Submersion Tags - Differential Diagnosis of https://ddxof.com/tag/submersion/ A systematic approach to the evaluation and management of various complaints. Wed, 24 Jan 2018 21:51:24 +0000 en-US hourly 1 https://wordpress.org/?v=6.9.1 https://ddxof.com/wp-content/uploads/2017/08/cropped-ddxof@1x-1-32x32.png Submersion Tags - Differential Diagnosis of https://ddxof.com/tag/submersion/ 32 32 46076767 Submersion Injury https://ddxof.com/submersion-injury/ Fri, 30 Dec 2016 08:00:53 +0000 http://ddxof.com/?p=1871 Pathophysiology Breath-holding until eventual involuntary gasp which triggers reflexive laryngospasm. Resultant loss of consciousness may cause laryngeal relaxation and aspiration. Fluid aspiration results in decreased surfactant activity and atelectasis. This is complicated by V/Q mismatch and atelectrauma which can lead to ARDS. Symptoms Progressive respiratory distress AMS: due to cerebral hypoxia Shock: uncommon, consider trauma... Continue reading →

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]]> Pathophysiology
  • Breath-holding until eventual involuntary gasp which triggers reflexive laryngospasm. Resultant loss of consciousness may cause laryngeal relaxation and aspiration.
  • Fluid aspiration results in decreased surfactant activity and atelectasis. This is complicated by V/Q mismatch and atelectrauma which can lead to ARDS.

Symptoms

  • Progressive respiratory distress
  • AMS: due to cerebral hypoxia
  • Shock: uncommon, consider trauma

Management

  • Albuterol
  • BiPAP
  • Endotracheal intubation
  • ECMO

Disposition

  • Asymptomatic or minor event: observe 2-3 hours
  • Mildly symptomatic: observe 4-6 hours
  • Hypoxia: admit
  • PPV: ICU

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