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Preventing Drowning And Other Submersion Injuries

This is another post derived from a presentation given at the 2011 Annual Summer Meeting of the Wilderness Medical Society. Tracy Cushing, MD, of the University of Colorado School of Medicine gave an excellent presentation on submersion injury—i.e., the dangers of becoming submerged under water. What follows is some of what we learned.

Historically there have been many terms and definitions, such as “drowning,” “near-drowning,” “dry drowning,” and others. Current experts favor the term “submersion injury” as any adverse effect from submersion in water. This commonly causes difficulty breathing, for many reasons. “Immersion syndrome” refers to the situation where there is a lethal heart rhythm during or after a cold-water exposure, usually attributed to stimulation of the vagus nerve, which slows the heart rate. “Shallow water blackout” refers to a person becoming unconscious after hyperventilating prior to attempting a lengthy period of breath-holding underwater.

Drowning is the Read more »

This post, Preventing Drowning And Other Submersion Injuries, was originally published on Healthine.com by Paul Auerbach, M.D..

Only The Good Die Young – Who Wants To Live Forever?

Ask almost any surgeon and he will tell you your chances of surviving a catastrophe are inversely proportional to your usefulness to society. This sentiment is expressed in different ways by different surgeons but the basic message is the same. If two people come in with exactly the same injuries and one is a teacher who spends his extra time in community upliftment projects and the other is an armed robber, the armed robber will sail through treatment and be back on the streets in no time, but the teacher will slowly waste away in ICU and finally die. Unfortunately it seems to be true.

There was a super clever cardiologist friend of mine who speculated as to why this was the case. He basically divided people into two groups, those with over active immune systems and those with just the basic immune system. The first group would tend to be allergic to everything and be over protected by their mothers. They would tend to grow up in a protected environment devoting their time to inside activities (safe from the dangers of the outside world, including grass and pollen and dog hairs and the like) reading and bettering themselves. The latter group would be immunologically free to run around like wild things doing whatever they liked.

He then extrapolated this to the likelihood that the first group possibly had a higher chance of developing SIRS (systemic inflammatory response syndrome) after major trauma and it was in fact their own immunity’s overreaction that finally brought them down. Amazingly enough this theory is based on logical scientific thought.

Like all surgeons I too tend to think that the good guy will probably die and the bad guy will survive. I have seen it too often. But unlike my boffin cardiology friend I think it is just some sort of evil cosmic reverse karma that is out to destroy all good people in this world. This makes much more sense to me than actually trying to understand immunology. And that is why I try to do at least one bad thing a day so that if something does befall me I at least have a chance of surviving. But there are always limits.

A few years ago our hospital organised a weekend away for all the doctors and their families. It was at a really nice lodge here in the Lowveld and truth be told, it was great. The days were pretty much spent lounging around the pool. That is of course if you didn’t play golf. I don’t play golf.

Anyway, there I was producing vitamin D for all I was worth when I glanced over at the pool. One of the other doctors had a small boy of about 4 years old that had been running around all day like a mad thing. But at that moment, as I looked at him leaning over the edge of the pool he toppled in. I was about 10 meters away so I first looked to see who was closer that would respond. No one moved. No one had seen him fall in except me.

Then everything went into slow motion. I could see that he could clearly not swim. His eyes were wide open as his arms an legs flayed about helplessly not bringing his head any closer to the surface. He was clearly in trouble. Then a strange thought went through my mind based on my above mentioned philosophy.

“If I leave him, that is bad enough that I will probably live forever.”

Who actually wants to live forever?

So I rushed over and pulled the kid out.

His mother seemed pleased.

*This blog post was originally published at other things amanzi*

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