What Is a Near Drowning?

Rescuing drowning patients includes on-site rescue and in-hospital rescue. In order to facilitate memory and implementation, it is described together.

Basic Information

Visiting department

Emergency Department

Multiple groups

Drowning patient

Common causes

Accidental drowning

Drowning first aid steps and methods

1. Rescue in water and after treatment

A strong swimmer rescues the patient from the water. Others immediately look for floating objects. Before leaving the water, the patient should be placed on a floating wooden board to remove water and dirt from the mouth and nose, and open the airway. When mouth-to-mouth artificial respiration is used, care should be taken not to flex the neck and maintain the head and neck spine on an axis to avoid aggravating the possible spinal cord injury.

2. First aid after getting out of water

Immediately after landing, clear the mouth and nose of the patient's nose and waterweed, and raise the jaw or raise the lower jaw with both hands to open the airway. Artificial respiration and chest compressions should be performed as soon as possible after opening the airway.

There is no need for patients to implement various methods of water control measures. Most drowning patients do not have much water inhaled, and they will soon enter the blood circulation. There is no need to remove water from the airways.

3. First aid for cardiac arrest and apnea

For those with heartbeat breathing cessation, perform on-site cardiopulmonary resuscitation immediately, including opening the airway, removing foreign matter in the nose and mouth such as sediment, aquatic weeds, artificial respiration and chest heart compression. Note that the heartbeat and breathing may stop again. Evacuation should be organized while on-site rescue.

4. Oxygen

(1) Patients who are nearly drowning (with pulse) and completely drowning (without pulse) may not have water in the lungs, and drainage from the lungs cannot delay oxygen supply. Good swimmers can start mouth-to-mouth breathing while stepping on the water. In shallow water, patients can also put their head and chest on their knees to start mouth-to-mouth artificial respiration. The patient can only perform chest heart compression after clearing the water and clear the throat. Even if the lungs only inhale a small amount of water, 100% oxygen and IPPV (intermittent positive pressure ventilation) should be given as soon as possible.

(2) Sea water damages the lungs and fresh water damages the heart, both of which cause suffocation and damage the brain. Before seawater drowning pulse arrest, it is necessary to do IP-PV with 100% oxygen and quickly normalize blood volume. Nearly drowning and freshwater drowning were rescued before cardiac arrest, and electrolyte disturbances have returned to normal after 30 to 60 minutes of water. The main problem for patients with drowning is various causes of lung water retention and severe and long-term hypoxia. Give adequate oxygen early.

5. Prevent brain damage

The main problem after resuscitation of cardiac arrest in drowning patients is brain damage after resuscitation. To prevent brain damage, a large amount of corticosteroids and dehydrating agents can be used to prevent brain edema. Give hypertonic glucose to strengthen brain nutrition and tolerance of hypoxia, use hyperbaric oxygen tank when possible, sedatives when twitching, and central stimulants for coma.

6. In-Hospital Treatment

Pay attention to maintaining water-electrolyte acid-base balance. Use antibiotics to prevent lung infection and aspiration pneumonia, pay attention to the occurrence of delayed pulmonary edema, and prevent acute renal failure.

7. Bathtub drowning treatment

If drowning (mostly children) occurs in the bathtub at home, the rescue process is the same as that of freshwater drowners. Call 120 at the same time as the on-site cardiopulmonary resuscitation.