First Aid for Colleges and Universities 10th Edition Chapter 26 © 2012 Pearson Education, Inc. Water Emergencies Slide Presentation prepared by Randall Benner, M.Ed., NREMT-P

Learning Objectives Explain the difference between drowning and near-drowning. Explain the difference between wet and dry drowning. Explain why you should always try to resuscitate someone who has had an accident in cold water. Explain how to safely reach someone in trouble in the water. © 2012 Pearson Education, Inc.

Learning Objectives Describe and demonstrate how to protect a victim in the water if you suspect spinal injury. Describe and demonstrate first aid care for a near-drowning victim. Describe the various kinds of diving emergencies. © 2012 Pearson Education, Inc.

Learning Objectives List the signs and symptoms of air embolism and decompression sickness Describe and demonstrate first aid care for a victim of air embolism or decompression sickness. Describe and demonstrate first aid care for a victim of barotrauma. © 2012 Pearson Education, Inc.

Introduction Nearly 4,000 deaths occur annually from water accidents. The First Aider may find themself in a work- related or recreation-related activity when a water emergency occurs. Important to remember: never attempt a water rescue unless you are a specially trained and good swimmer who has donned a personal flotation device and has the help of others. © 2012 Pearson Education, Inc.

Drowning and Near-Drowning Definitions –Drowning: death from suffocation due to submersion –Near-Drowning: at least temporary survival from near soffocation due to submersion Most commonly happens to children under age 5, and people between 15 and 24 years of age May not occur in large bodies of water © 2012 Pearson Education, Inc.

Drowning and Near-Drowning Remain alert for signs of struggle. –Sudden splashing –Screams –Calls for help –Swimmer who is thrashing © 2012 Pearson Education, Inc.

Drowning and Near-Drowning Wet drowning occurs when the victim has aspirated fluid or a foreign body into the lungs. Dry drowning occurs when laryngeal spasms prevent fluid from entering the lungs, but the person still suffocates. Secondary drowning occurs when a resuscitated victim dies within 96 hours of the incident from aspiration pneumonia. © 2012 Pearson Education, Inc.

Progression of Drowning © 2012 Pearson Education, Inc.

Drowning and Near-Drowning Types of drowning refer to the victim’s activities prior to unresponsiveness and death –Active drowning – victim is still trying to remain afloat and breathing with great energy expenditure –Passive drowning – victim is not moving, is usually face down or submerged; drowning results from total expenditure of energy © 2012 Pearson Education, Inc.

The Role of Panic in Drowning © 2012 Pearson Education, Inc.

Drowning and Near-Drowning Resuscitating Cold Water Submersion Victims –Cold water emergencies have a higher chance of survival (below 68 degrees F) –Beneficial effects result from the mammalian diving reflex and the effects of cold water on the body’s metabolic rate –Any cold water submersion victims should be resuscitated, even if submersion has been lengthy (over 30 minutes) © 2012 Pearson Education, Inc.

Drowning and Near-Drowning Ensuring your own safety –Always act with your personal safety first. –Never attempt a deep water rescue unless all of the criteria below apply: You’re a strong swimmer. You’ve had water rescue technique training. You’re wearing a personal flotation device. You’re accompanied by others to assist you. © 2012 Pearson Education, Inc.

Drowning and Near-Drowning Water rescue close to shore or in shallow water for a conscious victim –Keep firm footing for yourself, don’t slip into the water. –Lean backwards as you pull the victim out. –Use an object (rope, oar, branch, etc.) for the victim to grab so you can pull them in. –Use a shepherd's crook if available. © 2012 Pearson Education, Inc.

Drowning and Near-Drowning Water rescue for a conscious victim out of your reach –Items to toss to victim: a ring buoy a heaving line a throw bag a heaving jug Shout to victim to get their attention. Stand on rope’s end before throwing. Swing underhand with intent of throwing device just past the victim. © 2012 Pearson Education, Inc.

