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Near-Drowning

(Drowning; Submersion Incident)

Definition

Near-drowning is respiratory impairment from being in or under a liquid. Normal air exchange is prevented by inhaled liquid when a person’s nose and mouth are under the surface of a liquid or when a person’s face comes in contact with liquid.

Causes

Near-drowning is caused by liquid, most commonly water, filling the lungs resulting in breathing problems. At first, the person will hold their breath. Eventually, the person will no longer be able to hold it. The liquid will then flow into the lungs. This liquid will not allow the normal gas exchange in the lungs to happen.

Risk Factors

Factors that may increase your chance of near-drowning include:
Children are most often the victims of near-drowning. The following factors increase a child’s risk of near-drowning:

Symptoms

Symptoms of near-drowning may include:
In some people, breathing problems may not happen until several hours after a near-drowning accident.

Diagnosis

A near-drowning injury will be diagnosed based on events and symptoms. A physical exam will be done.
Imaging tests can assess bodily structures. These may include:
Your doctor may need to test your body's oxygen levels. This can be done with:
Brain Damage from Lack of Oxygen
Brain Damage Oxygen
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Treatment

Call for emergency medical services right away. Treatment will depend on how badly the near-drowning episode damaged the body.

Emergency Response

Emergency response and first aid must be done quickly to restore breathing and prevent death.
  • Immediate cardiopulmonary resuscitation (CPR)—Done to provide oxygen-rich air to the vital organs of the body. This may involve giving rescue breaths or doing chest compressions. In all unconscious people and those who have been diving, the head and neck should be supported in case of injuries to the spine.
  • Warming treatments—Done if the body's temperature dropped after being in cold water (hypothermia). They are done slowly to avoid further injury to the body.
  • Endotracheal intubation—A narrow tube is placed into the trachea (windpipe) to maintain an open airway.
Nasogastric (purple) and Endotracheal Intubation
FI00035 96472 1 Endotracheal and Nasogastric Tube Insertion
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Follow-up Care

Near-drowning can cause delayed complications from the incident or treatment. Further treatment that is needed depends on what the complications are and their severity.
Complications may include:

Prevention

To help reduce chances that that you or someone you know will drown, take the following steps:

RESOURCES

American Red Cross http://www.redcross.org

Healthy Children—American Academy of Pediatrics http://www.healthychildren.org

CANADIAN RESOURCES

Canadian Red Cross http://www.redcross.ca

Children’s Safety Association of Canada http://www.safekid.org

References

Driscoll TR, Harrison JA, et al. Review of the role of alcohol in drowning associated with recreational aquatic activity. Inj Prev. 2004;10(2):107-113.

Drowning and near-drowning in children and adolescents: A succinct review for emergency physicians and nurses. Pediatr Emerg Care. 2005;21(9):617-619.

Harries M. Near drowning. BMJ. 2003;327(7427):1336-1338.

Near-drowning. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated March 8, 2013. Accessed November 7, 2014.

Salomez F, Vincent JL. Drowning: A review of epidemiology, pathophysiology, treatment, and prevention. Resuscitation. 2004;63(3):261-268.

Sibert J, John N, et al. Drowning of babies in bath seats: Do they provide false reassurance? Child Care Health Dev. 2005;31(3):255-259.

Szpilman D, Bierens JJ, et al. Drowning. N Engl J Med. 2012;366(22):2102-2110.

5/28/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Committee on Injury, Violence, and Poison Prevention. Policy statement—Prevention of drowning. Pediatrics. 2010;126(1):178-185.

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