Orlando Health Emergency Medicine
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 Drowning vs near-drowning? Wet vs dry?
Primary vs secondary? A process resulting in primaryrespiratory impairment fromsubmersion/immersion in a liquidmedium. Epidemiology Estimated 500,000 deaths per year,worldwide Pathophysiology Submersion Breathholding Air hunger Reflex gasping Aspiration Salt vs Fresh water? Salt vs Fresh water? Surfactant washout Atelectasis VQ mismatch Pulmonary edema ARDS H+ O2 Management Pre-hospital 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 cardiacdysrhythmia due to sudden contact withcold water ASSOCIATED WITH CONGENITALPROLONGED QT SYNDROME Caused by V.fib/Asystole secondary tocatecholamine release in response toquick temperature change CXR Routine steroids or antibiotics NOTrecommended Disposition Symptomatic patients - admit forobservation, supplemental O2 Asymptomatic - observe for 4-8 hours Prevention Fences around pools Swimming lessons
Close monitoring of infants/children Avoiding alcohol/drug use whileswimming Thank you!