Drowning Types and Complications Quiz

Emergencies PARA 3500

• BLS v3.4 standards are referenced for various emergencies
• Specific standards for Trauma, Burns, Cold, Electrocution, and Submersion are detailed in the provided materials

General Trauma Standard

• Ask the victim to stay still
• Extricate or move the victim if necessary and safe to do so.
• Survey the scene for any dangers.
• Perform a rapid primary survey.
• Perform a rapid trauma survey.
• Consider SMR (Specific Medical Requirements)

Additional Trauma Standard Procedures

• Estimate blood loss
• Leave impaled objects in place unless interfering with airway or CPR.
• Assess injuries using CLAPS D TICS (a mnemonic for injury assessment).
• Complete a secondary survey if major or multiple trauma is present or suspected.
• Remove clothing/jewelry that compromises the injury site.

Temperature Regulation

• Core temperature of deep structures (liver) differs from peripheral body tissues.
• Normal core temperature is 98.6°F (37°C) , with a variation of 1°–2°.
• The body maintains core temperatures through metabolism.
• Metabolism is the sum of all chemical processes in an organism that produce energy (heat as a byproduct).
• Internal heat comes from cellular metabolism, amplified by shivering and strenuous exercise.
• Environmental heat transfer occurs via the thermal gradient (difference in temperature).
• The hypothalamus regulates temperature like a thermostat.

Hypothermia

• Hypothermia is a condition where heat loss exceeds heat gain, resulting in abnormal low body temperature.
• Hypothermia is measured as a core temperature below 35°C.
• Heat loss mechanisms include radiation, convection, conduction, and evaporation.
• Windchill and water immersion amplify heat loss.
• Stages of hypothermia are classified based on core temperature (mild, moderate, and severe).

Exposure to Cold

• Generalized hypothermia is a significant decrease in body temperature.
• Local cold injury is damage to body tissues in a specific part or parts of the body.

Hypothermia Stages

• Mild: 34°C–36°C, characterized by shivering that's not under voluntary control, but the victim can walk and talk.
• Moderate: 30°C–34°C, marked by decreased consciousness (dazed), impaired motor coordination, slurred speech, severe shivering, and often irrational behavior.
• Severe: ≤30°C, marked by cessation of shivering, unconsciousness, rigidity, and slowed or absent vital signs (bradycardia).

Pathophysiology of Hypothermia

• Immediate vasoconstriction
• Catecholamine release
• Increased heart rate and respiration and shivering
• Decreased antidiuretic hormone (ADH)
• Increased urine output
• Depleted glucose and shivering stops
• Rapid cooling
• Decreased or stalled heart rate, respiration, and blood pressure
• Leftward shift of oxygen-hemoglobin dissociation curve
• Decreased oxygen release to tissues
• Depression of insulin release
• Hyperglycemia (high blood sugar).
• Cardiac arrest

Predisposing Factors for Generalized Hypothermia

• Cold environments
• Immersion in water
• Age (elderly and very young)
• Alcohol abuse
• Shock
• Head or spinal cord injury
• Burns
• Generalized infection
• Diabetes
• Hypoglycemia
• Some medications and poisons

Signs and Symptoms of Hypothermia

• Cool or cold skin temperature, abdomen changes, decreasing mental or motor function, poor coordination, memory disturbances, reduced or lost sensation to touch, mood changes, less communicative, dizziness, and difficulty speaking.

Signs and Symptoms (continued...)

• Stiff or rigid posture, muscular rigidity, shivering (present or absent), rapid or shallow breathing, slowly responding pupils, rapid or slow and weak pulse.
• Low or absent blood pressure, poor judgment (i.e., removing clothing), joint and muscle stiffness, initially skin may be red but becomes pale, cyanotic, stif and hard.

ECG Changes in Hypothermia

• Mainly occurring late
• Bradycardia that is unresponsive to Atropine (a substance that increases the heart rate)
• Small or absent P waves on the ECG
• Abnormal ST and T waves on the ECG.
• Development of Osborne or J waves.

Windchill

• Windchill measurements are provided in a table format that correlates wind speed and air temperature with the resulting windchill.
• Low temperatures combined with wind can result in rapid heat loss, increasing the risk of frostbite and hypothermia.

Immersion in Cold Water

• A table shows expected time intervals for death/injury according to water temperature.
• An antiexposure suit can increase survivability time.

