How long does a person stay alive if he loses the ability to breathe? Brain cells remain viable under hypoxic conditions for no more than 5-6 minutes. Although drowning in cold water, this time may increase. In any case, assistance to the victim should be provided even before the arrival of the medical team. In this situation, the matter is decided by minutes. This is why knowing how to help is so important.

Not all people, however, are ready to answer the question, and even more so to show in practice how to act correctly in case of drowning. And this is very sad. For some reason, many believe that only employees of specialized services should have such skills, while an ordinary person, far from medicine, does not need to know this. But life sometimes puts people in difficult situations. Very scary - to see how it dies close person and not know how to help him.

What is drowning?

This is a life-threatening condition characterized by the inability to breathe as a result of a person falling into water or other liquid. Often, the airways fill with water, although this is not strictly necessary. Death from respiratory failure can occur even if the lungs remain "dry". On this basis, by the way, they distinguish different types drowning.

Classification by mechanism leading to death

1. True drowning. It is called so because in this case water (or other liquid) enters the lungs. The pathological processes underlying true drowning differ depending on whether the drowning occurred in fresh or salt water. In the first case, water quickly penetrates from the alveoli into the vascular bed, thinning the blood and destroying red blood cells. Salt water, on the contrary, promotes the release of plasma from the vessels, which is accompanied by thickening of the blood, as well as the development of pulmonary edema.
2. Asphyxial drowning. In this case, water does not enter the lungs, as the glottis closes, protecting the airways from the penetration of fluid into them. However, breathing still becomes impossible, because with laryngospasm, air is also not allowed to pass. The person dies of suffocation.
3. Syncope drowning. The main cause of death is reflex cardiac arrest. The lungs remain dry. A similar situation is possible when drowning in very cold water.

Classification according to the color of the skin of the victim

Types of drowning by skin color:

1. White asphyxia. As the name suggests, it is characterized by a pronounced pallor of the skin. Occurs if there is no flooding of the respiratory tract with liquid. This type is most typical for the syncopal mechanism of drowning, when death occurs as a result of the cessation of cardiac activity.
2. Blue asphyxia. It occurs when the victim makes respiratory movements, as a result of which the lungs fill with water. The skin becomes bluish in color due to severe hypoxia. Death occurs due to respiratory failure. Cardiac arrest occurs after the cessation of breathing.

Appearance of the victim

Different types of drowning have certain differences in clinical manifestations.

If the victim was conscious at the time of immersion in water, the scenario for the development of events looks something like this. A person tries to escape by swallowing water. Breathing becomes impossible, the body experiences hypoxia, as a result of which a characteristic bluish coloration of the skin appears. Often there is an expansion of the veins of the neck. Pink foam comes out of the mouth. If a person is removed from the water at the stage of agony, breathing and heart activity may still be preserved.

If drowning was preceded by depression of the functions of the central nervous system, laryngospasm often occurs. The lungs do not fill with water, but death also occurs as a result of asphyxia. The skin becomes bluish in color.

Occurs against a background of severe fright or cold shock. In the first place in the pathogenesis comes the cessation of cardiac activity. The skin is pale, there is no release of liquid and foam from the nose and mouth of the victim, which is characteristic of other types of drowning. White asphyxia is the most favorable for resuscitation, the time with it can be significantly lengthened.

Basic Principles of Drowning Rescue

The types of drowning are varied and require different approaches to care, but the general principles remain the same in all cases.

All events include 2 stages:

1. Extraction of the victim from the water.
2. Providing assistance on the coast.

How to save a drowning person?

No matter how different types of drowning are from each other, first aid for drowning should begin with ensuring the safety of the rescuer himself. A drowning person (if he is still conscious) can behave extremely inappropriately. That is why, when pulling the victim out of the water, care should be taken. Otherwise, the lifeguard runs the risk of becoming a drowning man himself.

If a person is close enough to the shore, you can try to reach him with a stick, use a rope or other devices to pull him out. If the victim is too far away, you will have to swim to get to him. The main thing in this situation is not to forget about the danger, because the victim can drown his savior. Therefore, you need to act quickly and unceremoniously. It is best to swim up to the drowning man from behind and wrap one arm around his neck, you can grab his hair (this is even more reliable), and then pull him to dry land as soon as possible.

Remember: you don’t need to get into the water if you don’t swim well yourself!

when drowning. Activities on the coast

There are different types of drowning, and their signs are discussed above. This knowledge must be taken into account when assisting the victim.

• Everything is extremely simple if the person extracted from the water is conscious. The main actions will be aimed at warming him up and calming him down.
• If the person is unconscious, the first thing to do is remove water from the airways. With white asphyxia, this is not necessary (the mechanism of this type of drowning is discussed above), you can immediately start resuscitation.
• With the blue type of drowning, we first clean the mouth and nose from algae, sand, etc. Then we press on the root of the tongue, thereby determining the presence of a gag reflex. The preservation of the latter means that the victim is alive, so the primary task will be to remove water from the lungs and stomach. For this, we turn the victim over on his stomach, turn his head to one side, make him vomit several times, press on his chest. Then we repeat these steps every 5-10 minutes, until water stops coming out of the mouth and nose. It is necessary to monitor breathing and pulse, be ready to perform resuscitation.
• If the gag reflex is absent, it is urgent to check the presence of vital functions. Most likely they won't. Therefore, you should not spend a lot of time on removing water from the lungs (no more than 1-2 minutes), but start resuscitation as soon as possible.

