DROWNING AND NEAR-DROWNING

The time for apparent death of a drowning person reduces to 3 minutes. Trying to save himor herself, a drowning person makes a great physical effort and loses a lot of muscular energy, which quickly depletes his/her oxygen reserve, hence the necessity for artificial ventilation as soon as possible. It is started immediately the person is brought out of the water, while the period he/she is being carried to the shore. In cardiac standstill, external heart massage is started while artificial ventilation of the lungs is continued. Do not waste time trying to evacuate water from his/her lower respiratory tract.

On the shore it is much easier to perform cardiopulmonary resuscitation. The drowning person always has the stomach filled with water, which requires evacuation as soon as possible. The person is put on his/her side and the hand is used to press on the epigastral area, the oral cavity is then cleared of sand, mucus and other particles before resuscitation. In case there are no signs of cardiac standstill in a patient without evidence of breathing, 'mouth to mouth» artificial ventilation is only applicable. In the case of apparent death one or two people have to start cardiopulmonary resuscitation.

When a person drowns in fresh water with somewhat lower osmotic pressure than that of blood, water that entered the lower respiratory tract is quickly absorbed. It is therefore required that time not be wasted for evacuating the water from the trachea and bronchi.

In drowning in salted water with salt concentration of as much as 3, 5-4%, according to osmotic laws, plasma will try to find its way to the upper respiratory tract. The alveoli, trachea and bronchi may be filled with fluid, which can counteract artificial ventilation. Liquid can be partly evacuated by raising the lower part of the body in such a way that the upper part and the head will be hanging. These manipulations must be performed as fast.

When a person drowns in cold water, signs of hypothermia that inhibits metabolism, e.g. oxygenation, of the brain are diminished is observed. For apparent death to occur a longer period is needed and CPR can be a success even though the patient has stayed under water for a long time.

Each patient must be transported to hospital for further treatment and monitoring.

ELECTRIC SHOCK

Electric shock can cause respiratory arrest with subsequent cardiac standstill. In most cases, this kind of injury results from direct exposure to electricity. Electric energy can also affect distantly, particularly in cases of strong discharge. Lightening that has hit the ground or live electric wires on the ground can also cause electric shock.

The first aid involves evacuating the patient from the source before medical care is provided. In mild cases, place the patient supine and let them have complete rest. In respiratory arrest start artificial ventilation, while cardiac standstill requires closed cardiac massage.

HEAT INJURY

In heat stroke, the body becomes overheated, and heat regulation is impaired. Heat stroke occurs in people working in stuffy and poorly ventilated rooms with high temperatures as well as people wearing clothes made of synthetic materials.

Sunstroke follows long periods of direct exposure of the head or whole body to sunlight. The signs of heat and sunstroke include red skin discolouration, headache, weakness, nausea, vomiting, tachycardia, fever and fast pulse. Death results from cerebral oedema.

As a first aid measure the undressed patient is transferred to a cool place and given a cold beverage. Measures are taken to cool the body: cold water is poured on the patient; ice packs are applied to the major blood vessels, i.e. those of the neck and groins. In respiratory problems oxygen therapy is provided. In severe cases (e.g. cardiac standstill) CPR is immediately initiated and the patient is subsequently transferred to hospital.

TESTS

⇐ Предыдущая11121314151617181920Следующая ⇒

Поделиться: