ch 44

A 10-year-old girl was rescued from a school swimming pool, where she was found unconscious, and transported to a nearby hospital, where her lungs were discovered to be dry. What could cause dry lungs in this near drowning?

A. Her glottis spasmed and prevented pool water from entering her lungs.
B. Her young age and the cool pool water prevented serious pulmonary injury.
C. Chlorinated pool water is quickly absorbed across the alveolar-capillary membrane.
D. She swallowed the water.

What are complications associated with a near drowning in unclean, swampy water?

1.Pneumonia
2.Acute respiratory distress syndrome (ARDS)
3.Pulmonary fibrosis
4.Pulmonary hypertension

A. 1, 2, 3
B. 3, 4
C. 1, 2
D. 1

In comparing the pathologic changes to the lungs caused by freshwater versus saltwater, which of the following can be stated?

A. Freshwater causes more damage.
B. Cold water of either type causes more damage than warm water of either type.
C. Both cause identical pathologic changes.
D. Saltwater causes more damage.

The effects of a near-drowning victim inhaling water into the lungs include:
1. alveolar consolidation.
2. bronchospasm.
3. production of frothy, white secretions.
4. pleural effusion.
A. 2, 3
B. 2, 3, 4
C. 1, 3, 4
D. 1, 2, 3

Favorable prognostic factors in clean water near drowning include:

1.greater effort to reach the surface.
2.alcohol in the victim.
3.colder water.
4.younger age.

A. 3, 4
B. 2, 3, 4
C. 1, 2
D. 1, 3, 4

What water temperature has been shown to be a favorable prognostic factor in near drowning?

A. Higher than 104°F
B. Between 70°F and 98°F
C. Between 27°F and 70°F
D. Between 98.6°F and 104°F

A near-drowning victim in cardiac arrest has been placed in an ambulance. During transport, the goals of the paramedics should be to:

1.contact the victim’s insurance carrier.
2.perform high-quality CPR.
3.conserve the victim’s body heat.
4.administer FIO2 1.0.

A. 1, 2, 4
B. 2, 3, 4
C. 2
D. 2, 3

Hospital management of near-drowning victims includes:
1. measurement of arterial blood gas values.
2.rewarming if the patient is hypothermic.
3.measurement of venous blood gas values.
4.chest radiography.

A. 2, 3, 4
B. 1, 3
C. 1, 2, 4
D. 1, 2, 3

Which of the following would be routinely ordered for the majority of wet-drowning victims?
1.Positive end-expiratory pressure (PEEP)
2.Hemodialysis
3.Extracorporeal membrane oxygenation (ECMO)
4.Mechanical ventilation

A. 1, 2, 3
B. 1, 2, 4
C. 1, 4
D. 3, 4

Warming techniques for a cold-water near-drowning victim include:

1.cooling the extremities and warming the body core.
2.warming the inspired oxygen.
3.heated intravenous solutions.
4. heated lavage of the pericardial space.
A. 1, 2, 3
B. 1, 3
C. 2, 3, 4
D. 1, 2, 4

After an extended time underwater, a near-drowning victim will most likely have:

A. tachypnea.
B. a normal respiratory rate.
C. apnea.
D. bradypnea.

Which of the following breath sounds would be expected during auscultation of a wet-drowning victim?

1.Bronchovesicular
2.Vesicular
3.Crackles
4.Friction rub

A. 3
B. 2, 4
C. 1, 2, 3
D. 1

The pulmonary function findings for a wet-drowning victim would reveal:

A. increased DLCO.
B. increased TLC.
C. decreased VC.
D. increased IRV.

The initial chest radiograph appearance of a near-drowning victim may include:

1.normal lung fields.
2.atelectasis.
3.pulmonary edema.
4.pencil point sign.

A. 1, 3
B. 1, 2, 3
C. 2, 4
D. 2, 3, 4

In the United States, approximately how many unintentional drownings occur annually?
A. 2500
B. 4500
C. 3500
D. 1500

According to the World Health Organization, where does drowning rank worldwide as a cause of unintentional death?

A. It is the second leading cause of unintentional death.
B. It is the leading cause of unintentional death.
C. It is the third leading cause of unintentional death.
D. It ranks 23rd among the causes of unintentional death.

What is the upper time limit that a cold-water near-drowning victim can be submerged and survive?

A. 20 minutes
B. 10 minutes
C. 60 minutes
D. 40 minutes