CASE SHARE: Delgado, a 4-year-old boy from Texas, USA, went swimming with his parents at a dam last week. The whole swim was fully equipped, his dad didn’t leave an inch, and there were no accidents at all. However, that night the child said he had a stomach ache, and a few days later the child was vomiting and had diarrhea and shoulder pain, and when he was taken to the hospital, the doctors said it was too late to do anything about it. The child left this life that day. The doctor gave the cause of death as: drowning. And said it was dry drowning, the little boy eventually drowned because of swimming that day, only not in the water, but on the shore …… The whole article looks like a suspenseful story, very eye-catching, the logic is quite confusing, but quite alarming to young parents. How dare you let your child go into the water in the future? Will not always have to tremble after swimming? Now let everyone understand the process of drowning and some basic concepts, so that when we face similar problems are not fooled, do not somehow do people’s marketing pushers. The process of drowning Drowning is the process of being submerged by water leading to respiratory damage, and its main lethal mechanism is hypoxia, carbon dioxide retention and acidosis. When the drowning person’s airway begins to submerge in water, he or she will first hold his or her breath autonomously, and then unable to hold it in, the water will enter the pharynx and throat to cause involuntary laryngospasm. During the period of holding his or her breath and laryngospasm, the drowning person is unable to breathe in the air, which leads to the reduction of oxygen in the body and the inability to discharge carbon dioxide, which will lead to hypercapnia, hypoxemia and acidosis. When the partial pressure of the drowning person’s blood oxygen drops further, the laryngospasm decreases and subsequently water enters the lungs. The amount of water inhaled into the respiratory tract varies from drowning victim to drowning victim. Drowning victims are categorized into dry drowning and wet drowning based on whether or not fluid enters the lungs. Dry drowning is characterized by laryngeal spasm and obstruction of the airway, resulting in death by asphyxiation. When the larynx spasms, it can cause reflex cardiac arrest or cardiac arrest due to asphyxia and myocardial hypoxia. Such patients have no or only a small amount of water in their lungs. Wet drowning people submerged in water instinctively cause reactive breath holding to avoid water entering the airway. Due to the lack of oxygen, the breath hold cannot be maintained and the person is forced to take deep breaths, thus allowing water to enter the lungs. On-site rescue of drowning Regardless of whether it is dry drowning or wet drowning, it is important to take timely and needed on-site rescue measures based on the state of the drowning person after being rescued to shore. Conscious, breathing with pulse: call 120, keep company, keep warm, wait for rescuers or send to hospital for observation. Unconscious (no response to call), breathing with pulse: call 120, clean up foreign objects in the mouth and nose, stabilize the lateral position, wait for rescuers. Closely observe respiration and pulse, CPR if necessary. Coma, no breathing with pulse: similar to the “false death” state, the patient may be laryngospasm, no breathing, weak pulse on the verge of stopping, at this time only to open the airway, artificial respiration, pulse and heartbeat can be rapidly enhanced. After breathing is restored, the patient can lie on his side and wait for rescuers. Unconscious, no breathing, no pulse (cardiac arrest): Immediately clear the mouth and nose of foreign objects, open the airway, artificial respiration (Breathing), chest compression (Compression), that is, the use of traditional A-B-C CPR first aid. Remember to call 120 at the same time and continue resuscitation until the patient’s respiratory rate returns or emergency personnel arrive. Proper first aid gives drowning and other cardiac arrest patients a better chance of survival! Finally, once again, under no circumstances do you need to control the water after the drowning patient has been rescued to shore! Do not control the water under any circumstances! Do not control the water under any circumstances! Whether it is water control with the back turned upside down or water control by pressing the back with the knees against the abdomen, both are unhelpful and harmful. If the drowning victim is conscious and breathing well after being rescued from the shore, or if he or she awakens within a short period of time with adequate respiratory oxygenation, the majority of these patients continue to recover and have a good prognosis. However, there are a small number of patients, after being rescued to the shore, the surface seems to have no obvious abnormality in the early state of consciousness, respiration, oxygenation, circulation, but in the following hours or even 72 hours after the occurrence of severe respiratory distress or even life-threatening, known as “secondary drowning”, in essence, the pathophysiological process of drowning is still continuing to progress. Secondary drowning is a rare form of dry drowning that is insidious and delayed. This is why even if a conscious drowning victim is rescued, he or she still needs to be observed in a hospital emergency room, both for further evaluation of the drowning hazards and because of the possibility of progression. Regardless of the cause, drowning or no drowning, when a child has frequent coughing, shortness of breath, wheezing, unresponsiveness, and depression, he or she should seek medical attention as soon as possible. Do not let the rumors fly The 4-year-old boy mentioned above, according to the description of no drowning process at all, why dry drowning? Drowning drowning, you have to have a drowning process first. The instant choking that occurs during daily water or breastfeeding, or swimming in an autonomous state, is not dry drowning, and secondary drowning does not occur, so there is no need to panic. If the case of this child’s death is true, the description of the article alone, consider the child’s cause of death and swimming is not related at all, but some other diseases lead to death. Warm reminder: to prevent drowning is important to prevent, learn first aid love family, every summer there are drowning incidents, especially children drowning, even if this circulating article is not true, parents should still pay full attention to their children’s waterproof safety, after all, safety is no small matter.