The various approaches to helping the victim have been given above. There are different types of drowning, it is not surprising that they require different measures. However, it is always carried out according to a certain plan, which is not affected by the causes that led to clinical death.

What is included in the revitalization package?

• Restoration of airway patency.
• Artificial respiration.
• Indirect cardiac massage.

No matter how different the types of drowning are, first aid always begins with cleansing the mouth and nose of sand, algae, vomit, etc. Then water is removed from the lungs. For this purpose, the victim should be turned face down and laid on his stomach on his knee. The head, therefore, will be lower than the body. Now you can press on the chest, stimulating the flow of fluid from the lungs. If assistance is provided to a small child, it can be thrown over the shoulder head down or even taken by the legs and turned over, thereby creating more favorable conditions for water to flow out of the lungs.

Next, we proceed to the execution of the Victim should be laid on a hard surface, tilt his head back, push his lower jaw forward with his fingers and, pressing on his chin, open his mouth. Now you can proceed to Pressing your lips tightly against the mouth of the victim, we exhale. The criterion of effectiveness will be the rise of the chest. After two exhalations, we begin. The base of the right hand is placed on the lower third of the sternum, left hand put on top of the right. We begin to perform chest compressions, making sure that the arms remain straight, do not bend at the elbows. The latest recommendation (2015) is that the ratio of exhalations to compressions should be 2:30, regardless of whether one or two rescuers are performing resuscitation.

In conclusion

Never forget about the rules of behavior on the water. It is easier to prevent a tragedy than to try to fix it. Remember: life is given only once. Take care of her and don't play with death.

There are three types of drowning: primary (true, or "wet"), as-

fixed ("dry") and secondary. In addition, in case of accident

there may be death in the water, not caused by drowning (trauma, heart attack

myocardium, disorder cerebral circulation etc.).

Primary drowning is the most common (75-95% of all accidents)

cases in water). It causes fluid to be aspirated into the respiratory

paths and lungs, and then its entry into the blood.

When drowning in fresh water, severe hemodilution quickly occurs.

and hypervolemia, hemolysis develops, hyperkalemia, hypoproteinemia, hy-

ponatremia, a decrease in the concentration of calcium and chlorine ions in plasma. Ha-

rakterna sharp arterial hypoxemia. After removing the victim

from water and first aid, pulmonary edema often develops with

secretion of bloody foam from the respiratory tract.

When drowning in sea ​​water, which is hypertensive with respect to

blood plasma, hypovolemia develops, hypernatremia, hypercalcemia,

hyperchloremia, there is a thickening of the blood. For true drowning in the sea

which water is characterized by the rapid development of edema with secretion from the respiratory

paths of white, resistant, "fluffy" foam.

Asphyxial drowning occurs in 5-20% of all cases. With him

reflex laryngospasm develops and water aspiration does not occur, but

asphyxia occurs. Asphyxial drowning occurs more often in children and

women, as well as if the victim gets into a contaminated, chlorinated

water. In this case, water in large quantities enters the stomach. Maybe

develop pulmonary edema, but not hemorrhagic.

Secondary drowning develops as a result of cardiac arrest

due to the victim getting into cold water("ice shock",

"immersion syndrome"), a reflex reaction to the ingress of water into the respiratory

paths or middle ear cavity with a damaged tympanic

ponque. Secondary drowning is characterized by a pronounced spasm of the peripheral

some vessels. Pulmonary edema usually does not occur.

Symptoms. The condition of the victims extracted from the water is largely determined by

is divided by the duration of stay under water and the type of drowning, the presence

mental trauma and cooling. In mild cases, consciousness may be

preserved, but the patients are agitated, trembling, frequent vomiting is noted. At

relatively long true or asphyxic drowning consciousness

tanno or absent, sharp motor excitation, convulsions. Dermal

covers are cyanotic. For secondary drowning, a sharp pallor is characteristic

skin covers. The pupils are usually dilated. breath bubbling,

frequent or with prolonged stay under water rare with participation

accessory muscles. When drowning in sea water, edema quickly increases

lungs. Severe tachycardia, sometimes extrasystole. With long and

secondary drowning, the victim can be removed from the water without recognition

respiration and cardiac activity.

Complications. With true drowning in fresh water, already at the end of the first

hours, sometimes later, hematuria develops. Pneumonia and atelectasis

which can develop very quickly, at the end of the first day after drowning

With severe hemolysis, hemoglobinuric nephrosis and

acute renal failure.

Urgent care. The victim is removed from the water. With loss of consciousness

artificial ventilation the easy way mouth to nose preferably

start on the water, but these techniques can only be performed by a well-prepared

tovlenny, physically strong rescuer. artificial lung ventilation

carried out as follows: the rescuer conducts his right hand under right

howl with the victim's hand, being behind his back and to the side. His right

with the palm of the hand, the rescuer closes the mouth of the victim, at the same time pulling

up and forward his chin. The blowing of air produces in the nasal passages

dy drowned.

