Re: [Paddlewise] Heimlich & CPR

Yeah... where's Quincy?

I found another source that seemed to be a fairly comprehensive and
up-to-date resource on drowning:  
Bove, Alfred A. (ed). 1997. "Diving Medicine" 3rd Edition. Saunders.
(http://www.amazon.com/exec/obidos/ASIN/0721660568/qid=929462965/sr=1-6/002-
4098079-8080248).  

I browsed the section on "near-drowning" and there were some updates and a
review on aspiration of water during drowning.  The book was $73.00 plus tax
locally and $69 at Amazon.com, so I passed on buying it for now at least. 
Bove's review, as best I can recall from my cursory scan of the chapter,
reported that most of the earlier studies on drowning which involved
haemodilution and haemoconcentration from fresh water vs. salt water were
done on animals with endotrachial tubes.  Actual drownings or near drownings
seem to present with the level of blood chemistry changes caused by the
water itself.  Pulmonary edema appears to be caused from asphyxia rather
than water intrusion, this is supported by the articles I referenced you
from medline.

However, the chapter in Diving Medicine cited research that claimed there
was no water aspiration in 15 to 20% of drownings... this is in contrast to
the earlier research that said that there was no water aspiration in 80 to
95% of drownings.  However,... because...because...  there was not the
problem with heamodilution (fresh water) that was earlier suspected based on
the experimental drownings in animal studies.


Diving medicine did go on to discuss near-drowning treatment of pulmonary
infections as a consequence of water aspiration... namely, the aspiration of
silicates and diatom and other bacteria.

IN summary, it appears that the 3rd edition of diving medicine concurs that
there is aspriation of water in at least a certain percentage of
near-drownings.  The conseqences are not what they were first thought to be,
regarding blood chemistry changes.  The bottom line in answer to the
original post concerning Heimlich first as a routine measure is:  It's a
waste of precious, precious time, and could additionally harmful for a
cervical or other injury.  

If you happen to find me upside down in my boat and not breathing... you can
skip the Heimlich!  

Swipe, inflate. If no pulse... go into the cpr cycles.

----------
>From: Mlberr_at_aol.com
>To: robtcline_at_earthlink.net
>Subject: Re: [Paddlewise] Heimlich & CPR
>Date: Mon, Jun 14, 1999, 20:34
>

>so the trachea opens upon death but the larynx remains shut, tightly enough 
>to keep out water? hmmm seems strange..but i'll checkout the sources you 
>mentioned... thanks for providing them...but a forensic pathologist might be 
>the best source... where's quincey when you need him....
>
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