Submersion Injuries In Children

WHAT YOU SHOULD KNOW:

• Submersion (sub-MER-zhun) injuries are conditions caused by not being able to breathe under any liquid substance, such as water. Liquids entering the lungs may prevent your child from getting enough air and the brain from getting enough oxygen. Water rescue is when your child remains alert after a submersion or immersion injury. Your child may have temporary (short-term) symptoms like coughing that clears up quickly. Near-drowning is when your child survives but has more serious symptoms after an immersion or submersion injury. Drowning is caused by a long period of immersion or submersion that leads to death.
  
  
• Your child may have trouble breathing. He may be vomiting (throwing up) or confused, and may lose consciousness. Complications may include pneumonia, acute respiratory distress syndrome (ARDS), hypothermia and brain damage. A complete physical examination will be done by his caregiver. Tests, such as an electroencephalogram (EEG), magnetic resonance imaging (MRI), computed tomography (CT) and chest x-ray may be used to check for other problems. Treatment may include cardiopulmonary resuscitation (CPR), oxygen, medicines for infection and pain, and endotracheal tube insertion. Early CPR may increase the chances of your child surviving. Treating submersion injuries as soon as possible may decrease possible complications. Careful attention to basic water safety practice and having adequate supervision may prevent many of the drowning deaths.

CARE AGREEMENT:

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.

RISKS:

Treatment of submersion injuries may cause unpleasant side effects. Antibiotics and pain medicines may cause stomach problems such as nausea (upset stomach) and vomiting (throwing up). Endotracheal intubation and other procedures may cause bleeding and infection. Submersion injuries when not treated are almost always life-threatening. Ask your child's caregiver for the care and management of submersion injuries.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that your child may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your child's medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done to your child. Make sure all of your questions are answered.

Activity:

At first your child may need to rest in bed. It may be easier for him to breathe if he rests with the head of his bed raised. Your child can also breathe easier if he rests his head on three or four pillows. Resting in a reclining chair may also help your child breathe better. Another way to breathe easier is by saving your child's energy and resting more. If your child has trouble breathing, call your child's caregiver right away. Your child may get out of bed when his caregiver says it is OK.

Medicines:

Your child may be given any of the following:

• Antibiotics: This medicine is given to help prevent or treat an infection caused by bacteria.
  
  
• Antinausea medicine: This medicine may be given to calm your child's stomach and control vomiting (throwing up).
  
  
• Pain medicine: Your child may need medicine to take away or decrease pain. Know how often your child should get the medicine and how much. Watch for signs of pain in your child. Tell caregivers if his pain continues or gets worse. To prevent falls, stay with your child to help him get out of bed.

Tests:

Your child may have any of the following:

• Blood gases: These tests are also called arterial blood gases (ABGs). Blood is taken from an artery usually in your child's wrist. ABGs may be done if your child has trouble breathing or other problems caused by his illness.
  
  
• Blood tests: Your child may need blood tests to give caregivers information about how his body is working. The blood may be taken from your child's arm, hand, finger, foot, heel, or IV.
  
  
• CT scan: This test is also called a CAT scan. An x-ray and computer are used to take pictures of your child's body. Your child may be given dye, also called contrast, before the test. Tell the caregiver if your child is allergic to dye, iodine, or seafood.
  
  
• EEG: This test is also called an electroencephalogram. Many small pads or flat, metal buttons are put on your child's head. Each pad has a wire that is hooked to a machine. This machine records a tracing of brain wave activity from different parts of your child's brain. Caregivers look at the tracing to see how your child's brain is working.
  
  
• MRI: An MRI uses a powerful magnet and radio waves to take pictures of the inside of your child's body. Caregivers may use the MRI to look at your child's brain, muscles, joints, bones, or blood vessels. Your child will need to lie still during his test. Never enter the MRI room with any metal objects. This can cause serious injury.
  
  
• Neurologic signs: These are also called neuro signs, neuro checks, or neuro status. During a neuro check, caregivers see how your child's pupils react to light. They may check his memory and how easily he wakes up. His hand grasp and balance may also be tested. How your child responds to the neuro checks can tell caregivers if his illness or injury has affected his brain.
  
  
• Chest x-ray: This is a picture of your child's lungs and heart. A chest x-ray may be used to check your child's heart, lungs, and chest wall. It can help caregivers diagnose your child's symptoms, or suggest or monitor treatment for medical conditions.

Intake and output:

Caregivers may need to know how much liquid your child is getting and urinating. Your child may need to urinate into a container in bed or in the toilet. A caregiver will measure the amount of urine. If your child wears diapers, a caregiver may need to weigh them. Do not throw away diapers or flush urine down the toilet before asking a caregiver.

Oxygen:

Your child may need oxygen if his blood oxygen level is lower than it should be. Oxygen will help your child breathe easier. Your child may get oxygen through small tubes placed in his nostrils, or through a mask. He may instead be placed in an oxygen tent. Never take off your child's oxygen tubes or mask or remove him from the tent without asking his caregiver first.

Pulse oximeter:

A pulse oximeter is a device that measures the amount of oxygen in your child's blood. A cord with a clip or sticky strip is placed on your child's foot, toe, hand, finger, or earlobe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your child's oxygen level is low or cannot be read.

Treatment options:

• ET tube: Your child may need an endotracheal (ET) tube to help him breathe. An ET tube is put in your child's mouth or nose, and goes into the trachea (windpipe). It may be connected to a breathing machine called a ventilator. The ET tube will be taken out when your child is breathing better.
  
  

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Submersion Injuries In Children (Inpatient Care)