Introduction
There are an estimated 8,000 deaths per year in the United States from drowning. Near-drowning occurs anywhere from 2-20 times more frequently (for estimated 16,000-160,000 events per year)7. The definitions for drowning and near-drowning have for the longest time been very confusing to understand. Recent health officials have attempted to resolve some of this confusion by redefining drowning as “the process of experiencing respiratory insufficiency or difficulty following a submersion or immersion in a body of liquid.” Near-drowning has also been redefined as “survival from a drowning event which involved impaired consciousness or water inhalation for 24 hours or more”2. Both near drowning and near-drowning occur when someone experiences a submersion event. A submersion event is when someone, in this case a pediatric patient, experiences an unexpected submersion in water. When an unexpected submersion, regardless of water type (salt or fresh) occurs, the individual experiences breath hold, panic, and a struggle to resurface1. Humans, naturally, can only hold their breath for a short period of time. This prolonged breath hold results in hypoxia and eventually leads to involuntary gasping. As the individual attempts to gasp for air they sometimes aspirate7. This paper will attempt to look at the clinical presentation of a near-drowning patient who has suffered from a submersion event.
Research
It was previously thought that the type of water aspirated posed a serious threat to the patient and drastically increased their chance of mortality. In particular, salt water was thought to be one of the more potent types of water to aspirate due to it’s tonicity. This previous thought that salt water was more harmful to...
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4. Oehmichen, M, Hennig, R, and Meissner, C (2007). Near-drowning and clinical laboratory changes. Legal Medicine;10:1-5.
5. Gregorakos, L, Markou, N, Psalida, V, Kanakaki, M, Alexopoulou, A, Sotiriou, E, Damianos, A, Myrianthefs, P (2009). Near-drowning: clinical course of lung injury in adults. Acute Lung Injury;187:93-97.
6. Beeck, EF, Branche, CM, Szpilman, D, Modell, JH, and Bierens, JJ (2005). A new definition of drowning: towards documentation and prevention of a global public health problem. World Health Organization;83(11):853-856.
7. Ender, PT, and Dolan, MJ (1997). Pneumonia Associated with Near-Drowning. Clinical Infectious Diseases;25:896-907.
8. Leroy, P, Smismans, A, and Seute, T (2006). Invasive pulmonary and central nervous system aspergillosis after near-drowning of a child: case report and review of literature. Pediatrics;118(2):509-513.
Many have been told to follow the eight x eight dictum, but as said in the article no scientific studies support that notion. It's even said that doing that can be harmful to you. The way water is dangerous too you if overdone, is the kidneys cannot flush it out fast enough and the blood becomes waterlogged. This can result in your cells swelling to accommodate all the water. The real danger though is hyponatremia, where the cells reach the brain and neurons, and when your neurons become waterlogged it can be very dangerous as said in the article “hyponatremia causes entry of water into brain cells leading to brain swelling, which manifests as seizures, coma, respiratory arrest, brain stem herniation and death”. Proving further that water can be
British Thoracic Society, (2008), Guideline for Emergency Oxygen Use in Adult Patients, Thorax: an International Journal of the Respiratory Medicine, 63 (6), DOI: 10.1136/thx.2008.102947
N.A. “Traffic Safety facts 2011: Alcohol-Impaired Diving.” National Highway Traffic Administration. 2012. Web. 2 April 2014. .
The term “failure to rescue” refers to a clinical scenario where hospital doctors, nurses, or caregivers fail to recognize symptoms. Responders do not respond adequately to clinical signs that would prevent harm (Morse, 2008, p.2). Dr. Jeffery H. Silber, Director of the Center for Health Outcomes and Policy Research, first coined the term “failure to rescue” in the 1990’s. He characterized the matrix of institutional and individual errors that contribute to patient deaths as “failure to rescue” (Aleccia, 2008). Since 1990, it has been well documented patients usually exhibit signs and symptoms of impending cardiac or respiratory arrest 6-8 hours before an arrest (Schein, Hazday, Pena, Ruben, & Spring, 1990). Buist, Bernard, Nguyen, Moore, and Anderson’s (2004) research reported similar findings. They found patients had documented clinically abnormal signs and symptom prior to arrest (Buist, et al., 2004). When certain abnormal signs and symptoms are identified early, critical bedside consultat...
Schwarz, J. (2007). Exploring the option of voluntarily stopping of eating and drinking within the context of a suffering patient's request for a hastened death. From http://web.a.ebscohost.com.ezproxy.pstcc.edu:2048/ehost/detail?vid=4&sid=6385b97a-9fde-4480-980a-4c8ed8929923%40sessionmgr4003&hid=4107&bdata=JnNjb3BlPXNpdGU%3d#db=nyh&AN=27970586 received 2/04/14
Kemp, J. S. et al. Unintentional Suffocation by Rebreathing: A Death Scene and Physiologic Investigation of a Possible Cause of Sudden Infant Death. Journal of Pediatrics. 1993;122:874-880.
