injuries poisoning
Drowning
Diagnosis of Drowning
Clinical evaluation For concomitant injuries, imaging studies as indicated Pulse oximetry and, if results are abnormal or if respiratory symptoms and signs are present, arterial blood gases (ABG) and chest x-ray Core temperature measurement to rule out hypothermia Evaluation for causative or contributing disorders (eg, seizure, hypoglycemia, myocardial infarction, intoxication, injury) Ongoing monitoring as indicated for delayed respiratory complications Most people are found in or near water, making the diagnosis obvious clinically. Resuscitation after drowning , if indicated, should precede completion of the diagnostic assessment. Cervical spine injury is considered, and the spine is immobilized in patients whose mechanism of injury potentially involves diving or trauma. Secondary head injury and conditions that may have contributed to drowning (eg, hypoglycemia, myocardial infarction, stroke, intoxication, arrhythmia) are considered. All patients undergo assessment of oxygenation by Pulse Oximetry or, if results are abnormal or if there are respiratory symptoms or signs, arterial blood gas (ABG) and chest x-ray. Because respiratory symptoms may be delayed, even asymptomatic patients are transported to the hospital and observed for several hours. In patients with symptoms or a history of prolonged submersion, core body temperature is measured, electrocardiography and serum electrolytes are obtained, and continuous oximetry and cardiac monitoring are done. Patients with possible cervical spine injury undergo Diagnosis . Patients with altered consciousness undergo head CT. Any other suspected predisposing or secondary conditions are evaluated with appropriate testing (eg, fingerstick glucose for hypoglycemia, electrocardiography for myocardial infarction, cardiac monitoring for arrhythmia, evaluation for intoxication). Patients who drown without apparent risk factors are evaluated for Long QT Interval Syndromes , 