Korean drowned - Panglao, Bohol, Philippines

[Colliam7]

How did the diver drown when he/she never submerged under water?

(https://www.ajc.com/news/national/d...cognize-the-signs/VR0Sf0mMBxkUcZjMwo9HYM/)You can 'drown at the surface', by aspirating a sufficient quantity of water to block the airways, or inhibit gas exchange in the lungs. And, it may take only 20-60 seconds to lose consciousness. Plus, just because a victim is at the surface doesn't mean their mouth / nose is out of the water.

There was a video posted of the CPR attempt but sadly the person administering the CPR did know what he was doing. He gave the victim chest compressions only... NO BREATHS OF AIR!!!

Well, that may not necessarily have been a reflection that the person 'did not know what he was doing'. There are data (https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.112.124115) that support the benefits of compressions-only CPR, compared to traditional chest compressions+rescue breaths.

In this case, I tend to agree with your concern, because the primary issue was probably not cardiac arrest, rather airway compromise associated with (probable) aspiration of sea water. But, studies have also shown that rescue breathing administered by laypersons is often inefficient, and takes time away from chest compressions, which are actually more important - to circulate even partially oxygenated blood to the brain and vital organs.

 

[DandyDon]

There are data (https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.112.124115) that support the benefits of compressions-only CPR, compared to traditional chest compressions+rescue breaths.

I don't think that applies to drownings, or young children.

 

[Colliam7]

I don't think that applies to drownings, or young children.

There are no specific data on young children, but the concept is equally applicable. In this case the victim was a 34 y.o. adult, anyway.

The issue to consider - and where I tend to understand the comment from SirRat, as well as the point that I think you are making - is that those data regarding the efficacy of chest compressions-only CPR come from patients in which cardiac arrest was the probable initiating event. In this case, asphyxsiation (respiratory failure) was the probable initiating event. So, we do not know for certain whether the data apply.

The problem with this case is, without clearing the airway of the aspirated water, even rescue breaths would be of limited benefit from the perspective of gas exchange.

 

[DandyDon]

There are no specific data on young children, but the concept is equally applicable. In this case the victim was a 34 y.o. adult, anyway.

Yeah, the suggestion for young children is not well defined, like how young is rescue breathing needed, but I was referring the fact that he drowned, and rescue breathing is suggested for drownings. The popular push to encourage chest compressions-only undermines that need.

 

[Radoo]

The problem with this case is, without clearing the airway of the aspirated water, even rescue breaths would be of limited benefit from the perspective of gas exchange

21% even with impaired gas exchange is better than 0%.

 

[npole]

Compression only CPR is part of the CPR procedures. There's some reason of why it's performed (one of those is personal safety). If you take a CPR course (that I would recommend to anyone) you'll learn this bits (and much more).

 

[InTheDrink]

21% even with impaired gas exchange is better than 0%.

Not if your lungs are full of water.

I had IPE and no amount of constant flow 100% o2 was reviving me until someone pushed some of the gunk from my lungs.

I certainly wouldn’t dream of blaming the attempted rescuers here but in cases of drowning you need to get at least some fluid out of lungs as well as compressions.

Thx

 

[InTheDrink]

Not if your lungs are full of water.

I had IPE and no amount of constant flow 100% o2 was reviving me until someone pushed some of the gunk from my lungs.

I certainly wouldn’t dream of blaming the attempted rescuers here but in cases of drowning you need to get at least some fluid out of lungs as well as compressions.

Thx

Ok so I kinda contradicted myself. Apologies.

(Hard) rescue breaths with drowning may create enough space for any level of O2 to start helping so @Radoo yes pushing any gas in there is helpful even if just initially to get rid of some water/crap.

 

[Radoo]

IPE it’s a different story - the fluid is in a different space (alveoli) and there is no other way to get rid of it other than using diuretics/diuresis.
In a drowning patient you have mechanical obstruction of the airway but at least initially you don’t have much fluid where the gas exchange happens. Trying to remove the fluid using mechanical methots (Heimlich manoeuvre) is no longer recommended but you can use simple airway opening manoeuvres (head tilt/chin lift) which are usually sufficient.
Hypoxia is the main cause of deaths in drowning victims so oxygen delivery by any mean can only improve the outcome.

 

[BlueTrin]

What’s the correct way to get water out of the lungs ?

I think during my rescue class I was only shown how to open the airways by tilting the head a bit backwards using I think a pistol grip