When removing the victim to a boat, lifeboat or shore

it is necessary to continue artificial respiration, for this purpose it is possible to use

use an airway or mouth-to-nose mask and Ruben bag. When from-

In the absence of a pulse in the carotid arteries, an indirect compression should be started immediately.

heart massage. It is a mistake to try to remove "all" the water from the lungs.

With true drowning, the patient is quickly laid with his stomach on the thigh

the rescuer's leg of the rescuer and with sharp jerky movements compress the sides

chest surfaces (within 1015 s), after which again

bring him back. The oral cavity is cleaned with a finger wrapped in a handkerchief

or gauze. If trismus of masticatory muscles has come, you should press

fingers on the corners of the lower jaw. If there is an electrical or

foot suction to clean the mouth, you can use a rubber

teter of large diameter, but with pulmonary edema, one should not strive to

remove foam from the respiratory tract, as this will only increase swelling.

When carrying out artificial ventilation of the lungs by methods from the mouth to

mouth or from mouth to nose, one condition is absolutely necessary:

the patient's head should be in the position of maximum occipital extension

banya. Rescuer, being on the side of the victim, with one hand

holds his head in an unbent position, pressing his palm on his forehead,

and with the other hand slightly opens his mouth by the chin. At the same time, I do not follow

it is not possible to bring the lower jaw forward, since with the correct position of the go-

catches the patient's tongue root and epiglottis is displaced anteriorly and opens

air access to the larynx. The rescuer takes a deep breath and, cuddling up

with his lips to the mouth of the patient, makes a sharp exhalation. This is followed by 1 and

II with the fingers of the hand placed on the forehead, squeeze the wings of the nose to prevent

blocking the exit of air through the nasal passages. If you open the patient's mouth

it is possible or the oral cavity is not freed from the contents, to blow in air

can be through the nose of the victim, covering his mouth with his palm. The rhythm is artificial

leg breathing 12-16 in 1 min.

In some cases, the respiratory tract of a drowned person may not be

walkable due to the presence of a large foreign body in the larynx or persistent

laryngospasm. In this case, a tracheostomy is indicated, and in the absence of

necessary conditions and tools - conicotomy.

After the patient has been delivered to the rescue station, resuscitation measures

riyatiya must be continued. One of the most common mistakes is

premature termination of artificial respiration. The presence of the victims

greater respiratory movements, as a rule, do not indicate recovery

lesion of full ventilation of the lungs, so if the patient does not have

consciousness or pulmonary edema has developed, it is necessary to continue artificial

breath. Artificial respiration is also necessary if

the victim has respiratory rhythm disturbances, increased breathing more than 40

in 1 min, sharp cyanosis.

With saved breathing, inhalation of ammonia vapors should be carried out.

alcohol (10% ammonia solution).

With chills, it is necessary to carefully rub the skin, wrap

injured person in warm dry blankets. Heating pads are contraindicated

if consciousness is absent or impaired.

With respiratory disorders and pulmonary edema, tracheal intubation and

artificial ventilation of the lungs, preferably 100% oxygen

house. Intubation can be done by intravenous

muscle relaxants (listenone - 100-150 mg) with a preliminary introduction of 0.1%

atropine solution - 0.8 ml. With a sharp excitation of the patient, atropine and

listenone can be injected into the root of the tongue. In the presence of a respirator type RO,

"Phase", "Lada" output resistance +8 is shown; +15 cm aq. Art. under

BP control.

Particular emphasis should be placed on the danger of premature termination of the

artificial lung ventilation. The appearance of spontaneous respiratory

movements does not mean the restoration of an adequate pulmonary valve

tion, especially in conditions of pulmonary edema.

After tracheal intubation and initiation of artificial respiration,

insert a probe into the stomach and evacuate the water accumulated in it and stagnant

content.

When drowning in fresh water to the victim in stationary conditions

with severe cyanosis, swelling of the cervical veins, high central venous

pressure shows bloodletting in a volume of 400-500 ml from the central vein

(subclavian or jugular). With severe hemolysis, intravenous

transfusion of 4-8% sodium bicarbonate solution at a dose of 400-600 ml

(under the control of the acid-base state). Against the backdrop of artificial

created metabolic alkalosis, lasix 40-60 mg should be administered

2-3 times a day until the disappearance of gross hematuria.

Concentrated protein transfusion is indicated for hypoproteinemia

(20% albumin - 100-150 ml).

With late development of pulmonary edema, if there are no indications for artificial

ventilation of the lungs, inhalation of oxygen passed through

50% alcohol or antifomsilane. If pulmonary edema develops against the background of arterial

al hypertension, intravenous administration of ganglionic blockers (ar-

fonad 5% solution - 5 ml or pentamine 5% solution - 0.5-1 ml in 200 ml 5%

glucose solution drip under strict control of blood pressure). It is necessary to

changing large doses of corticosteroids - 800-1000 mg of hydrocorgizone or

150-180 mg of prednisolone per day. Previous use of antibiotics

for the prevention of aspiration pneumonia. To combat motor

arousal and to protect the brain (prevention of hypoxic encephalopathy)

ii) shows intravenous administration of sodium hydroxybutyrate - 120-150 mg / kg

or neuroleptanalgesics - 0.3-0.7 mg of menthanil with 12-15 mg of droperidol.

