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Encyclopedia of Health and Medicine

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Drowning 369<br />

MONARY RESUSCITATION (CPR) may be necessary when<br />

the person is brought to shore or the pool’s edge.<br />

Follow-through Emergency medical personnel<br />

typically transport cold water drowning victims to<br />

a hospital emergency department or trauma center<br />

even when resuscitative efforts appear unsuccessful<br />

because there is the possibility for revival<br />

when body temperature returns to normal. A doctor<br />

should thoroughly assess a person who survives,<br />

as secondary complications may occur.<br />

See also RESPONDER SAFETY AND PERSONAL PROTEC-<br />

TION; SITE AND SITUATION ASSESSMENT; SYMPTOM ASSESS-<br />

MENT AND CARE TRIAGE; WARM WATER DROWNING.<br />

rescue breathing A method to revive a person<br />

who has stopped BREATHING (RESPIRATORY FAILURE)<br />

but who still has a HEART beat (PULSE). Rescue<br />

breathing may be necessary in drowning, poisoning,<br />

ELECTROCUTION, <strong>and</strong> other circumstances in<br />

which the respiratory failure occurs suddenly <strong>and</strong><br />

the first response is rapid. The BRAIN begins to<br />

experience irreversible damage after about 6 minutes<br />

<strong>of</strong> oxygen deprivation, so urgent response is<br />

essential.<br />

Site <strong>and</strong> situation assessment Risks for the first<br />

responder may include the continued presence <strong>of</strong><br />

the cause <strong>of</strong> the person’s respiratory failure, such<br />

as live electricity.<br />

Responder personal protection measures Essential<br />

responder personal protection items include<br />

latex or latex-style gloves <strong>and</strong> a resuscitation<br />

shield.<br />

First response actions Position the person to lie<br />

flat on his or her back <strong>and</strong> tilt the head back.<br />

Sometimes this action is sufficient to clear the airway<br />

<strong>and</strong> the person begins to breathe. Check for a<br />

PULSE (press two fingers against the side <strong>of</strong> the<br />

neck just beneath the notch at the back <strong>of</strong> the<br />

lower jaw) <strong>and</strong> watch <strong>and</strong> feel for signs <strong>of</strong> air<br />

movement. When there is also no heart beat,<br />

CARDIOPULMONARY RESUSCITATION (CPR) is necessary.<br />

CPR adds chest compressions to pump the<br />

heart to push BLOOD through the body. If there is a<br />

pulse but no evidence <strong>of</strong> air movement, begin rescue<br />

breathing:<br />

1. Quickly look (<strong>and</strong> feel, if wearing latex gloves)<br />

inside the person’s MOUTH for any objects that<br />

could block air from entering the airway (such<br />

as dentures, food, vomitus, or blood).<br />

2. Place a resuscitation shield over the person’s<br />

mouth, pinch the nostrils closed, <strong>and</strong> breathe<br />

with normal intensity into the shield (or the<br />

person’s mouth) until the chest rises.<br />

3. Give one breath about every five seconds. Pull<br />

away from the shield to allow air to leave the<br />

LUNGS.<br />

4. Continue rescue breathing until the person<br />

resumes breathing independently or emergency<br />

medical personnel arrive <strong>and</strong> take over.<br />

Follow-through A person who stops breathing<br />

requires urgent evaluation <strong>and</strong> treatment from a<br />

physician at a hospital emergency department or<br />

trauma center.<br />

See also ANAPHYLAXIS; COLD WATER DROWNING; POI-<br />

SON PREVENTION; RESPONDER SAFETY AND PERSONAL<br />

PROTECTION; SITE AND SITUATION ASSESSMENT; SYMPTOM<br />

ASSESSMENT AND CARE TRIAGE; WARM WATER DROWN-<br />

ING.<br />

warm water drowning Drowning that occurs<br />

when the water temperature is higher than 60ºF.<br />

Most warm water drownings take place in swimming<br />

pools <strong>and</strong> shallow lakes. The risk for death is<br />

very high when the person has been underwater<br />

longer than three minutes, thus rapid response is<br />

essential. However, there is great risk for the<br />

responder in an attempted rescue when the<br />

responder does not have training in water rescues.<br />

Site <strong>and</strong> situation assessment Important aspects<br />

<strong>of</strong> the situation include the type <strong>of</strong> water (pool,<br />

lake, river), how long the person has been under<br />

water, <strong>and</strong> whether injuries in addition to drowning<br />

are possible. SPINAL CORD INJURY or head injury is<br />

likely when diving into the water, for example.<br />

Responder personal protection measures Essential<br />

responder personal protection items include<br />

latex or latex-style gloves <strong>and</strong> a resuscitation<br />

shield.<br />

First response actions When the person is still<br />

in the water <strong>and</strong> is conscious, the responder<br />

should use items such as ropes, poles, <strong>and</strong> flotation<br />

devices to attempt to help the person rather<br />

than jumping into the water, unless the responder

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