Types of drowning, first pre-medical emergency medical care for drowning.

There are three types of drowning. Drowning can be primary wet, dry and secondary. In addition to drowning, sometimes death occurs in water caused by various injuries, heart diseases, brain disorders, and so on..

Types of drowning, first pre-medical emergency medical care for drowning.

Drowning is possible under a variety of circumstances:

1. From injury sustained in water.
2. In case of sudden cardiac arrest.
3. In case of cerebrovascular accident.
4. Spasm of the larynx and inability to inhale and exhale:
because of fear;
sudden cooling when suddenly exposed to very cold water.

Types of drowning.

Primary (true) drowning.

This is the most common form of drowning. The drowning man does not immediately plunge into the water, but tries to stay on the surface, in a panic, he begins to make feverish and erratic movements of his arms and legs. The most common form of water accident..

With it, fluid enters the respiratory tract and lungs, and then enters the bloodstream. When inhaling, the drowning man swallows a large amount of water, which overflows the stomach, while falling into the lungs. A person loses consciousness and sinks to the bottom. Oxygen starvation hypoxia gives the skin a bluish color, so this type of drowning is also called blue.

. The basis of this is the body’s reflex reaction to the ingress of water into the respiratory throat or ear when there is damage to the eardrum. Secondary drowning is characterized by a pronounced spasm of peripheral blood vessels. Pulmonary edema, as a rule, does not develop. Such drowning occurs when a person does not try or cannot fight for his life and quickly sinks.

This often happens during shipwrecks at sea, the overturn of boats, rafts, when a person plunges into the water in a state of panic fear. If the water is also cold, then this can lead to irritation of the pharynx and larynx, which in turn often leads to sudden cardiac arrest and breathing. This type of drowning can also occur if a person in the water has a head injury or has already fallen into the water with it. In this case, a quick loss of consciousness occurs. The skin is characterized by increased pallor, hence the name of the type.

Rescue of the drowning.

When rescuing a drowning person, do not grab him by the hair or by the head. The most reliable and safe way to grab it under your armpits, turn your back to yourself and swim to the shore, trying to keep the victim’s head above the water.

State of victims of drowning.

It is associated with the duration of being under water, with the type of drowning and the degree of cooling of the body. In mild cases, consciousness is preserved, but excitement, trembling, repeated vomiting are noted. With prolonged exposure to water, with true or dry drowning, consciousness is impaired or completely absent, the victims are very excited, there may be convulsions, and the skin is bluish. With secondary drowning, marked pallor of the skin is noted, the pupils are dilated. Victims have bubbling rapid breathing.

When drowning in sea water, pulmonary edema quickly develops, and the heartbeat becomes more frequent. When drowning is prolonged and secondary, the victim can be recovered from the water in a state of clinical or biological death. 

Emergency Drowning Care.

Regardless of the type of drowning, help should be provided immediately, otherwise irreversible brain changes occur. With true drowning, this occurs within 4-5 minutes, in other cases after 10-12 minutes. First aid on the shore will be different with blue and pale drowning. In the first case, it is necessary first of all to quickly remove water from the respiratory tract. For this, standing on one knee, lay the victim on a bent second leg so that the lower part of the chest rests on it, and the upper body and head hang down.

After that, you need to open the victim’s mouth with one hand and pat him on the back with the other, or gently press on the ribs from the back. Repeat these steps until the rapid flow of water stops. Then perform artificial respiration and indoor cardiac massage. With a pale type of drowning, artificial respiration is necessary immediately, and when the heart stops, a closed massage. Sometimes in the airways of the drowned person are large foreign bodies that get stuck in the larynx, as a result of which the airways become impassable or a persistent spasm of the glottis develops. In this case, a tracheostomy is performed..

With any type of drowning, it is strictly forbidden to turn the victim’s head, as this can cause additional trauma in case of a possible fracture of the spine. To prevent the head from moving, place rollers from tightly twisted clothes on both sides, and if necessary, turn over the victim, while one of the assistants should support the head, preventing it from moving independently.

Resuscitation, in particular artificial respiration, must be continued, even if the victim develops spontaneous breathing, but there are signs of pulmonary edema. Artificial respiration is also carried out when the victim has a respiratory failure (i.e., his frequency is more than 40 in 1 minute, irregular breathing and a sharp blue skin). If breathing is maintained, then the patient should be allowed to breathe ammonia vapor. If the rescue of the victim was successful, but chills beats him, you need to rub the skin, wrap it in warm, dry blankets. You can not use heaters in the absence or impaired consciousness.

In severe types of drowning, the victim must be delivered to the intensive care unit. During transportation, mechanical ventilation should be continued. An emergency doctor or a resuscitation department of a hospital with respiratory failure and pulmonary edema in the victim introduces a breathing tube into the trachea and connects it to a device or mechanical ventilation device.

Previously, a probe is inserted into the stomach of the victim. This will prevent the contents of the stomach from entering the airways. The patient must be transported in a supine position with the headrest of the stretcher lowered. It is dangerous to prematurely stop mechanical ventilation. Even if a person has independent respiratory movements, this does not mean the restoration of normal breathing, especially with pulmonary edema.

When drowning in fresh water, the victim in a hospital setting with a sharp bluish blue, swelling of the cervical veins sometimes bleed. With a pronounced decay of red blood cells, a solution of sodium bicarbonate, red blood cells, and blood plasma are intravenously transfused. To reduce edema, diuretics, such as furosemide, are administered. Decreased protein in the body is an indication for transfusion of concentrated albumin.

With the development of pulmonary edema against the background of arterial hypertension, a 2.5% solution of benzohexonium or 5% solution of pentamine, glucose solutions are intravenously administered. Apply large doses of hormones: hydrocortisone or prednisone. Antibiotics are prescribed to prevent pneumonia. To calm down with motor excitement, 20% sodium oxybutyrate solutions, 0.005% fentanyl solution or 0.25% droperidol solution are intravenously administered.

Based on the book “Quick help in emergency situations”.
Kashin S.P..

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