Submersion Injuries

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 the victim from getting enough air and the brain from getting enough oxygen. Water rescue is when the victim remains alert after a submersion or immersion injury. The victim may have temporary (short-term) symptoms like coughing that clears up quickly. Near-drowning is when the victim 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 of the victim. Taking alcohol or drugs, or having a heart attack, seizures (convulsions), or accidents may increase your risk for submersion injuries.
  
  
• Victims of submersion injuries may have trouble breathing, may be vomiting (throwing up), confused, and loose consciousness. Complications may include pneumonia, acute respiratory distress syndrome (ARDS), hypothermia and brain damage. A complete physical examination will be done by the caregiver to diagnose submersion injuries. Tests, such as an electroencephalogram (EEG), glucose testing, magnetic resonance imaging (MRI) and radiographs 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 survival of the submersion victim. Treating submersion injuries as soon as possible may decrease possible complications.

CARE AGREEMENT:

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

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.

WHILE YOU ARE HERE:

Informed consent:

The victim has the right to understand his health condition in words that he knows. He should be told what tests, treatments, or procedures may be done to treat his condition. His doctor should also tell him about the risks and benefits of each treatment. He may be asked to sign a consent form that gives caregivers permission to do certain tests, treatments, or procedures. If he is unable to give his consent, someone who has permission can sign this form for him. A consent form is a legal piece of paper that tells exactly what will be done to him. Before giving consent, make sure all of his questions have been answered so he understands what may happen.

Activity:

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

The victim may be given any of the following:

• Antibiotics: Antibiotics may be given to help treat or prevent an infection caused by germs called bacteria.
  
  
• Pain medicine: The victim may be given medicines to treat pain, swelling, or fever while he is in the hospital. These medicines are safe for most people to use. However, they can cause serious problems when used by people with certain medical conditions. Tell caregivers if the victim has liver or kidney disease, a history of bleeding in his stomach, or any other medical problems. Also tell the caregiver about any allergies he has to medicines. Tell the caregiver about all other medicines, herbs, or supplements that the victim may have taken lately.

Tests:

The victim may have any of the following:

• Blood gases: This test is also called an arterial blood gas or ABG test. Blood is taken from an artery (blood vessel) in the arm or groin. The groin is the area where the abdomen (stomach) meets the upper leg. The blood is tested for the amount of gases in it, such as oxygen, acids, and carbon dioxide.
  
  
• Blood tests: The victim may need to have blood taken for tests. The blood can be taken from a vein in the hand, arm, or the bend in the elbow. It is tested to see how the body is doing. It can give caregivers more information about the victim's health condition. Blood may be drawn more than once.
  
  
• Electroencephalogram: This test uses many small pads or metal discs placed on the victim's head. Each has a wire that is hooked to a machine. This machine prints a paper tracing of brain wave activity from different parts of the brain. Caregivers look at the tracing to see how the brain is working.
  
  
• Glucose meter: A glucose meter is a small machine used to test the amount of sugar in the blood. The finger is pricked so caregivers can get a small drop of blood. The blood is put onto a testing strip, and put into the glucose meter. A screen on the glucose meter will show the amount of sugar in the blood. This test may be done several times a day.
  
  
• Magnetic resonance imaging: This is also called an MRI. During the MRI, pictures are taken of the head. An MRI may be used to look at the brain, muscles, joints, bones, or blood vessels. The victim will need to lay still during a MRI. Never enter the MRI room with an oxygen tank, watch, or any other metal objects. This can cause serious injury.
  
  
• X-ray: This is a picture of the bones, lungs and heart. Caregivers use it to see how the lungs and heart are working, and if bones are broken. Caregivers may use the x-ray to look for signs of infection like pneumonia, or collapsed lungs. Chest x-rays may show tumors, broken ribs, or fluid around the heart and lungs.

Neurologic signs:

Neurologic signs are also called neuro signs, neuro checks, or neuro status. Caregivers check the victim's eyes, memory, and how easily he wakes up. The victim's hand grasp and balance may also be tested. This helps tell caregivers how the victim's brain is working after an injury or illness. The victim may need to have his neuro signs checked often. His caregiver may even have to wake him up to check his neuro signs.

Oxygen:

The victim may need extra oxygen to help him breathe easier. It may be given through a plastic mask over the mouth and nose. It may also be given through a nasal cannula, or prongs, instead of a mask. A nasal cannula is a pair of short, thin tubes that rest just inside the nose. Tell caregivers if the victim's nose gets dry or if the mask or prongs bother him. Ask caregivers before taking off the oxygen. Never smoke or let anyone else smoke in the same room while the oxygen is on. Doing so may cause a fire.

Pulse oximeter:

A pulse oximeter is a machine that tells how much oxygen is in the victim's blood. A cord with a clip or sticky strip is placed on his ear, finger, or toe. The other end of the cord is hooked to a machine. Caregivers use this machine to see if the victim needs more oxygen.

Ventilator:

A ventilator is a special machine that can breathe for the victim if he cannot breathe well on his own. He may have an endotracheal tube (ET tube) in his mouth or nose. A tube called a trach may go into an incision (cut) in the front of his neck. The ET tube or trach is hooked to the ventilator. The ventilator can also give oxygen to him.

Vital signs:

This includes taking the victim's temperature, blood pressure, pulse (counting your heartbeat), and respirations (counting his breaths). To take his blood pressure, a cuff is put on his arm and tightened. The cuff is attached to a machine which gives his blood pressure reading. Caregivers may listen to his heart and lungs by using a stethoscope. His vital signs are taken so caregivers can see how he is doing.

Treatment options:

• Hyperbaric oxygen therapy: Hyperbaric oxygen therapy is used to get more oxygen into the body. The oxygen is given under pressure to help it get into the tissues and blood. The victim may be put into a tube-like chamber called a hyperbaric or pressure chamber. The victim will be able to see his caregivers and talk with them through a speaker. The victim may need to have this therapy more than once.
  
  

Copyright © 2012. Thomson Reuters. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

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 (Inpatient Care)