1/3. Drowning and near-drowning--some lessons learnt.Over a period of sixteen months, 17 cases of submersion injury (encompassing victims of drowning and near-drowning) were attended to at our Accident and Emergency Department at Changi General Hospital. Most of the victims were inexperienced recreational swimmers, and in 6 of them, early bystander cardiopulmonary resuscitation enabled them to recover without severe morbidity. Non-cardiogenic pulmonary oedema with resulting chest infection was the commonest complication in survivors. Most of the episodes occurred in an urban setting in swimming pools without supervision by lifeguards. About two-thirds of the cases were adults over the age of fifteen years. In addition, there were patients in whom submersion injury was associated with more sinister conditions (fits, traumatic cervical spine injury, dysbarism, intoxication from alcohol or drugs), some of which were unsuspected by the doctors initially. Apart from the immediate threats of hypoxia and pulmonary injury, active search for any possible precipitating causes and associated occult injury should be made. In this study, the determinants of survival from near-drowning were early institution of cardiopulmonary resuscitation, presence of pupil reactivity, and presence of a palpable pulse and cardiac sinus rhythm.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
2/3. Unusual freshwater near-drowning syndrome in a hospitalized postlobectomy patient.Near-drowning syndrome depends on the duration of submersion, the amount of fluid aspirated, and the severity of hypoxia. We report a case in which a patient developed ARDS shortly after undergoing a left upper lobectomy and a chest wall resection for a lung carcinoma. On further investigation, the ARDS was caused by near-drowning in a basin of freshwater: the patient's face was submerged by the patient's companion as part of a cultural tradition of trying to clean his lung. We believe that this case presents the etiology of freshwater near-drowning syndrome due to an ethnogenic practice not previously reported.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
3/3. Near-drowning-associated aeromonas pneumonia.aeromonas is increasingly recognized as a human pathogen that causes a variety of different infections. aeromonas has rarely been reported as a cause of respiratory infection, and it has been described in near-drowning-associated pneumonia. This article reviews a case of aeromonas sobria pneumonia associated with a near drowning and considers the clinical and epidemiological characteristics of 10 previously reported cases. Nearly all of the cases involved young healthy men, a rapid development of pneumonia and sepsis after a brief stable period postimmersion, and bilateral infiltrates on chest radiography. A very high rate of positive blood cultures and mortality was also noted. The epidemiological and clinical data in this review may be helpful to the clinician caring for near-drowning victims. Although prophylactic antibiotics are not recommended for near-drowning victims, broad-spectrum antibiotics should be rapidly instituted with any evidence of infection.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |