When we talk about drowning we are talking about a diagnosis of death, so it would be more correct to talk about “semi-drowning,” by which we denote the condition of a subject to have survived suffocation by immersion. The greatest risk of this eventuality is related to aspiration of water into the airway. This leads to loss of consciousness and the need for patient care.
The water could be hypertonic or hypotonic. In the first case the patient will encounter hemoconcentration, in the second a Hemodilution and hemolysis. The tests to be performed are arterial blood gas analysis, pH and bicarbonates. In fact, it happens that most drowned people are In acidosis, initially respiratory and metabolic, then metabolic type.
Principles of therapy
It is first necessary to take the patient out of the water, trying to reach it with the help of a rope or stick. Pending of transportation to the hospital, immediately disostruct the oral cavity, practice mouth-to-mouth or mouth-to-nose breathing and keep the patient on a flank.
In resuscitation it is necessary:
- Postural drainage
- Oxygen therapy
- Possible intubation
- Correction of acidosis and volemia
- Monitoring and support of cardiovascular function
- Treatment of any neurological complications
- Antibiotic therapy
Prognosis is related to early intervention and is usually favorable and free of long-term sequelae.
Source: Medical Guard Handbook edited by Piercarlo Salari
