Near Drowning Treatment - Secondary Drowning

[sipadiver]

Hi,

I have a question about the treatment for near drowning victims.

If the victim has a near drowning experience or has swallowed a considerable amount of water, obviously sending the person to a hospital would be the next step to prevent secondary drowning / dry drowning.

But what if there is no hospital near by? And you lack a oxygen tank?

If I remember correctly, the victim is suppose to be propped up, not lying down and kept reasonable warm and comfortable- and obviously monitored while medical help is sought.

Is that correct? And is there more I can do?

This is a hypothetical question. I and no one that I know is in any danger.

 

[Duke Dive Medicine]

Hi sipadiver,

Part of the problem is swallowing water, which can alter the body's electrolyte balance (salt water is more likely to do this than fresh, given equivalent volumes). The other serious potential issues are pulmonary edema (swelling of the lung tissues) from aspirating even relatively small amounts of water and pneumonia from aspirating mud, seaweed, gunk, etc. These can't be treated effectively without specialized equipment.

The best thing you can do absent medical help is exactly what you said, which is monitor the victim and support breathing if necessary. If you are planning on being distant enough from a hospital where you could encounter this situation, at a minimum I'd recommend investing in a large O2 tank, a bag valve mask with a PEEP valve, a portable manual suction device, and a satellite phone; and getting trained as an EMT. Or, ensuring that those resources are available at your dive site.

Best regards,
DDm

 

[Rred]

If you need medical help and it is not available, you die. (We all will, sooner or later.) Just something to consider when you are in remote areas for any reason. So training, equipment, and a means to try getting a medevac are all worth considering.

More practically, Doc? Would you keep the victim on their side (to help keep the throat clear) or perhaps in the Trendelenburg position, to help any material left in the lungs to be spat out? As opposed to letting them sit/stand in any normal way, which just traps things in the lungs?

 

[Duke Dive Medicine]

If you need medical help and it is not available, you die. (We all will, sooner or later.) Just something to consider when you are in remote areas for any reason. So training, equipment, and a means to try getting a medevac are all worth considering.

More practically, Doc? Would you keep the victim on their side (to help keep the throat clear) or perhaps in the Trendelenburg position, to help any material left in the lungs to be spat out? As opposed to letting them sit/stand in any normal way, which just traps things in the lungs?

Red,

The best position for someone in respiratory distress is typically Fowler's or high Fowlers (sitting up). If there were any large pieces of solid material in the lungs they would probably have to be removed via bronchoscopy. Liquid material and small solid particles are mixed with mucus and moved up the bronchial tree via ciliary action.

Best regards,
DDM

 

[Rred]

Thanks Doc. that's valuable to know.

"removed via bronchoscopy" Well, that ain't gonna happen until the medevac crew gets the victim off the boat. Just can't seem to find any decent $20 bronchoscopy kits on Amazon!