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| | eMedicine - Submersion Injury, Near Drowning : Article by Suzanne Shepherd, MD, MS, DTMandH (Site not responding. Last check: 2007-10-14) |
 | | The submersion time, water temperature, water tonicity, degree of water contamination, symptoms, associated injuries (especially cervical spine and head), presence of co-ingestants, underlying medical conditions, type of rescue, and response to initial resuscitation are all relevant factors. |
 | | The mechanism for this reflex has been postulated to be reflex inhibition of the respiratory center (apnea), bradycardia, and vasoconstriction of nonessential capillary beds triggered by the sensory stimulus of cold water touching the face; these responses preserve the circulation to the heart and brain and conserve oxygen, thereby prolonging survival. |
 | | Patients exhibiting significant hypoxia requiring intubation, worsening dyspnea with the potential for intubation, evidence of hypoxic cerebral injury, evidence of renal insufficiency, evidence of hemolysis, or severe hypothermia requiring cardiopulmonary bypass must be in a facility capable of providing appropriate, age-related intensive care. |
| www.emedicine.com /emerg/topic744.htm (4773 words) |
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