firedoc5 Posted June 15, 2008 Share Posted June 15, 2008 Every year we had the Street Machine Nationals come to town. Actually they were in DuQuoin, IL, but it seemed like everyone would come to Mt.Vernon to party. Huge crowd, great cars, and hot babes. Very late at night had call of a drowning at a motel inside pool, CPR in progress. Male, mid -20's. When arrived he was on the deck near the pool, water everywhere. Full arrest. I tubed while one of the other guys did a quick look. Course V-fib. Defibed x 2, converted into sinus brady (no one got shocked). Still unconscious. Witnesses stated he was seen hanging onto the side of the pool flirting with a "string bikini", no problems noted. 5-10 mins. later was spotted in deep end of pool on the bottom. Down time approx. CPR adm. immediately. Possible down time 3-5 mins., 9-11 mins. prior to ALS. Followed ACLS protocols completely. One pupil dialated, the other reactive but sluggish. ETOH very evident. Large amount of water suctioned, possibly coming from both stomach and lungs. ETA to nearest hosp. 3 mins. While en-route pt. started posturing decorticate on right side. Outcome? Chlorinated water vs. fresh water? ETOH as a factor? Link to comment Share on other sites More sharing options...
Richard B the EMT Posted June 15, 2008 Share Posted June 15, 2008 Question: Was the water cool or bathtub warm? (Thinking possible mammalian diving reflex) Statement: I feel this is a fresh water drowning, as there's no salt as from the ocean to change the body's blood chemistry via osmosis in the alveoli of the lungs. Statement of uncertainty: I do not know if pool-type chlorinated water is unhealthy over the percentage usually used to keep pool water at a healthy level. Can anyone enlighten me? Link to comment Share on other sites More sharing options...
mobey Posted June 16, 2008 Share Posted June 16, 2008 Well I can tell you that drinking water has approw 0.2-0.5 ppm of free chlorine (chlorine available to kill bacteria in your taps). Pool water is usually around 2.0 - 4.0 ppm. That said > 4ppm is considered toxic to humans. But I wonder about a neuro problem with this guy? Link to comment Share on other sites More sharing options...
Kaisu Posted June 16, 2008 Share Posted June 16, 2008 But I wonder about a neuro problem with this guy? Me too. The unilateral dificit is not typical of hypoxia due to near drowning. I wonder if a neurological incident is what precipitated the drowning. Link to comment Share on other sites More sharing options...
rdelisle Posted June 16, 2008 Share Posted June 16, 2008 Perhaps the "String Bikini" or her boyfriend took offence to the Pts advances and kicked him in the head prior to the drowning. Were there any signs of trauma? Link to comment Share on other sites More sharing options...
firedoc5 Posted June 16, 2008 Author Share Posted June 16, 2008 No signs of trauma noted. With the large crowd I think the motel added extra chlorine. The smell was very strong, but probably not toxic. In the ER I believe his ETOH was .28. Patient did finally make it to ICU. EEG was very discouraging. Large amount of brain damage due to hypoxia, but not quite brain dead. I know he was in the ICU for three weeks on life support. I believe he did develope bi-lateral pneumonia due to the large amount of chlorinated water. He was down from MI to party and the car show. He was transferred back to MI where he died two weeks later. I believe a combination of the chlorinated water ingested, ETOH, down time prior to ALS (I don't think CPR was being done correctly), were all a factor. Any other opinions? This case really frustrated me. At the scene we had plenty of medics. So when I got him tubed very quickly, I was free to do nothing but take care of the air way. It was an easy intubation. At least two others were able to adm. the rest of the other duties. And had two Basics doing CPR. It was a big help. Link to comment Share on other sites More sharing options...
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