Drowning & First Aid Response
There is always danger when water is present. Death can occur rapidly as a result from submersion in water. In this paper I will discuss the management of drowning and hypothermia. Information on water hazards and preventive measures, the risks associated with rescuing people from the water, and the pathophysiology of drowning and hypothermia.
The term drowning refers to submersion in water, or when the mouth and/or nostrils become immersed in a liquid, causing suffocation. Death may occur as a result of pathophysiological effects other than simple asphyxiation, such as rapid fluid change and electrolyte balance, or cardiac arrest. (Pounder, 1992) Immersion syndrome is sudden cardiac arrest in cold water. It may be a vagal response coupled with vasoconstriction, which may result in vagal inhibition leading to sudden stoppage of the heart muscle. (Draper, 2008) Rarely, but especially in children, cold water shuts the body down.
The heart rate drops and blood vessels constrict in major organs and muscles, so that the heart and brain functions are ceased. Hypothermia sets in and the body's demand for oxygen drops dramatically. (Nemiroff 1991, Draper 2008, The Merck Manuals 2009, Verive 2009)
The Five Phases of Drowning:
Submersion is followed by struggle, which subsides with exhaustion, and drowning begins.
Breath-holding lasts until carbon dioxide accumulates stimulation respiration, resulting in inhalation of water.
Gulping of water, coughing and vomiting is followed by loss of consciousness.
Profound unconsciousness and convulsions are associated with involuntary respiratory movements and the aspiration of water.
Death typically occurs within two to three minutes and is almost inevitable when the period of submersion exceeds ten minutes.
According to the Water Safety Forum (NWSF 2009a), most incidents occur in domestic settings such as baths, garden ponds, water filled containers and other locations. Responding quickly and knowing...