Drawning

Drawning occurs 40% in children,younger than 4 years of age.
Near drawning defined as survival for at least 24 hours after submersion in liquid,the disposing factors include youth,inability to swim,alcohol & drug abuse, barotrauma (in scuba diving) ,head and neck trauma and loss of consciousness in associated with epilepsy, diabetes,syncope or dysrhythmia

Treatment Begin with

• resuscitation,
• focussing on airways management and
• ventilation(see in CPR) with 100% oxygen ,
• an IV line should be established with normal saline or Ringer 's lactate solution,
• the cervical spine should be immobilize, since trauma may be present ,
• hypothermia should be vigorously treated
• nasogastric tube should be retained for bowel compression
• prophylactic antibiotics should be reserved for document infection,
• prophylactic glucocorticoids have no role
• cerebral edema may occur within the first 24 hrs and is a major cause of death

  patients who have survived severe episode of near drawning should be admitted to an ICU The asymptomatic patients with a questionable or brief episode may be observed for 4-6 hrs and discharge if chest x-ray and ABG are normal (Ann Emerg Med 15:1084,1986) ,However if there is a long submersion initial cyanosis or apnea , or ever brief requirement for resuscitation,the patients must be admitted for at least 24 hours