Imagine you have just been brought into a small, gray room. In the middle of it, you see a chair; Almost like a dentist chair. The interrogator straps you in it so you can’t move. You feel hopeless as your arms and legs are being strapped to the table. They recline you backwards so your feet are above your head. Then, they take a wet towel and slap it over your head. Your breath starts to get louder, louder, and louder until it feels like you can’t breath. Then, the water comes. Down your mouth, nose, and into your lungs. You are coughing and trying to ask for mercy but you can’t say anything. The water keeps coming while the interrogator screams at you. You feel helpless and you feel the life sucking out of you. Waterboarding should not continue
...o those patients with chest pain, in order to maintain oxygen saturations as close to 100%, unknowingly realizing that the patient is being exposed to significant periods of hyperoxia (Moradkham & Sinoway, 2010 ). It has been suggested that this is due to poor monitoring skills by health professionals. (Moradkham & Sinoway, 2010 ). From reading this essay it is clear that there is a high demand and need of further clinical research into the effectiveness of oxygen in the client with chest pain. More research also has to be conducted in order for the health professionals to fully understand what oxygen does to the body. Through completing and implementing more updated and reviewed evidence and research on the effect of oxygen on the client with chest pain, a better practice can be put in place to ensure the patient is receiving the best care to save their life.
Legal justification for waterboarding is based on the argument that it does not specifically intend to enforce extreme suffering, physical, or mental pain. Some experts say the feeling of drowning a person has no real physical pain because the person is not being put in any harm or pain physically or mentally. The part of the who may be suffering is not the victim because the period of time is not long enough as it is not a protracted A mount of time occurring. This argument point is that integrators go through training in person I get water boarded themselves by a fellow member and do not experience any physical or mental health problems further down the road in life because of that experience.
Upon reviewing the case, it was reported that the patient— a 45-year-old male with a history of traumatic brain injury (TBI), limited use of extremities and contractures of his left elbow and shoulder1— was unattended during aquatic therapy as the physical therapist (PT) was assisting another patient. After allowing the patient to walk around the pool by himself holding onto the handrail, a physical therapy aide found the patient submerged. CPR was administered by the physical aide and the patient was taken to the hospital where he remained for about one month to get treatment for adult respiratory distress syndrome and aspiration pneumonia.
I just pulled it out and then stepped onto the beach. I felt the sand flow through my toes as my foot indented the sand. I put on my wet suit and my snorkel mask and headed out. Getting my body up to my chest in the water was easy but my head was hard. After giving myself a pep talk, I dunked my head under water. For the first 5 seconds I had my eyes closed because of the cold water. I immediately forgot about the cold as soon as my eyes opened. I saw a bunch of tropical fish and was amazed. As I went deeper I saw more and more fish and coral. I saw an angel fish and decided to dive down to it. After about 4 feet down I could feel the pressure on my body from all sides. I felt like gravity turned upside down as I tried to swim deeper. My lungs felt like a vacuum that was imploding on itself. I then had to surface. I knew that my mom m used to be a life guard so I asked her for help. She told me to take 3 deep breathes before diving down and that I should mainly use my legs for power. I tried it and I was able to reach the angelfish. After about 20 minutes I started to really feel the cold. On my way in I saw my first sea turtle! I called for my family and they came over to see it. I was careful to not swim over it so that
These films consume most of the morning of training, but once the films have finished, the in-water tests begin. The pool training and testing is the most difficult and can make or break a guard. In-water testing consists of three exams; swimming a 500, retrieving a brick, and treading water. When swimming the 500, a trainee can use whatever stroke they'd like and goggles as oppose to the other tests. Retrieving the brick can be strenuous, especially when the black brick is dropped on the black line. Diving down into the 13 foot pool to recover a camouflaged object, then backstroking with the brick on your chest above water signifies what saving a submerged victim would resemble. Personally, treading water for three minutes was the hardest part, solely because trainees could not use hands to keep a steady pace. After finishing the water tests, the training portion then begins. For instance, we learned in-water back-boarding, saving submerged or struggling victims, deep water saving, and how to enter the pool depending on the victim’s status. If the swimmer is immobile and floating atop the water, for example, guards are to enter the water slowly to decrease the chance of paralysis. After learning and acquiring skills in the water, we then learn proper CPR depending on the status of the victim. One of the most
The categories of the different types of asphyxia deaths are classified as mechanical, chemical, environmental, and pathological asphyxia. Mechanical asphyxia is the interference of respiration by hanging, strangulation, smothering, gagging, choking, and drowning (TASA Group). Chemical asphyxia is the inhalation of a gaseous substance that effects the body’s utilization oxygen. Examples of the common substances that initiate asphyxia are helium, methane, nitrogen and argon (emedicine). This type of asphyxia is commonly used as a form of suicide from the use of inert
About two years ago; we were in the keys on the southern tip on Florida, and had just boarded a fairly homely dive boat for my first ocean dive ever. My Father and I had been planning this trip for months, and today was the day it would happen. As the sound of the motors choking to start came into my ears, and the smell of the gasoline seeped into my nostrils I imagined where we were going to be in an hour. We both glared at each other every few minutes as we scurried around the deck of the boat. The boat was cluttered with Scuba cylinders, Buoyancy Compensators, Regulators, dive lights, and my wetsuit, which I had just picked up.