IF SYMPTOMS PERSISTS
By DR. JOSE PUJALTE JR.
“O Lord, methought what pain it was to drown!
What dreadful noise of waters in my ears!
What sights of ugly death within my eyes!”
— William Shakespeare (1564–1616), English poet and playwright,
King Richard III (I, iv), (1592)
It’s summer. It’s hot and people swim. Some people drown. Here’s a typical story of a family outing. Two girls, aged 8 and 10, jumped into the deep part of the swimming pool. The parents were busy preparing food in a rented cottage and ignored the commotion until it was too late. The girls met a silent, watery death.
Near Drowning and Drowning. The Merck Manual of Medical Information defines near drowning as “severe oxygen deprivation caused by submersion in water but not resulting in death.” So purists say “the poor girl nearly drowned” (because if she did drown, she would be dead).
What Happens. If there’s any part of the body that must be water tight, it’s our lungs. In fact, the vocal cords, at the threat of unwelcome water, suddenly go into spasm in a heroic attempt to dam. Unless the person surfaces, it is just a matter of time before the lungs are filled with water. With this comes the disruption of the efficient transfer of oxygen to the blood and the result is brain damage and finally death. A watery death, to be sure.
Who is at Risk? Statistics vary but world-wide, children less than 4 years are at highest risk. In the US, approximately 300 children under 5 drown every year in swimming pools alone.
Curious and frisky, they’d be gone in a second, falling into water and not necessarily in a pool but into drums of water (the ubiquitous pinag-igiban), bathtubs, etc. Babies, according to the Mayo Clinic, can drown in an inch of water (!). Teenagers and adults drown too, not because they don’t know how to swim but because of alcohol intoxication. Some have taken sedatives or get a seizure making it easier to drown. The old game of who can stay under water the longest has claimed lives. The supposed “winner” who stayed submerged after every one else had shot up to gasp air may have actually passed out.
Signs and Symptoms. As a rule, drowning children who can’t swim sink within less than a minute (compared to adults who manage to call attention by splashing mightily). Because drowning people are reflexively trying to breathe, few can cry for help. Those who are rescued have bluish skin (cyanotic) – a sign that oxygen in the blood has been minimal. Near drowning victims may cough, vomit, or breathe with difficulty. One result of water getting into the lungs would be infection because of sand particles, chemicals, or even algae. But this will not be known immediately and may take a few days to manifest.
CPR. Cardio-pulmonary Resuscitation or CPR is indicated for rescued victims no longer breathing. CPR is done without hesitation and it is everyone’s duty to know the basics (http://www.kidshealth.org) of CPR. It is a combination of mouth to mouth resuscitation and chest compressions. The local Red Cross offers a regular course on first aid and this includes CPR. But briefly, think of A-B-C. A stands for Airway and this must be open or clear of obstructions for air to enter freely. B is for Breathing or rescue breathing to be exact and means forcing air into the victim’s lungs by mouth to mouth. C stands for Circulation and this is done by chest compressions of about 30 times for every 2 rescue breaths. CPR is a skill that is learned and practiced. Every parent should know CPR.
Prevention. The most obvious is to teach children how to swim. This summer might be the right time. Schools with pools have swimming for PE but sometimes the class is too big for all the children to learn. The rule of thumb is that a child who is ready to bike is ready to swim and this is about the age 5. All children must wear a flotation device like an inflatable life jacket.
Never swim alone. Don’t drink booze and party by the beach or pool (teenaged boys at highest risk of drowning). In unfamiliar water, don’t dive head first. The surest way of breaking your neck or cracking your skull is plunging head down into two feet of water thinking it was six.
Resist swimming in flood water. It really is swimming in a septic tank.
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