When drowning in sea water, artificial ventilation of the lungs with

living pressure at the end of the exit should be started as early as possible.

Transfusion of protein solutions (plasma, albumin) is shown. Special attention

should be addressed to the elimination of hypovolemia and correction of rheological

blood properties. Intravenous transfusion of rheopolyglucin is indicated, previously

the use of heparin - 20000-30000 IU / day.

The rest of the therapy is carried out according to the principles described above.

Hospitalization. In severe forms of drowning of the victim, it is necessary

transport not to the nearest hospital, but to a well-equipped department

resuscitation institute. During transportation, you must continue to use

artificial ventilation of the lungs and all other necessary measures. Beli

a gastric tube was inserted, it is not removed during transportation.

If for some reason the tracheal intuation was not performed, trans-

it is necessary to port the victim on his side with the headrest lowered

Water is a serious element that is not to be trifled with. In it, a person obtains food, with its help he waters planted plants and waters animals, and also uses it for entertainment: swimming, diving, and doing various sports. All this carries the potential danger of drowning in water. Moreover, children and, oddly enough, good swimmers are more at risk of drowning: both of them neglect the danger and dive, jump into the water from a height, go swimming in a storm.

Drowning is an insidious state. Firstly, almost the entire body of a person is hidden by water, and even those swimming nearby do not see how bad it is for him. Secondly, a drowning person never stretches out his arms and calls for help: he is fighting for his life and is only busy breathing in some more air. From the outside - especially if a child is drowning - it looks like he is playing: bouncing over the water and diving again. Thirdly, there is such a condition as secondary drowning. In this case, a person has been on land for a long time, but the water that has entered his respiratory tract continues its destructive effect and can kill him if treatment is not started in time.

Why do people drown?

Drowning is a life-threatening condition associated with a person falling into water. It results from:

• panic when overwhelmed by a wave at a depth
• emergency situations: floods, sinking of the ship;
• swimming in a storm;
• violations of the rules of swimming, including diving;
• swimming in strong currents;
• buying faulty diving equipment;
• falling into swamps and swamps;
• occurrence or exacerbation of diseases during bathing. This is a faint, an epileptic attack, an acute violation of cerebral circulation (stroke), a heart attack, hypothermia, due to which it reduces the muscles of the legs;
• suicide, when a person either swims very deep, or dives to depth, or jumps into the water from a height. In the latter case, death can be provoked by three mechanisms:
  1. loss of consciousness due to brain injury;
  2. paralysis of all limbs due to fracture of the cervical vertebrae;
  3. reflex cardiac arrest, provoked either by a sharp immersion in cold water, or by pain from hitting the water;
• murders.

Not all people die as a result of water entering the respiratory tract: there is such a type of it when the air stops passing into the lungs due to the fact that a person has a reflex spasm of the larynx in the water. This type of drowning is called "dry".

Who is most at risk of drowning

Of course, the young and healthy people who are engaged extreme views water sports. But such activities increase the risk in only a small number of people. In most cases, drowning occurs:

• after taking a large amount of alcohol, which dulls the person’s reactions and “inspires” fearlessness in him. In addition, when alcoholic beverages "push" a person into the water, they contribute to hypothermia of the body, which increases the chance of drowning even more (with strong cooling, the body "throws" all the blood to the internal organs, leaving the working muscles with minimal blood supply);
• when it enters a strong or rip current (reverse) current: it does not allow a person to reach the shore;
• when overwhelmed by a wave, when water enters the respiratory tract, and, in addition, causes panic in a person;
• if a person suffers from epilepsy or faints. In this case, loss of consciousness leads to water entering the respiratory tract;
• when swimming alone: ​​in this case, the chance of first aid is reduced if a person is injured under water, gets into the area of ​​\u200b\u200bthe current or his leg is reduced from cold water;
• when swimming in full stomach. In this case, the deterioration of the human condition, which can lead to drowning, occurs through one of three mechanisms:
  1. the main amount of blood after eating rushes to the stomach and intestines. Under these conditions, the heart itself begins to be supplied with blood worse - its work worsens, a heart attack may develop;
  2. water squeezes the full stomach, as a result, its contents rise up the esophagus. At the time of inhalation, food mixed with gastric juice can enter the respiratory tract (especially people who are in a state of intoxication are at risk). This is how inflammation of the lung tissue develops, which is difficult to treat - pneumonitis;
  3. deterioration can develop according to the previous scenario, only the airways (bronchi or trachea) can become clogged with a large piece of food. Even if this food can not completely block the diameter of the bronchus or trachea, it is still dangerous: it will cause a coughing fit, and in water it can end with fluid entering the respiratory tract;
• with existing heart diseases: the work of muscles in water makes the heart work harder, which can worsen its condition. If bathing takes place in cold water, then the load on the heart increases even more: it has to process a larger volume of blood due to the narrowing of the skin vessels.

