2. DROWNING :-
Definition
:-Drowning is the
result of complete immersion of the nose
and mouth in water .( or any
other liquid ) water enters the
wind pipe and lungs ;
clogging the lungs
completely .Drowning cause by
water entering the lungs or by causing
the throat to go into spasm so constricting
the air passage . It is a
major source of death .
Signs and
symptoms :-
è Do not waste
time trying to remove , any water
from the casualty's lungs .
è Pull the patient from the water
using rope , pole , stick or shirt etc ,
Lie down flat on your stomach and extend hands on leg .
è Act quickly remove sea weeds
and mud from the nose and throat
start artificial ventilation immediately
.
è Throw him an object that will
float with line I.e tyre ; foam cushions
–log board , plastic toys , Make sure that your own position is safe
è Turn the victim face down with head to one side
and arms stretched beyond his head . infans or children could be held upside down for a short period
.
è Use boat and life jacket , if
available
è When you can place him as a firm
surface , check breathing , place in the
recovery position .
è Keep him warm , if possible , remove wet clothing and dry him
off. Cover with spare clothes and if necessary
treat of hypothermia .
è Arrange removal
to hospital .
Prevention
:-
For
Adults:-
*learn to swim never swim alone at the beach or in a
swimming pool .A lifeguard or other
adult swimmer should be near by incase you suffer a leg cramp or other problem .
* wear a
personal flotation device when you are on a boat , when you fish etc.
* Never
drive into an above ground pool .
For children :-
*Never leave an infant or child alone in any type of
bathtub , supervise young children in the bathroom.
* Never
leave a child alone near water , swimming pools ect .
* Have a
phone near outdoor pools ect.
* Teach
children to swim
* Put a
personal flotation device an each
child when near the water or as a
boat .
*
Take CPR and water safety courses.
SHOCK :-
* Shock
is defined as a state of cellular
and tissue hypoxia due to reduced oxygen delivery and
/or increased oxygen consumption or inadequate oxygen utilization
.
*
This must commonly occurs when there is
circulatory failure manifested as hypotension (le , reduced tissue perfusion )
* Shock
is initially reversible , but must be reorganized and treated immediately to prevent progression to
prevent progression to irreversible organ dysfunction .
*Undifferentiated
shock “ reters to the situation where shock is recognized but the cause is
unclear .
CLASSIFICATION AND ETIOLOGY:-
Four
types of shock are recognized :-
1.
Distributive 2. Cardiogenic 3.
Hypovolemic 4. Obstructive
*However
, these are not exclusive , and many patients with
circulatory failure have a
combination of more than
one form of shock .
* There
are many etiologies within each class ,
all of which are discussed in detail in the sections below .
* (see ‘
Distributive ‘ below and ‘cardigenic’ below and
hypovolemic ‘below and obstructive
‘ below and combined below .
*
septic shock , a form
of distributive shock is the most common form of shock among patients admitted to the intensive
care unit , followed by cardigenic and
hypovolemic shock : obstructive shock is rate .
*
As an example , in a trail of 1600
patient with undifferentiated shock ,
septic shock occurred in 62 percent , cardiogenic shock in 16 percent ,
hypovolemic shock in 16 percent , other
types of distributive shock in & percent
( eg – neurogenic shock , anaphylaxis
) and obstructive shock in percent .
Treatment
:-
1. Lay the person down , if
possible :-
*Elevate the
person’s feel about 12 inches
unless head , neck , or back is injured or you suspect broken hip or leg bones .
*
Do not
raise the person’s head .
*
Turn the
person on side if he or she is
vomiting or bleeding from the mouth .
2.
Begin CPR , if necessary :-
If the
person is not breathing or
breathing or breathing seems dangerously weak :-
·
For
a child , start CPR for children
·
For an adult , short adult CPR
·
Check
breathing every 5 min until help arrives .
3.Treat
obvious Injuries
4.
Keep person warm and comfortable :-
* loosen restrictive
clothing
* cover
with coat or blanket
* Keep
the person till Do not move the
person unless there is danger .
*
Reassure the person
* Do not
give anything to eat or
drink .
5.
Follow up :-
* At the hospital
, the person will be given oxygen
and intravenous liquids
* Other
treatment will depend on the cause of shock .
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