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Posted: September 1st, 2022
The Treatment Plan for the Pediatric Victims of Near-Drowning
Drowning is one of the leading courses of pediatric deaths worldwide. In the United States, drowning accounted for more than 1500 lives of children below the age of 20 in 1998, ranking as the second cause of accidental deaths in children that year. In 2005, drowning accounted for 30% of accidental deaths in children between one and four years.
Near-drowning occurs when one remains submerged underwater and is therefore unable to breathe for a significant period of time. During this time, liquid enters the lungs, preventing the body from accessing enough oxygen, and major organs, including the brain and the heart, begin to shut down. In children, this happens in a matter of seconds while it takes longer in adults.
Treatment care plan for nearly-drowning children
The treatment plan for a nearly drowned child focuses on helping the body regain adequate oxygenation, opening up the airway, sustaining cerebral perfusion, reversing effects of hypothermia, and monitoring vital functions such as blood pressure to avert any complications.
Resuscitation
Due to the hypoxia and ischemia that occurs during drowning, many victims are often clinically unresponsive with signs of apnea and no pulse. The first step after removing the form of the water is to begin CPR. Timely and effective CPR involving mouth-to-mouth rescue breathing and chest compressions have proven lifesaving on numerous occasions. Failure to start timely resuscitation, the hypoxic-ischemic shock is will most likely result in a complete cardiac arrest.
Shock
After the airways are sustained, and the child begins to breathe, the child should be transferred to the emergency room for more advanced care. In the emergency room, the health care provider should initiate a comprehensive evaluation and treatment. A rapid and thorough cardiopulmonary assessment based on the shock should be performed. Signs of shock may include cerebral perfusion, tachycardia, slipping in and out of consciousness, acidosis, and oliguria. Shock is treated and managed using continued fluid resuscitation and hemodynamic monitoring.
Hypothermia and Trauma
The child should also be evaluated for hypothermia. According to studies, maintaining a mild state of hypothermia for at least 12 hours can help children victims who have their vitals stabilized. However, children experiencing severe hypothermia should be rewarmed, especially those with cardiovascular instability. The health care provider should also scan for other physical traumatic injuries such as intra-abdominal injury, intracranial, and occult cervical spine. A full evaluation of emotional trauma should follow after physical recovery.
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