Close suffocating: new water, ocean water or frosty water

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Close suffocating: crisp water, ocean water or frosty water

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Near suffocating: new water, ocean water or cool water – is there any distinction? Goran Popić Pulmonary Division, Dpt of Medicine, General Hospital, Pula

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Near suffocating is the survival of a suffocating occasion and can prompt to genuine optional inconveniences including passing.

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Near suffocating rescue right now of birth: during childbirth the aviation routes are loaded with liquid. Arrival of pressure after entry through the birth channel causes air to be sucked in. Huge constrain is important amid the principal motivation to beat the surface pressure. After that – huge amounts of surfactant are discharged by the pneumocytes II.

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The central physiologic outcomes of submersion are constant hypoxemia and resultant ischemic acidosis . An amazing level of hypoxia can exsist without clinical signs.

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Near suffocating causes lung tissue hypoxia and successive changes as in: high elevation pneumonic edema "mechanical" (strangulation and so forth.) reasons for aspiratory edema torrential slide casualties intense lung harm/ARDS

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Question : Near suffocating in new water (hypotonic) ... what's more, the importance of → surfactant pulverization? serum electrolyte lopsided characteristics? hemolysis? Answer : UNIMPORTANT ! (as far as administration)

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Question : Near suffocating in ocean water (hyperosmolar) ... furthermore, the significance of → liquid exudation into the alveoli? surfactant washout? hyperosmolar damage of the epithelium? serum electrolytic changes? Answer : UNIMPORTANT ! (as far as administration)

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Question : Near suffocating in cool water? Definition: cool water = under 21 ˚ C Answers : Bad : troublesome swimming (strong shortcoming), debilitated judgment, center hypothermia and VF Good : hypothermia and neuroprotection, the mammalian plunging reflex

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The mammalian jumping reflex is activated by icy water reaching the face (ophthalmic division of the trigeminal nerve) and causes: Apnea Bradycardia Peripheral vasoconstriction Thoracic blood move and topping off alveoli with plasma

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Near suffocating in icy water, anticipation: Age of casualty – the more youthful the better Water temperature – the colder the better Victim's battle – the more the more terrible Note: if a man has been submerged for LESS THAN ONE HOUR, full resuscitative endeavors ought to be utilized

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General Hospital, Pula: 46 sequential instances of close suffocating casualties, review survey: 78% guys 75% swimmers 72% voyagers at times - incapatitation emerging from liquor, heart assault, seizure, stroke In others – barotrauma or power outage on rising from profound plunge No indications of atelectasis seen on the x-beams Two passings in healing center

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Treatment of close suffocating casualties, some vital focuses: Immediate on location CPR is the way to build the possibility of survival. Try not to DO a particular moves (Heimlich) to remove water from the lungs. ED perception for 8 hours to screen for those requiring healing center confirmation. Blood vessel blood gas investigation and trunk x-beams are the most dependable parameters. Cautioning of any pyrexial disease after release (optional pneumonic contamination).

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