Topcat47
Well-Known Member
OK, can we just, for the sake of information, have a thread on this subject about signs and symptoms, free from petty bickering about whether to call emergency services or not? I really think this is important.
Secondary Drowning
- Thread starter Topcat47
- Start date
Thistle
Well-Known Member
I think that's the whole point: there are no signs and symptoms. Hence the strong advice that anyone who has inhaled any water into the lungs should seek immediate medical assistance.
See, for example, the current (10th) edition of the St John/St Andrews/Red Cross First Aid Manual at p100: "Call 999/112 for emergency help even if he appears to recover immediately after rescue."
See, for example, the current (10th) edition of the St John/St Andrews/Red Cross First Aid Manual at p100: "Call 999/112 for emergency help even if he appears to recover immediately after rescue."
Sailfree
Well-Known Member
Any useful advice if its MOB mid channel? What treatment would a hospital do? For many medical help could be hours away.
Last edited:
jerrytug
N/A
I asked your exact question at my first aid course recently, what if medical help is far away, the only possible answer is do your best to get the casualty medical help in the prevailing circumstances.
Mid channel you would easily be in range of a lifeboat or a helicopter. Mid Biscay, Mid Pacific, what would you do? It's a great idea to consider it in advance, I really hope an expert will come on here and tell us.
I am also very curious about what a hospital would do to a) reduce the likelihood of secondary drowning
b) actions in advance to reduce the severity /risk, should SD happen to occur later (prophylactic antibiotics perhaps? Encourage the casualty to cough up as much as possible, or discourage them from coughing???)
c) what they actually DO to treat SD if it occurs...
Last edited:
alan_d
Well-Known Member
I am not an expert on drowning or respiratory problems, but I think I can offer some answers to your questions.
Secondary drowning is not something that comes on suddenly de novo sometime after the initial inhalation. The process starts when water is inhaled but it is only once normal physiological corrective mechanisms are overwhelmed that external signs will be seen. Assessment in hospital will include checking for any reduction in the oxygen saturation of the blood and any disturbance in plasma acid/base balance. Evidence will also be sought of any fluid volume disturbance (which is likely to differ depending on whether it was fresh or salt water which was inhaled) or signs of haemolysis (rupture of red cells due to osmotic imbalance). If all these parameters are normal further problems are unlikely, if any are deranged then a period of further observation is required.
Any treatment will be directed towards reversing changes from normal physiology: inhaled oxygen for lowered blood-oxygen saturation, intubation and artificial ventilation if there is severe pulmonary oedema, intravenous infusions to correct disturbances of plasma volume or chemistry. Antibiotics are unlikely to be helpful in the acute stage but could be required later if there is secondary infection.
Tricia
Well-Known Member
TBH, not meaning to sound unfeeling, but I think this is very rare. I googled it and netmd seems to think that only 1% or 2% of all drowning instances are either secondary drowning or dry drowning (two different things). I don't think it's high on the list of things to worry about that are likely to kill you.
If secondary drowning was a high probability outcome there wouldn't be anyone left alive at Guantanamo Bay or any other "rendition" center. After all holding a cloth over someones mouth and nose and pouring water on it to make them think they are drowning pretty much guarantees they would inhale water.
If secondary drowning was a high probability outcome there wouldn't be anyone left alive at Guantanamo Bay or any other "rendition" center. After all holding a cloth over someones mouth and nose and pouring water on it to make them think they are drowning pretty much guarantees they would inhale water.
Triassic
Well-Known Member
The way my wife has explained it to me (she's a GP) is that with secondary drowning it isn't the water that you initially inhaled into your lungs that drowns you, it's the body's subsequent reaction to it. The water you inhaled has caused some damage to the tissues in the lungs and they swell up and produce fluid. In this respect it is similar to flu. It is this fluid that "drowns" you. The point about "no signs or symptoms" is that there may not be any immediately after the incident as it is something that could develop later. If the casualty is displaying any symptoms, for example pink frothy breath (the gentleman in the canoe incident had it coming from his nose) you do need to treat that as an emergency.
If they are not, and they have ingested water properly, then it is good advice to have them see a doctor as Alan_d explained there are further tests they can do, however this condition is extremely rare and I for one don't think it justifies involving the emergency services, but that's been thrashed out of the other thread.
If they are not, and they have ingested water properly, then it is good advice to have them see a doctor as Alan_d explained there are further tests they can do, however this condition is extremely rare and I for one don't think it justifies involving the emergency services, but that's been thrashed out of the other thread.
jerrytug
N/A
Alan-d thanks very interesting.
TWINSCREW
Well-Known Member
Your good lady's explanation is the one as taught to me courtesy of the RN many years ago, men were being rescued seemingly perfectly ok and dying later, it is the irritation of the lungs by salt water that makes them produce their own fluid and thereby "drowning" the casualty.
Rivers & creeks
Well-Known Member
+1 and thanks for that, I now understand what's going on. Apart from the pink frothy discharge from the nose there seem very few symptoms for a lay-person to assess. It's always been a standing agreement between us onboard that an MOB when underway is an automatic Mayday, in the main because of the difficulty in recovering to the deck and also because we had in mind the possibility of secondary drowning, but I wasn't at all clear what the process involved.
hartcjhart
Well-Known Member
have a read of this
http://www.huffingtonpost.com/linds...-know-about-secondary-drowning_b_5500471.html
although it is about a child it would be the same for a grown up,also 'clip on' blood/oxygen monitors are fairly cheap
http://www.clinicalguard.com/clinic....html?osCsid=d1eb90a503e6f844588b62cacfe1cc35
http://www.huffingtonpost.com/linds...-know-about-secondary-drowning_b_5500471.html
although it is about a child it would be the same for a grown up,also 'clip on' blood/oxygen monitors are fairly cheap
http://www.clinicalguard.com/clinic....html?osCsid=d1eb90a503e6f844588b62cacfe1cc35
Strolls
Well-Known Member
They're about half that price on eBay - I wonder if there's any way to test them.
And, more to the point, would these actually be of help diagnosing secondary drowing?
http://search.ebay.co.uk/search/search.dll?query=oximeter
hartcjhart
Well-Known Member
yep they are cheaper on ebay,I just did a search and copied the first that came up as an example,
as for diagnosing SD no they cannot,BUT, as steady depletion of oxygen in the blood is 1 sympton they 'could' help you make the decision wether to call coast guard etc,if on land,as has been said,any incident of drowning however short a period, the casualty should be taken to A&E
Juan Twothree
Well-Known Member
And remember that secondary drowning can occur up to 72 hours after immersion.
It's important to attend A&E to be checked over, even if you feel fine.
Many immersion victims showing no symptoms have gone to bed never to wake up.
It's important to attend A&E to be checked over, even if you feel fine.
Many immersion victims showing no symptoms have gone to bed never to wake up.
Sailfree
Well-Known Member
What does a Dr do to treat SD please?
Juan Twothree
Well-Known Member
When it happened to two of my colleagues, chest x-rays, followed if necessary by hospital admission and treatment with some kind of anti-inflammatory drug.
Someone drove them to hospital, there was no need for an ambulance, but it needed checking nonetheless.
To quote from the RNLI Casualty Care manual (where it's now called late-onset near drowning):
"........ casualties may initially appear fine, but deteriorate rapidly within a few hours........ It usually occurs within the first 12 hours, but can occur up to 72 hours later.
Without immediate intensive hospital treatment, late-onset near [secondary] drowning is often fatal".