Drowning

Drowning DR MAHMOUD MOHAMED MAHMOUD

Drowning ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

2002 World Congress on Drowning ,[object Object],[object Object],[object Object],[object Object],[object Object]

Near Drowning ,[object Object],[object Object]

Statistics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

EPIDEMIOLOGY ,[object Object],[object Object],[object Object],[object Object],[object Object]

Morbidity & Mortality ,[object Object],[object Object]

Drowning modalities ,[object Object],[object Object],[object Object]

Bucket drownings ,[object Object],[object Object],[object Object],[object Object]

Tub drownings ,[object Object],[object Object],[object Object]

Baby swim classes ,[object Object],[object Object],[object Object],[object Object]

Near Drowning Groups at Risk ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Near Drowning Risk Factors: Age

Toddler Drownings ,[object Object],[object Object],[object Object],[object Object]

Causes of Near Drowning Recreational Boating ,[object Object],[object Object],[object Object],[object Object],[object Object]

Other Causes Diving Injuries ,[object Object],[object Object],[object Object],[object Object],[object Object]

Other Causes Spas, Hot Tubs ,[object Object],[object Object],[object Object],[object Object]

Near-Drowning Epilepsy ,[object Object],[object Object],[object Object],[object Object],[object Object]

Near-Drowning Long QT Syndrome (LQTS) ,[object Object],[object Object],[object Object],[object Object],[object Object]

The event, part 1 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

The event, part 2 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Pathophysiology with aspiration ,[object Object],[object Object],[object Object],[object Object]

Pathophysiology with aspiration ,[object Object],[object Object],[object Object]

Pathophysiology without aspiration ,[object Object],[object Object],[object Object]

Pathophysiology ,[object Object],[object Object],[object Object],[object Object]

Pathogenesis 1 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Pathogenesis 2 ,[object Object],[object Object],[object Object],[object Object]

Salt vs Fresh There are REAL differences Salt vs Fresh

Atelectasis Aspiration leads to collapse of the alveoli due to loss of surfactant and pulmonary edema normal alveoli surfactant collapsed alveoli

Pulmonary Edema capillary Interstitial fluid shift Alveoli O 2 CO 2 Reduced perfussion O 2 CO 2

Potential Fresh Water Damage ,[object Object],[object Object],[object Object],[object Object]

Drowning ,[object Object],[object Object],[object Object],[object Object]

Near Drowning Multi-Organ Effects ,[object Object],[object Object],[object Object],[object Object]

ASPHYXIA ,[object Object],[object Object],[object Object],[object Object],Central Nervous System 1. anoxic damage 2. defective autoregulation 3. cerebral edema 4. increased ICP Renal 1. acute tubular necrosis 2. acute cortical necrosis Cardiac 1. myocardial ischemia 2. fibrillation Asphyxia low BP

[object Object],[object Object],[object Object],VASODILATION decreased ICP decreased BP CENTRAL NERVOUS 1. reduced metabolism 2. reduced ICP 3. ?protection? 4. may produce picture of clinical death DEATH RENAL FAILURE Rogers, Pediatric Critical Care

WATER OVERLOAD ,[object Object],[object Object],[object Object],[object Object],Central Nervous System 1. cerebral edema 2. intracranial hypertension Dilution Effects 1. hypokalemia 2. hemodilution 3. hemolysis Gastrointestinal 1. gastric distension 2. vomiting, aspiration 3. ileus Water Overload

Near Drowning Multi-Organ Effects ,[object Object]

Near Drowning CNS Injury ,[object Object],[object Object],[object Object],[object Object],[object Object]

Near Drowning Pulmonary Injury ,[object Object],[object Object],[object Object],[object Object],[object Object]

Near Drowning Pulmonary Injury: Fresh Water vs. Salt Water ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

The Bottom Line Fresh Water and Salt Water ,[object Object],[object Object],[object Object],[object Object]

Labs & tests ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Essential First Aid Management ,[object Object],[object Object],[object Object],[object Object],[object Object]

Treatment Transport ,[object Object],[object Object],[object Object],[object Object]

Immediate hospital management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Treatment Emergency Department ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Predicting Ability for ED Discharge ,[object Object],[object Object],[object Object],[object Object],[object Object]

The problem with looking well ,[object Object],[object Object],[object Object]

ICU Management Strategies Intubation/Ventilation ,[object Object],[object Object],[object Object],[object Object],Indications

ICU Management Strategies Respiratory ,[object Object],[object Object],[object Object],[object Object]

Management Strategies Cardiovascular ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Management Strategies Central Nervous System ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Management Strategies Central Nervous System ,[object Object],[object Object],[object Object]

ICU Management Strategies ,[object Object],[object Object],[object Object],Other Issues

Bad prognostic indicators ,[object Object],[object Object],[object Object],[object Object],Age <3 years CPR in ER Initial ABG pH <7.1 Initial core temp <33o

Neurologic prognosis ,[object Object],[object Object],[object Object]

Near Drowning The Best Approach Therefore: ,[object Object],[object Object],[object Object]

Near Drowning Keeping Your Child Safe ,[object Object],[object Object],[object Object]

Children with Epilepsy: Safety Recommendations ,[object Object],[object Object],[object Object],[object Object]

Near Drowning Swimming Pool Lore ,[object Object]

Recommendations ,[object Object],[object Object]

Recommendations ,[object Object],[object Object],[object Object]

Drowning

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