Types of drowning

The division of drowning into types is due to the fact that in each case different mechanisms lead to death and you can get rid of them in different ways.

There are 4 main types of drowning:

1. "Wet" or true drowning. It develops as a result of the ingress of water - sea or fresh - into the respiratory tract; occurs in 30-80% of cases. The true form of drowning suggests that a person has resisted the action of water for some time. The skin color of this type of drowning is blue. This is due to venous congestion in the skin. Very seriously, the condition worsens when 10 ml of water enters the lungs for every kg of body weight. More than 22 ml/kg is considered lethal.
2. "Dry" drowning. It occurs when, when a person enters water, the glottis reflexively spasms (shrinks), as a result of which neither water nor air enters the lungs. This type of drowning occurs in every third drowned person. The color of the skin during this drowning is white, associated with a spasm of the skin vessels.
3. Drowning syncopal type occurs when, upon falling into water (usually from a height and into cold water), a person’s heart stops reflexively. Then he does not flounder and does not swallow water, but immediately goes to the bottom. Syncopal drowning is the least common - in every 10 cases, more common in people with heart disease.
4. Mixed drowning. In this case, water first enters the airways, as in true drowning, and because of this, the glottis spasms (as in its “dry” form). Then, when consciousness is already lost, the larynx relaxes, and the water again flows into the lungs. This type occurs in every fifth drowned person.

The mechanisms leading to death in "wet" drowning depend on what kind of water got into the lungs - sea or fresh.

So, when drowning occurred in fresh water, there are processes associated with the fact that water, in comparison with the fluids of our body, is hypotonic. This means that less salts are dissolved in it, and because of this, it penetrates into areas where body fluids are contained and dilutes them. As a result, water that has entered the respiratory tract:

• first fills the alveoli - those structures of the lungs, in which the exchange of gases - oxygen and carbon dioxide - between the blood and the respiratory tract takes place. These are respiratory "sacs", which normally always remain open and contain air, due to the presence of a substance called "surfactant" in them;
• being hypotonic, fresh water (and with it bacteria and plankton) quickly passes from the alveoli into the blood: the vessel is located on the outside of each alveoli;
• fresh water destroys the surfactant;
• there is a lot of fluid in the vessels, and it goes back to the alveoli, causing pulmonary edema. Since erythrocytes burst from fresh water, the fluid in the alveoli becomes saturated with their "debris". This makes the foam that comes out of the respiratory tract red;
• when water dilutes the blood, the concentration of electrolytes (potassium, sodium, chlorine, magnesium) in it decreases. This disrupts the functioning of internal organs.

If drowning occurred in sea water, which, on the contrary, is saturated with sodium salts, the picture will be different:

• sea ​​water that has entered the alveoli "attracts" fluid from the lung tissue and blood into the alveoli;
• due to supersaturation of the alveoli with fluid, pulmonary edema develops. The emitted foam (it comes from the surfactant) is white. At the same time, each breath “beats” the foam even more;
• because some of the liquid has left the blood, the blood becomes more concentrated;
• it is difficult for the heart to pump thick blood;
• thick blood cannot reach small capillaries, since here it is not the force of the heart that pushes it, but the wave that was formed at the previous stage by medium-sized arteries;
• such blood contains a high concentration of potassium, which causes cardiac arrest.

Who is more likely to survive drowning

When rescuing a drowning person, a huge factor is the time that has passed since falling into the water. The sooner assistance is started, the greater the chance of saving a person.

The chances of saving a person increase if:

• drowning occurred in ice water. Although such drowning is most likely of a “dry” nature, when it enters low temperatures, all biochemical processes in the body slow down greatly. This gives a chance even to restore the work of the body, when the heart did not beat for some time (up to 10-20 minutes, depending on the temperature of the water);
• is a child or young person without chronic diseases: their ability to regenerate, including brain tissue, is higher.

How to suspect that a person is drowning

It is only in films that the signs of drowning are when the victim shouts “Drown!” or "Save!". In fact, a drowning person does not have the strength and time for this - he is trying to survive. So you can see how:

• he then rises above the water, then plunges into it again;
• his head rises above the water, thrown back, eyes closed;
• arms and legs move randomly, making attempts to swim;
• a drowning man coughs, spits out water.

The symptoms of drowning children look like a game at all: the child bounces over the water (every time - lower and lower), convulsively swallowing air, and from the side it seems that everything is in order with him.

Calling for help and purposeful arm waving is what precedes drowning. When a person feels that he is drowning, he develops a panic state associated with a feeling of lack of air. At this point, he is unable to think critically.

The following signs indicate that a person has survived drowning:

• severe cough, cough with foam or frothy sputum - white or with a reddish tint;
• rapid breathing;
• muscle tremors;
• frequent pulse;
• pale or cyanotic skin;
• wheezing when breathing;
• vomiting, in which a fairly large amount of fluid is released. It is swallowed water;
• excitement or, conversely, drowsiness when hitting the shore;
• convulsions - not the reduction of the limbs in the presence of consciousness, but the arching of the whole body or uncontrolled movements of the limbs - in an unconscious state.

