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淹溺

最后审阅: 9 Nov 2024
最后更新: 13 Jul 2021

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 呼吸障碍
  • 淹没或浸入的证据
完整详情

其他诊断因素

  • 体温过低
  • 创伤迹象
完整详情

危险因素

  • 年龄(1-4 岁)
  • 男性
  • 酒精或药物摄入
  • 独自游泳/潜水
  • 缺乏识别深水区危险的意识
  • 缺乏游泳技能
  • 心脏疾病
  • 癫痫
完整详情

诊断性检查

首要检查

  • 脉搏血氧测定/动脉血气分析
  • 胸部 X 线检查
  • 基础代谢检查
完整详情

需考虑的检查

  • 颈椎 CT 检查
  • 肌酸激酶
  • 血清酒精和滥用药物尿检
  • 心电图 (ECG)
  • 血清心肌生物标志物
  • 抗惊厥药物水平
完整详情

治疗流程

初步治疗

所有患者

急症处理

1 级(咳嗽时肺部听诊正常)

2 级(部分肺野存在啰音)

3 级(急性肺水肿,无低血压或休克)

4 级(急性肺水肿,伴有低血压或休克)

5 级(无自主通气,有颈动脉搏动)

6 级(呼吸心跳骤停)

撰稿人

作者

David Szpilman, MD

Medical Director - Brazilian Lifesaving Society - Sobrasa

Lieutenant Colonel MD, retired - Fire Department of Rio de Janeiro

Civil Defense Rio de Janeiro City - Education adviser Defesa Civil Municipal do Rio de Janeiro

Co-founder - International Drowning Researcher's Alliance - IDRA

Rio de Janeiro

Brazil

利益声明

DS is an author of several references cited in this topic.

Justin Sempsrott, MD, FAAEM

Executive Director: Lifeguards Without Borders

Medical Director: International Surf Lifesaving Association

Medical Director: Starfish Aquatics Institute

Medical Director: Innovative Attraction Management Starguard Elite

Board of Directors: Safer 3 Water Safety Foundation

Staff: Global Outreach Doctors

Jacksonville Beach

FL

利益声明

JS has given expert testimony in court cases involving drowning.

Andrew Schmidt, DO, MPH

Assistant Professor

Department of Emergency Medicine

University of Florida College of Medicine - Jacksonville

Medical Director

Jacksonville Beach Ocean Rescue

Deputy Medical Director

Trauma One

Jacksonville

FL

利益声明

AS declares that he has no competing interests.

鸣谢

Dr David Szpilman, Dr Justin Sempsrott, and Dr Andrew Schmidt would like to gratefully acknowledge Dr Bhakti K. Patel and Dr D. Kyle Hogarth, previous contributors to this topic. BKP and DKL declare that they have no competing interests.

同行评议者

Ajeet G. Vinayak, MD

Assistant Professor of Internal Medicine

Department of Medicine

Division of Pulmonary and Critical Care Medicine

Charlottesville

VA

利益声明

AGV declares that he has no competing interests.

Richard Franklin, PhD

Associate Professor

James Cook University

Townsville

Queensland

Australia

利益声明

RF declares that he has no competing interests.

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