Water Emergencies
- Submersion Incidents
- Drowning
- Definition
- Incidence
- Predictors of morbidity and mortality
- Types
- Freshwater
- Saltwater
- Pathophysiology
- Little difference in patient lungs regardless of what type of water submersion occurred
- Submersion in cold water results in better survival than warm water
- Age is a factor due to cardiovascular health
- Duration underwater effects outcome
- Submersion in very cold water can produce cardiac disturbances
- Hypoxia from submersion is major factor in death
- Diving in shallow water can cause spinal trauma
- Prolonged hypoxia causes death of brain tissue
- Unique Signs and Symptoms
- Airway – obstructed with water immediately after rescue
- Breathing
- May be coughing if early rescue
- Agonal breaths if prolonged submersion
- Respiratory arrest if very prolonged submersion
- Circulation
- May be in cardiac arrest
- Skin is cyanotic
- Skin may be cold
- Assessment Considerations
- Airway, ventilation, and oxygenation
- Oxygen saturation may be difficult to obtain if patient is cold
- Use spinal precautions when opening airway to assess if risk of spinal trauma is possible
- Auscultate breath sounds
- Assess for presence of other injuries
- Obtain past medical history
- Airway, ventilation, and oxygenation
- Management Considerations
- Airway, ventilation, and oxygenation
- Suction and maintain open airway
- anticipate vomiting
- position lateral recumbent if no risk of spinal injury
- Ventilate with bag-mask if impaired ventilation or respiratory arrest
- Administer oxygen by non-rebreather mask if breathing is adequate
- Suction and maintain open airway
- Circulation
- If cardiac arrest is present, refer to current American Heart Association guidelines
- Defibrillate with AED if indicated (refer to current American Heart Association guidelines)
- Transport Considerations
- Transport to appropriate facility
- All patients who had submersion injury with any report of signs and symptoms during or after submersion need transport to the hospital
- Airway, ventilation, and oxygenation
- Drowning
Content Creator: Joyce Lockwood
CAPCE Course Number: 21-EMTP-F3-2207
Total CE Hours: 1
Level: Advanced
EMT-CE uses the NEMSES guidelines as the foundation for every course outline.