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
其他诊断因素
- 体温过低
- 创伤迹象
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
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
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
治疗流程
所有患者
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.
指南
- 2021 年欧洲复苏委员会指南:特殊情况下的心脏停搏
- 复苏指南
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