Drowning (for those with a duty to respond e.g. Lifeguards, watersport coaches)
(10 True/False questions with explanations)
At a potential drowning incident, your first priority is to ensure your own safety.
TRUE: If everybody ensures their own safety, then the group quickly becomes safe and can then focus on the needs of the patient in a controlled manner.
It may be necessary to move someone who has drowned, before trying to resuscitate them.
TRUE: You may have to move them for your own safety, or because you cannot perform effective Basic Life Support where they are. Use gloves where possible.
For the patient who is unresponsive and not breathing, then if they are on a slope, it is preferable to have the head below the level of the feet.
FALSE: It is preferable for the patient to be lying level. If the person does vomit, turn the head to face down the slope, roll them onto their side to assist drainage from the airway.
For someone dragged unresponsive from the water, if they are wearing a helmet, remove it.
TRUE: This is to do with DR ABC. Airway comes before breathing. The strap of the helmet can constrict the airway. The size and shape of the helmet can also make it difficult to tilt the head back to open the airway. Sort out the airway first.
Try to empty the lungs of water before trying to give rescue breaths.
FALSE: It is difficult to expel water from the lungs. It will achieve little but waste valuable time.
For someone suspected to have drowned, if they are not breathing normally, the next step is to call 999.
FALSE: The next step is to give 5 rescue breaths. To protect from cross infection use a pocket mask with a good quality filter.
Chest compressions can not be done effectively if someone is wearing a buoyancy aid (BA).
FALSE: Chest compressions can still be effective through the buoyancy aid (BA) if the patient is on a firm surface. If you can unzip the BA, or slip your hands underneath it, then you can be more confident with correct hand placement on the sternum. Alternatively, if it is a pull-over style of BA, start chest compressions and your team can help cut the BA as soon as they are able. Do not delay resuscitation because of the BA.
Due to the risk of CoVid19 cross infection, chest compression only Basic Life Support is an option and is as effective as giving rescue breaths
FALSE: Although it is an option for those who want to minimise the risk of covid transmission, it is not as effective as also providing rescue breaths. The person who is in a drowning incident needs oxygen to be pumped up to their brain as soon as possible. In an emergency situation that oxygen is best delivered by giving rescue breaths.
People who have been recovered from the water might vomit.
TRUE: Water can enter the stomach if someone is in the process of drowning. This can lead to vomiting. Turn the patient onto their side to allow the vomit or water to drain away. Reassess the patient and act accordingly.
Severe complications can develop several hours after submersion.
TRUE: Acute Respiratory Distress Syndrome can develop up to 72hrs after immersion. This can be fatal. If any water has entered the lungs it can damage them and start a chain reaction, eventually leading to severe breathing problems and even death. Anyone suspected of inhaling water into the lungs need to be checked out at A+E. If in doubt, go to A+E.
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