And, finally, if the water that got into the respiratory tract caused a cessation of breathing and / or blood circulation, then such a person:

• loses consciousness (it must be removed from the water);
• he does not have respiratory movements of the abdomen or chest;
• there may be breathing, but it may be "sobbing" or gasping for air;
• there is no pulse on the carotid artery;
• discharge from the mouth and nose of the foam, when drowning in fresh water - pink.

Now we need to draw your attention twice:

• Even if a person managed to reanimate, this does not mean that his nervous system will be restored in full. He - immediately or after a while - may have the same symptoms that are characteristic of a stroke: loss of the ability to think and speak coherently, impaired speech (understanding or reproduction), impaired movement in the limbs, impaired sensitivity. A person can fall into a coma caused by cerebral edema due to hypoxia.
• All people who have survived drowning are subject to hospitalization and medical examination, even if they did not lose consciousness, and they have a pulse and breathing. This is due to a complication of drowning called "secondary drowning".

Drowning periods

This life-threatening condition is divided into 3 periods:

1. Elementary.
2. agonal.
3. clinical death.

Initial period

With true drowning, the initial period is when water has only begun to enter the lungs a little, and this has activated all the body's defense mechanisms. With asphyxia, this is from the moment it enters the water to a spasm of the respiratory gap (very short).

The man coughs and spit, strenuously rows his arms and tries to push off with his feet. Vomiting may occur. Coughing and vomiting lead to even more water entering the lungs, which hastens the onset of the next period.

agonal period

In this period defensive forces exhausted, there is a loss of consciousness. With asphyxic drowning, this causes the spasm of the glottis to stop, and water enters the lungs.

The agonal period is characterized by:

• loss of consciousness;
• "Sobbing" breath with its gradual disappearance;
• tachycardia, which is replaced by an arrhythmic pulse and its slowdown;
• change in skin color.

Period of clinical death

It is characterized by a triad of symptoms:

1. lack of consciousness;
2. lack of breathing;
3. the absence of a pulse, which is checked by pressing the index and middle fingers against the thyroid cartilage ("Adam's apple") on one side.

Clinical death turns into biological (when revival is no longer possible) after about 5 minutes, but if a person drowned in cold or icy water, then this time increases to 15-20 minutes (in children - up to 30-40 minutes).

Drowning self-help algorithm

All that a person can do when entering the water is:

• Don't panic. Although it is very difficult, but we must try to calm down, because panic only takes away such forces necessary for survival.
• Look around. If any wooden or plastic objects of sufficient size float on the surface of the water, try to grab them.
• As calmly as possible, saving strength, row in one direction (optimally - to the shore or to some kind of ship).
• Rest lying on your back.
• Periodically call for help (if it is dark). During the day, in the absence of visibility of people or ships, you need to save energy and not call.
• Try to breathe as calmly as possible.
• Turn your back to the waves (if possible).

How to save a drowning man

This also requires a separate algorithm. If you try to be a hero and, not knowing the rules, swim to the aid of a drowning person, you can easily die yourself: if a drowning person sees or feels the presence of another person, he will drown the rescuer in a panic in order to survive himself.

Therefore, drowning assistance is as follows:

1. Before swimming to the rescue, remove obstructing clothing and shoes.
2. Swim up to a drowning person only from the back. Next, you need to grab him by one shoulder with one of your hands, and with the other hand, lift his head by the chin so that he can breathe. At the same time, the second hand of the rescuer must press the shoulder of the drowning person so that he cannot turn over to face the one who saves him. In this position, you need to swim to the shore. The same position is used when transporting an unconscious person.
3. If you want to reach out to a drowning person, make sure that with your other hand you hold on to some kind of support.
4. Don't ignore the call for help.
5. You can throw some kind of floating object (for example, a life buoy) to a drowning person, informing him about it in monosyllables several times: “Hold!”, “Catch!”, “Catch!” and so on.
6. If a person lies motionless at the bottom, then it is important to raise him correctly:
   • they swim up to the person lying down from the side of the legs, clasp it in the armpit area and so lift it up;
   • to the one lying face up they swim up from the side of the head. Now you need to grab it from the back so that the rescuer's palms are on the chest of the victim, and raise the drowned man to the surface.

The main thing at this stage is to get the person out of the water. It is necessary to deal with the assessment of his condition already on the shore.

First aid for drowning

First aid algorithm for true drowning:

1. We call the ambulance.
2. We lay the patient with his stomach to himself on a bent knee so that his stomach is higher than his head and chest.
3. We take a piece of cloth, a scarf or clothes, open the victim's mouth, and remove everything that is in the mouth. If the skin is blue, then you need to additionally press on the root of the tongue: this will cause vomiting, which will remove water from both the lungs and the stomach.
4. In the “head down” position, we squeeze the chest well so that all the water comes out.
5. We quickly turn the victim on his back and begin cardiopulmonary resuscitation:
   • 100 compressions per minute on the chest with the palms of straight arms superimposed on each other;
   • every 30 pressures - 2 breaths into the open mouth (while the nose is pinched) or into the open nose (while the mouth is closed).
6. Continue resuscitation until pulse and breathing are restored. If there is only one resuscitator, you do not need to be distracted by checking these parameters every minute, but continue quite long time until there are signs of consciousness.

