How to rescue drowning
【Large Classroom】
According to media reports, drowning deaths occurred in many places during the floods. It is summer vacation now, and more attention should be paid to prevent young people from drowning. During the summer vacation every year, young people drowning occur from time to time. Relevant data show that drowning is the third leading cause of death from unintentional injuries around the world and one of the ten leading causes of death for children and youth. Approximately 57 thousand people die from drowning in our country each year, among which the number of children and children drowning accounts for 56.04% of the total number of drowning deaths.
In medicine, drowning, also known as drowning (submersion), refers to a situation where a person is submerged in water or other liquid media and is injured. It is one of the important emergency physical and chemical injury syndromes; the serious case of drowning is drowning. It is generally believed that those who die within 24 hours after drowning are called drowning. The multiplicity of causes of drowning, the complexity of the drowning environment, and the hazards of drowning to death have cast a veil on drowning. How to reveal the truth about drowning and scientifically understand the "nine water" drowning derived from the "shallow water" of homes, the "fresh water" of rivers, and the "salt water" of the ocean are of great significance to the current flood prevention and control and to keep people away from drowning.
Home drowning in "shallow water" dry. Among drowning patients, it involves living water with a relatively small depth, triggering drowning caused by the body's stress response, commonly known as "choking to death". There is no water in the lungs during autopsy, which is often called "dry drowning" or "dry drowning" in medicine. The common ones are: first, drowning with water in life (the bathtub, toilet, bucket, fish tank, etc. at home may be accidents in potential drowning places); During the medication, accidents caused by panic, fear, sudden cold and other stimuli, etc.); third, daily "drinking" drowning (the laryngospasm and glottal obstruction caused by nerve reflexes caused by coughing during drinking of the elderly and children at home) Accidents due to suffocation).
Rivers are drowning in "fresh water" wet. Among drowning patients, the drowning caused by a large amount of fresh water from the river entering the relevant organs and tissues can be called wet drowning. Common ones are: First, the lungs are "watered" drowning (the drowning time is very long, the throat muscles relax, a large amount of water enters the lungs for progressive respiratory distress and refractory hypoxemia, which may cause water to enter the lungs when drowning The emergence of "pathological washing" is related); the second is the "water accumulation" in the stomach drowning (when drowning occurs, most drowning people experience struggling and breathing during drowning. With struggling and hypoxia, a lot of Water is swallowed into the stomach, and part of the water can also be inhaled or returned from the stomach into the airway at the same time; third, the blood vessels are "more watery" drowning (fresh water enters the blood circulation, causing high blood volume, thereby diluting the blood , That is, hypotonic state-water and electrolyte imbalance, etc. cause cardiac arrest).
The ocean "salt water" features drowning. Among the drowning patients, the drowning caused by the stimulation of the body by different factors such as physical, chemical, biological and other factors involved in the salt water of the sea can be called characteristic drowning. Common are: First, low temperature "cold water" drowning (low temperature can cause hypercoagulable state, high blood sugar, slow blood flow and abnormal heart rhythm, which is one of the important causes of drowning death. For example, immersion syndrome refers to falling into Sudden death in ice water); the second is allergic "poisonous water" drowning (toxic organisms in the ocean such as jellyfish, jellyfish, etc., invade the body, airway obstruction and suffocation and anaphylactic shock caused by acute laryngeal edema caused by allergies); third is high Infiltration of "salt water" drowning (sea water is a hypertonic fluid that has chemical irritation to the respiratory tract and alveoli and can cause acute non-cardiogenic pulmonary edema, hypovolemia, and hypercalcemia, which can cause slow heartbeat, arrhythmia, and conduction block , Even the heartbeat stops).
The above-mentioned drowning phenomenon is related to each other and has its own characteristics. However, its pathophysiological mechanism is ultimately circulatory respiratory failure until cardiac arrest. Cardiopulmonary resuscitation (CPR) should be performed during rescue. How to do it?
For drowning patients who are unconscious (unresponsive), quickly determine the patient's breathing and circulatory signs (pulse, limb movement, vocalization, etc.), and no breathing or breathing abnormalities. Artificial respiration should be given immediately (5 consecutive times) and high quality Cardiopulmonary resuscitation (compression, ventilation, and electrical defibrillation) until the patient recovers his heartbeat (waking up, showing voluntary movements, etc.) or a professional arrives to take over.
When there are emergency equipment such as abdominal pressure-lifting cardiopulmonary resuscitation equipment nearby, you should quickly get them to implement the abdominal-pressure cardiopulmonary resuscitation method for first aid. Abdominal compression cardiopulmonary resuscitation can expel foreign bodies in the airway, which is conducive to the synchronization of breathing and circulation, and is especially suitable for rescuing drowning patients.
(Author: Wang Lixiang, former director of the Department of Emergency Department of the PLA General Hospital Medical Center, third, now chairman of the CPR Institute of Professional Committee for the China Research Hospital)