disease
Gunshot Wounds
Hand Injury: Fingertip Amputations
Head Injury
Liver Injury
Marine Stings
Muscle Strains
Rib Fracture
Ruptured Spleen
Shoulder Injury: A-C Separation
Spider Bites
Spinal Cord Injury
Sternum Fracture
Testicular Injury
Wrist Injury
hi Scuba Related Injuries
i Hand Injury Finger Amputaion
de Lecerations
de Cold Injury and Hypothermia
dd Dental Injury
xs Facial Injury
sdf Neck Injury
e Shoulder Injury Dislocation
e Ear Injury
ed Elbow Injury
de Elbow Injury Fracture
dfe Elbow Injury Nursemaids
ee Electrical Injury
de Eye Injury
ed Facial Injury General Considerations
fr Facial Injury Contusion
ed Hand Injury Finger Sprains
ded Fingernail and Toenail Injuries
dd Hand Injury Fractures
23 Head Injury Skull Fracture and Concussion
44 Chest Injury Myocardial Contusion
fde Heat Illness
ed Hest Injury Hemothorax
y Back Injury Disc Disease
;l High Altitude Illness


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