Summary about Disease
Near drowning, also known as non-fatal drowning, refers to survival after an incident involving submersion in a liquid that causes respiratory impairment. It's an event where someone experiences breathing difficulties and potential organ damage due to being underwater or submerged in a liquid. The person is rescued and survives, but may have a range of complications depending on the severity and duration of the submersion. It's considered a medical emergency requiring immediate intervention.
Symptoms
Symptoms can vary greatly depending on the length of submersion and the individual's health. Common symptoms include:
Coughing
Difficulty breathing or shortness of breath
Chest pain
Frothy sputum (pink or white)
Vomiting
Altered mental status (confusion, disorientation, lethargy, or unresponsiveness)
Bluish skin (cyanosis)
Rapid heart rate
Low blood pressure
Hypothermia (low body temperature)
Seizures
Causes
Near drowning is caused by immersion in a liquid leading to:
Laryngospasm: Involuntary spasm of the vocal cords, preventing air from entering the lungs.
Aspiration: Inhaling fluid (water, vomit) into the lungs.
Hypoxia: Lack of oxygen to the brain and other vital organs due to impaired breathing.
Risk factors: Lack of swimming ability, alcohol or drug use, seizures, heart conditions, trauma, hyperventilation before swimming, shallow water blackout, and unsupervised access to water (especially for young children).
Medicine Used
Treatment for near drowning involves supportive care and addressing specific complications. Medications may include:
Oxygen: Supplemental oxygen to improve blood oxygen levels.
Bronchodilators: To open airways (e.g., albuterol).
Diuretics: To reduce fluid in the lungs (e.g., furosemide).
Antibiotics: If pneumonia develops.
Vasopressors: To increase blood pressure if it is low.
Sedatives: To control agitation or seizures (e.g., lorazepam).
Induced Coma: In some instances, a medically induced coma is performed to minimize brain damage.
Is Communicable
Near drowning is not communicable. It is not an infectious disease and cannot be spread from person to person.
Precautions
To prevent near drowning, the following precautions are crucial:
Supervision: Never leave children unsupervised near water, even shallow water.
Swimming lessons: Enroll children and adults in swimming lessons.
Life jackets: Use properly fitted life jackets when boating or participating in water sports.
Avoid alcohol and drugs: Avoid alcohol and drug use while swimming or near water.
Secure pools: Install fences and self-closing gates around pools.
Learn CPR: Learn cardiopulmonary resuscitation (CPR).
Be aware of water conditions: Be aware of currents, tides, and water temperature.
Buddy system: Swim with a buddy.
Avoid hyperventilation: Avoid hyperventilating before swimming underwater.
Manage medical conditions: People with medical conditions like seizures or heart problems should take extra precautions and inform others of their condition.
How long does an outbreak last?
Near drowning is not an outbreak-related illness. It's an isolated incident caused by submersion. There isn't a period of "outbreak." Individual cases need immediate intervention and long-term outcomes depend on the severity of the initial incident and the speed of rescue.
How is it diagnosed?
Diagnosis of near drowning is based on:
History: Circumstances of the submersion incident.
Physical Examination: Assessing breathing, heart rate, mental status, and skin color.
Chest X-ray: To evaluate for pulmonary edema or aspiration.
Arterial Blood Gas (ABG): To measure oxygen and carbon dioxide levels in the blood.
Electrocardiogram (ECG): To assess heart rhythm.
Blood tests: To check electrolyte levels, kidney function, and signs of infection.
CT Scan or MRI: May be used to evaluate brain damage in severe cases.
Timeline of Symptoms
The timeline of symptoms in near drowning varies. Immediately after submersion:
Seconds: Gasping, breath-holding, laryngospasm.
Minutes: Loss of consciousness, aspiration of fluid, hypoxia.
Hours: Symptoms of respiratory distress (coughing, shortness of breath), altered mental status, hypothermia.
Days/Weeks: Potential complications like pneumonia, acute respiratory distress syndrome (ARDS), brain damage. The long-term effects depend on the severity and duration of oxygen deprivation.
Important Considerations
Immediate Action is Critical: Rapid rescue and initiation of CPR are essential for improving outcomes.
Severity Varies: The severity of near drowning ranges from mild respiratory distress to severe brain damage and death.
Complications: Complications can include pneumonia, ARDS, brain damage, and long-term neurological deficits.
Prevention: Prevention is the most effective strategy to reduce the incidence of near drowning.
Post-Resuscitation Care: Patients who have experienced near drowning require close monitoring and supportive care in a hospital setting.
Psychological Impact: Near-drowning experiences can be traumatic for both the victim and their family, requiring psychological support.