BLS 3.4 Cold Injury Standard

• Move the affected person as soon as possible after primary assessment to prevent additional heat loss.
• Consider life-saving threats.
• Determine exposure duration and type.
• During secondary survey, only expose what is needed to be examined. Remove wet or constrictive clothing, jewelry

Emergency Medical Care for Generalized Hypothermia

• SAFETY! Remove the patient from the environment and protect from further heat loss or wind-chill
• Remove wet clothing
• Avoid rough handling as it triggers arrhythmias
• Do not let the patient exert themselves
• Administer warmed oxygen if possible
• Monitor core and cardiac rhythm

Mild to Moderate Hypothermia Treatment

• Wrap the patient in blankets (and then a foil blanket for further warmth retention if available)
• Use external re-warming techniques (e.g., hot packs to groin, axillary, and cervical regions)
• Keep your patient's compartment warm.

Severe Hypothermia Treatment

• Wrap the patient in blankets (and foil blanket for further warmth)
• Avoid vigorous suctioning or airway management.

Frostbite: Treatment

• Wrap the affected area in blanket and foil blanket
• Do NOT rub or massage the area
• Leave blisters intact
• Dress digits separately

Frostbite - Deep Cold Injury: Treatment

• Remove jewelry
• Cover the area with loose, dry clothing or dressings
• Do not break blisters, rub, massage, or apply heat directly.
• Do not rewarm
• Do not allow patient to smoke, drink alcohol or use affected extremity.

Heat Emergencies

• Heat gain exceeding heat loss, leads to hyperthermia.
• High ambient temperatures and humidity limit heat loss (reducing evaporation).
• Exercise and activity increase heat production, leading to electrolyte loss from sweat.

Heat Cramps

• Most common heat-related illness.
• Muscular spasms due to electrolyte loss from sweating.
• Important to correct electrolyte imbalances.

Heat Exhaustion

• Dehydration due to sweating without sufficient fluid/electrolyte replacement.
• Symptoms include headache, weakness, fatigue, dizziness, decreased appetite, nausea, vomiting (often mild to moderate elevations in body temperature).

Heat Stroke

• Potentially life-threatening condition.
• Body fails to regulate temperature.
• Symptoms are severe and include deep and rapid breathing, dilated pupils, rapid pulse, decreased blood pressure, altered levels of consciousness, hot red skin, possible seizures, and coma.

Drowning and Near Drowning

• Drowning: Death by suffocation following submersion.
• Near Drowning: Recovery from a drowning episode
• Secondary Drowning: death from complications arising after the submersion episode
• Causes: exhaustion, loss of support, getting caught in debris, poor judgment, drug/alcohol use, hypothermia, trauma, diving accidents.
• Factors Affecting Survival Rates: Water cleanliness, submersion time, victim health conditions (co-morbid factors), water temperature.

Drowning and Near Drowning—Treatment

• Safety! Assess for spinal injury in diving accidents , conduct full assessment
• Perform CPR and AED as needed
• Do NOT use Heimlich maneuver
• If possible, start resuscitation in the water.

Drowning and Near Drowning—Prevention

• Never attempt a rescue unless you are a good swimmer and trained, wearing a life vest, and accompanied by other rescuers.

Flat Water Drowning Locations

• Provides the percentage of drowning incidents for various locations (i.e., swimming pools, buckets, tubs, fish ponds, etc.)

Factors Affecting Survival

• PFD (Personal Flotation Device) usage is critical to prevent boating accidents.
• Water temperature, Hypothermia, and the Mammalian Diving Reflex directly affect survival rates.

In-Water Patient Immobilization

• This is a step-by-step procedure that includes stages, assuring adequate personnel and equipment are available from a safety perspective, and maintaining a protective approach.
• Stages include: maintaining the airway (C-spine stabilization) by a primary rescuer. A secondary rescuer secures the patient. Securing and immobilizing in a board. Moving the patient out of the water and onto land.

Moving Water Rescue Techniques

• For deep or dangerous water conditions, use reach, throw, row, or go techniques.
• Moving water (currents), water hazards (obstacles), and safety precautions.
• Special precautions are necessary in cases of rapid currents and eddies, as well as locations of submerged objects.

Obstructions to Flow

• Explains how low-head dams and other similar hazards can create dangerous currents, with diagrams

Strainers

• Obstructions in water. (Downed trees, grates, and mesh filter water.)
• Explain dangerous implications of strainers to people in flowing water.

Foot/Extremity Pins

• Hazards of walking in moving water, over depths greater than knee level.
• People might get trapped or knocked below the surface of the water by its force.

Moving Water Self-Rescue

• Self rescue techniques for those with little training in an active water scenario are covered.

Local Cold Injury

• Includes generalized and specific types of cold injuries.

Test your knowledge on the different types of drowning and their complications. This quiz covers essential topics such as secondary drowning and the effects on red blood cells. Learn how to respond in cold water drowning situations as well.