All of the above points apply to first aid for both children and adults. It is only necessary to take into account that children need to press on the chest more often (the smaller the child, the more often), and apply less pressure. The sequence of inhalation and pressing on the chest is the same - 30 pressures, 2 breaths.

The first aid algorithm for asphyxic drowning consists of the same points, except for points 2-4. That is, if a person with very pale skin is pulled out of the water, you need to call for medical help and proceed directly to cardiopulmonary resuscitation.

What to do after the drowned person has regained consciousness

After drowning, whatever it may be - true or "dry", in no case should the victim be released. In order to avoid complications, he needs to be hospitalized and examined.

What will they do in the hospital?

In the hospital, a person will be carefully examined: oxygen and carbon dioxide will be determined in his blood (in the venous and arterial separately). An analysis will be performed on the content of potassium, sodium, chlorine and other indicators in the blood. Be sure to perform an ECG and chest x-ray.

If the patient is unconscious, will be started intensive therapy, which will consist of:

• providing it with an increased oxygen content (so that it can pass through the thickness of foam and water in the alveoli - into the blood);
• extinguishing foam in the lungs;
• removal of excess fluid from the lungs;
• normalization of the heartbeat;
• normalization of electrolyte levels, especially potassium and sodium;
• bringing the temperature to normal numbers;
• administration of antibiotics
• other events selected individually.

Complications of drowning

Drowning is often complicated by one of the following conditions:

• pulmonary edema;
• secondary drowning (when some water enters the lungs, but it is not removed from them in the near future). This water impairs the exchange of gas between the lungs and blood, and after a short time ends in death;
• pneumonia;
• cerebral edema, the consequences of which may be from the complete restoration of the work of the central nervous system to a coma, ending in death, or a complete vegetative state ("like a plant"). "Intermediate stages" are loss of sensation, impaired movement in one or more limbs, loss of hearing, vision, memory;
• decompensation of cardiac activity;
• gastritis and gastroenteritis - due to ingestion of dirty water, as well as due to reverse peristalsis caused by vomiting;
• sinusitis (inflammation of the sinuses of the cranial cavity), which can also be complicated by meningitis;
• panic fear of water.

Signs of true drowning:

- cyanosis facial skin,

- swelling of the vessels of the neck,

Turn on the stomach, clean the mouth and press on the root of the tongue.

If there is a gag reflex, continue removing water from the stomach (up to 2-3 minutes).

If there is no gag reflex, make sure that there is no pulse on the carotid artery and proceed to resuscitation.

If there is a pulse on the carotid artery, but there is no consciousness for more than 4 minutes, turn on the stomach and apply cold to the head.

In cases of shortness of breath, bubbling breathing - seat the victim, apply heat to the feet, apply tourniquets on the thigh for 20-30 minutes.

Attention! In the case of true drowning, death can occur in the next few hours from repeated cardiac arrest, pulmonary edema, and cerebral edema. Therefore, in each case of drowning, rescue services are necessarily called, and the rescued person must be delivered to the hospital. .

Actions in case pale drowning

Signs of pale drowning:

- lack of consciousness

- lack of pulse on the carotid artery,

- pallor of the skin,

- sometimes "dry" foam from the mouth,

- more common after falling into icy water.

Move the victim to a safe distance from the hole.

Check for a pulse on the carotid artery.

If there is no pulse on the carotid artery, start resuscitation.

If there are signs of life, transfer the rescued to a warm room, change into dry clothes, give a warm drink.

Attention! In the case of pale drowning, it is unacceptable to waste time removing water from the stomach.

Actions in case of the first stage of hypothermia

Signs of the first stage of hypothermia:

- blue lips and tip of the nose,

- chills, muscle tremors, goosebumps,

- Profuse frothy discharge from the mouth and nose.

If possible, wear additional warm clothing. Force to move.

Give 50-100 ml of wine or other sweet alcohol, provided that within 30 minutes the victim will be taken to a warm room and his mouth did not smell of alcohol .

Attention! The first stage of hypothermia is protective and not life-threatening. It is enough to use additional warm clothes, make them move and take warm food or sweets in order to prevent the onset of a more dangerous stage of hypothermia.

If, after removing from the hole, there is no supply of dry clothes and the ability to make a fire, if possible, lay any paper between the body and wet clothes and continue moving towards the settlement. After 5-7 minutes, the paper will begin to dry out and become a good heat insulator.

Actions in case of the second and third stages of hypothermia

Signs of the second and third stages hypothermia (as they appear):

skin blanching,

Loss of feeling cold and feeling comfortable in the cold,

Complacency and euphoria or unmotivated aggression,

Loss of self-control and adequate attitude to danger,

The appearance of auditory, and more often visual hallucinations,

Lethargy, lethargy, apathy,

Oppression of consciousness and death.

Offer warm sweet drink, warm food, sweets.

Take to a warm place as soon as possible.

If there are no signs of frostbite on the extremities, remove clothing and place in a bath of warm water or cover with plenty of heating pads.

Attention! Before immersing the victim in water, be sure to check its temperature with your elbow.

