NURS 287 Lecture Notes - Mammalian Diving Reflex, Septic Arthritis, Drowning
28 Apr 2013
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Document Summary
Submersion injury results when a person becomes hypoxic due to submersion in a substance, usually water. Drowning is death from suffocation after submersion in water or other fluid medium. Near-drowning is defined as survival from potential drowning. Immersion syndrome occurs with immersion in cold water, which leads to stimulation of the vagus nerve and potentially fatal dysrhythmias. Aggressive resuscitation efforts and the mammalian diving reflex improve survival of near-drowning victims even after submersion in cold water for long periods of time. Treatment of submersion injuries focuses on correcting hypoxia, acid-base imbalances, and fluid imbalances; supporting basic physiologic functions; and rewarming when hypothermia is present. Initial evaluation involves assessment of airway, cervical spine, breathing, and circulation. Mechanical ventilation with positive end-expiratory pressure or continuous positive airway pressure may be used to improve gas exchange across the alveolar-capillary membrane when significant pulmonary edema is present. Deterioration in neurologic status suggests cerebral edema, worsening hypoxia, or profound acidosis.