Drowning and Near-Drowning Water rescue for an unconscious victim out of your reach –If possible, make rescue attempt from a boat (not from in the water) –Use a shepherd's crook if available. –If rescuing from a boat, do not allow yourself to fall into the water. –Follow standard techniques and safety criteria described previously. © 2012 Pearson Education, Inc.

Drowning and Near-Drowning Head or spinal injury concerns –Suspect head or spinal injury if the victim is unconscious, or if known trauma has occurred. –Goal is to support the back and stabilize the head in the water. –Use the head-splint or the hip/shoulder support techniques. © 2012 Pearson Education, Inc.

Head Splint Technique © 2012 Pearson Education, Inc.

Drowning and Near-Drowning Head or spinal injury concerns –Use hip/shoulder support technique. –Position yourself aside the victim. –With your arms under the hips and shoulders, lift the victim’s body just high enough that their face is out of the water. –Remain in this position until medical help arrives. –Attempt to keep the victim’s body horizontal. © 2012 Pearson Education, Inc.

Drowning and Near-Drowning Head or spinal injury concerns –If you are not trained in water rescue do the following: Do not remove the victim from water. Keep the victim afloat on his or her back. Always support the head and neck, and keep them level with the back. Maintain the airway and support ventilation as possible. Maintain these maneuvers until medical help arrives. © 2012 Pearson Education, Inc.

Drowning and Near-Drowning The First Aider should –Activate the EMS. –Safely remove the victim from the water. –Maintain immobilization in water, if possible, prior to removal of the unconscious victim. –Once out of the water, assess and manage the airway, breathing, and circulation functions. –Maintain care and support any lost functions until EMS arrives. © 2012 Pearson Education, Inc.

Drowning and Near-Drowning © 2012 Pearson Education, Inc.

Drowning and Near-Drowning Ice rescues –Very dangerous for rescuers –Never stand on ice while attempting a rescue. –Throw the victim something to hold onto and pull them toward you, if possible. –If you cannot pull them in, throw something to help them stay afloat until additional help arrives. © 2012 Pearson Education, Inc.

Diving Emergencies Diving into shallow water –Injuries to the head, neck, back, extremities, or chest can occur. –Always assume spinal injuries have occurred and attempt rescue with immobilization techniques as described previously. –If victim has left the water, proceed with standard care as you would for any victim with suspected neck or spinal injuries. © 2012 Pearson Education, Inc.

Diving Emergencies Deep-water diving –Most serious complication is coma, which can result from asphyxiation, head injury, heart attack, air tank contamination, intoxication, or aspiration. –Victim may be unconscious from air embolism or decompression sickness. –A hyperbaric chamber for recompression may be needed at the hospital. © 2012 Pearson Education, Inc.

Diving Emergencies Air Embolism –Often occurs from holding one’s breath while diving (into a pool, using scuba gear, etc.) Damage to lungs causes air to enter the vascular system –Decompression sickness (the “bends”) Occurs when a diver ascends too rapidly from deep water and nitrogen bubbles form in the body –Has gradual onset; symptoms can develop 12–24 hours after a dive. © 2012 Pearson Education, Inc.

Diving Emergencies First aid care for air embolism or decompression sickness –In absence of trauma, place the victim on their left side in a 15 degree-head down position. –Provide support to airway, breathing, and circulation functions as needed. –Continue to monitor and care for the victim until EMS arrives. © 2012 Pearson Education, Inc.

Diving Emergencies Barotrauma (the “squeeze”) –Occurs with rapid ascent or descent when air in the body’s cavities cannot equalize –Can include mild or severe pain to affected areas with possible ear/nose discharge, dizziness, nausea, and disorientation –Victim requires immediate care and transportation to a medical facility to prevent worsening of the condition © 2012 Pearson Education, Inc.

Summary Drowning and near-drowning victims have special rescue and treatment needs. Never attempt a water rescue unless you are equipped and trained to do so safely. Victims of water emergencies should still be seen by a physician, regardless of how they feel, for a complete evaluation. Always suspect and treat for neck and/or spinal injury for any victims of shallow water diving. © 2012 Pearson Education, Inc.