After the warming bath, put on dry clothes, cover with a warm blanket and continue to give warm sweet drinks until the arrival of the medical staff.

Attention! It is unacceptable to offer alcohol to the victim lying in the water.

Related information:

1. A) This is what determines, stimulates, induces a person to perform any action included in the activity

Drowning- death or a terminal condition resulting from the penetration of water (less often - other liquids and bulk materials) into the lungs and respiratory tract.

Drowning is possible when swimming in water bodies, although sometimes it occurs in other conditions, for example, when immersed in a bath of water, in a container with some other liquid. A significant part of the drowned are children. A drowned person can be saved if first aid is provided in a timely and correct manner. In the first minute after drowning in water, more than 90% of the victims can be saved, after 6-7 minutes - only about 1-3%.

Drowning types:

1. Primary (true, or "wet"),

2. Asphyxial ("dry")

3. Syncope

In addition, in case of accidents, death in water can occur, not caused by drowning (trauma, myocardial infarction, cerebrovascular accident, etc.).

Primary drowning occurs most frequently (75-95% of all accidents in the water). With it, fluid is aspirated into the respiratory tract and lungs, and then it enters the bloodstream. When drowning in fresh water, pronounced hemodilution and hypervolemia quickly occur, hemolysis develops, and a decrease in the concentration of calcium and chlorine ions in plasma. Severe arterial hypoxemia is characteristic. After removing the victim from the water and giving him first aid, pulmonary edema often develops with the release of bloody foam from the respiratory tract. When drowning in sea water, which is hypertonic in relation to blood plasma, hypovolemia, hyperchloremia develop, and blood thickens. True drowning in sea water is characterized by the rapid development of edema with the release of white, persistent, "fluffy" foam from the respiratory tract.

Asphyxial drowning occurs in 5-20% of all cases. With it, reflex laryngospasm develops and aspiration of water does not occur, but asphyxia occurs. Asphyxial drowning occurs more often in children and women, as well as when the victim enters contaminated, chlorinated water. In this case, water in large quantities enters the stomach. Pulmonary edema may develop, but not hemorrhagic.

syncope drowning develops as a result of cardiac arrest due to the victim getting into cold water ("ice shock", "immersion syndrome"), a reflex reaction to water entering the respiratory tract or the middle ear cavity with a damaged eardrum. This drowning is characterized by a pronounced spasm of peripheral vessels. Pulmonary edema usually does not occur.

Drowning mechanism:

When drowning in fresh water, blood thins. This is due to the flow of water from the lungs into bloodstream. Occurs due to the difference in osmotic pressure of fresh water and blood plasma. Due to blood thinning and a sharp increase in blood volume in the body, cardiac arrest occurs (the heart is not able to pump such a huge volume). Another consequence of blood thinning that can cause complications and death is hemolysis, which occurs due to the difference in osmotic pressures of blood plasma and erythrocyte cytoplasm, their swelling and rupture. As a result, anemia, hyperkalemia develops, and a large number of cell membranes, cell contents and hemoglobin enter the bloodstream at a time, which, being excreted through the kidneys, can lead to acute renal failure.

When drowning in salt water, the exact opposite process occurs - blood clotting (hemoconcentration).

The usual mechanism of drowning is as follows: a non-swimmer who has fallen into the water takes deep breaths while fighting for his life. As a result, a certain amount of water enters the lungs and loss of consciousness occurs. Since the human body is completely immersed in water and respiratory movements continue, the lungs are gradually completely filled with water. At this time, spasms of the muscles of the body can occur. After a while, cardiac arrest occurs. A few minutes later, irreversible changes in the cerebral cortex begin. With an active struggle for its life, the body needs more oxygen, thus, hypoxia intensifies and death occurs in a shorter time.

When drowning in cold water, especially in children with low body weight and high regenerative capacity of the body, it is sometimes possible to fully or partially restore brain functions after 20-30 minutes after drowning.

Common Causes for Drowning :

1. Gross violation of the rules of behavior on the water and failure to follow simple precautions. There are common cases of drowning in persons who are intoxicated, when swimming in a storm, near ships and other floating facilities, when diving into dubious water bodies, when staying in cold water for a long time, when overestimating their physical capabilities.

2. Violation of the rules of scuba diving, diving alone. Causes of emergency at great depths - malfunction of equipment, exhaustion of air supplies in cylinders, cold shock, narcotic effect of nitrogen, oxygen poisoning, etc. As a rule, first aid for drowning at great depths is late.

3. Exacerbation of diseases directly during the bathing period - fainting, epileptic seizure, hypertensive crisis, cerebral hemorrhage, acute coronary insufficiency and other diseases in which a person loses consciousness.

4. Intentional killings - violent execution by drowning, suicide. 5. Fear and psychological shock when faced with an emergency. 6. Swimming accidents - concussion, spinal injury, loss of consciousness when hitting a rock, pool bottom, stones, etc. allergic reactions and muscle cramps that make any movement impossible.

8. Ruptures of the spleen, liver and other internal organs during a sharp dive to a depth.

9. Reflex traumatic shock during blows in the abdomen, which can develop when jumping into the water from a height.