Home care of the child and family after near drowning.

A significant number of children experience submersion accidents every year in the United States, and many of these children suffer irreversible brain injury as a result. The effects on family members can be overwhelming as they adjust to caring for their disabled child at home. Nurses assist the family in planning for home care and provide direct care in the home. Nursing care is adapted to meet the unique requirements of the home setting. The nurse must be technically competent as well as compassionate to meet the needs of the child and family.

Near drowning: a nursing challenge.

The victim of near drowning is one who presents multisystem problems for the critical care nurse. By understanding and recognizing the interrelationships of the problems that these individuals have, the nurse will be better able to meet the challenges presented.

Caring for the victim of near drowning.

If no complications arise, the near-drowning victim is usually discharged within 48 hours. However, some patients require complex care because of multisystem failure. These patients challenge the critical care nurse, who must understand the interrelationships of the problems to provide quality care. The major focus of care is stabilization and normalization of the cardiovascular, respiratory and neurologic systems through accurate nursing assessments and implementation of appropriate nursing care.

Care of the pediatric near-drowning victim. A nursing challenge.

In the pediatric near-drowning victim, hypoxia and related pathophysiologic factors affect the pulmonary, neurologic, cardiovascular, gastrointestinal, and renal systems. Other complications arise from the potential for infection; the immobile state; and anxiety and fear related to the hospitalization. Altered coping mechanisms and knowledge deficits related to home care and drowning prevention offer problems that the family must overcome during the recovery of their child from the near-drowning insult. Using this knowledge and the accurate, comprehensive ongoing nursing assessments, the nurse must recognize the needs of the child and family. The nurse then formulates appropriate nursing diagnoses with measurable patient-centered goals for each diagnosis and develops pertinent nursing interventions that can be continually evaluated for effectiveness and revised as needed. This process is integral to the effective care of the child and family who experience a near-drowning incident.

Continuing care for the near-drowning child.

The continuing care for a child survivor of a near-drowning accident presents a variety of challenges for the tertiary-care setting, community-based health care providers, and especially the family. The trauma the child receives from this type of neurologic insult coupled with the emotional issue of an accident such as a near drowning result in a long-term, usually lifetime situation of great stress and responsibilities for the family. Although long-term hospitalization is usually required for medical stabilization of the child, survivors of this type of injury will require some kind of continuing care outside of the hospital setting. In most instances, pediatric home care offers a reasonable alternative for the family. In the provision of skilled nursing support in the child's home environment, their medical needs can be met effectively. Additionally, home care offers a strong support to the families and can assist in fostering the long-term care environment parents must face if they are to successfully provide for their child at home. Planning for the child's discharge to home involves a comprehensive and coordinated approach to providing a community-based support network of care for the child and family. Additionally, parents must learn complicated, technical skills to meet the physical needs of their child. This process requires careful planning and implementation. During this time the hospital will assist the family in procuring the community-based services they will need. Once the child is discharged, the family focus is directed toward establishing positive work partnerships with the other service providers necessary to assist them in the care of their child. This process takes considerable planning and effort for all involved but, when successful, facilitates a positive, nurturing home care environment. The family remains the guiding force in this situation and ultimately determines if their child's care at home will be successful. In this context, success is not measured by recovery or cure but, instead, by the degree of enhancement the family receives in providing home-based care. The role of the home care nurse is an important one and is comprehensive in scope and responsibilities. The nurse not only delivers skilled care and treatment to the child but also offers support and assistance to the family. These home care nurses must be highly skilled and trained in the delivery of complex medical care and effectively provide the emotional and psychological support families of these children demand. An equally important function of the home care nurse is that of family advocate.(ABSTRACT TRUNCATED AT 400 WORDS)

Ethical issues in caring for patients who have suffered water-related injuries.

A person who has suffered a water-related injury is vulnerable and most likely in need of the most astute emergency and supportive medical and nursing care available. Caring for these persons from a medical and nursing perspective is challenging and additionally complicated by numerous ethical dilemmas. This article has reviewed the salient issues associated with informed consent, the erroneous perceptions frequently associated with ordinary and extraordinary treatment and the withholding and withdrawing of treatment, as well as the importance of the nurse as a patient advocate. The hallmark of effective ethical decision making about life-supportive treatment is the mutually interactive process of communication that assists patients and their families to make informed, voluntary, and competent decisions that are reflective of their values. This process of empowering the patient and family is the foundation of the role of the nurse as a patient's advocate. It is hoped that your interest in bioethics has been sparked, your understanding of these areas clarified, your decision-making skills strengthened, and your caring for people enhanced.

Psychosocial issues in water-related injuries.

A pediatric water-submersion injury is a devastating situation that impacts countless numbers of family members. The occurrence of such an event alters family functioning and the ability to carry on after the crisis.

Childhood near-drowning: nursing care and primary prevention.

Young children continue to be victims of drowning and near-drowning. The pediatric critical care nurse is often called upon to care for a child following a near drowning event. The role of the nurse in assessment, early intervention and continuing critical care management, and primary prevention of water-related injuries are reviewed.

Childhood drowning: review of the literature and clinical implications.

In children the risk of submersion is highest in those under 5 years of age and in male adolescents 15-19 years of age. This review examines the research literature that identifies factors related to drownings and near drownings, strategies to prevent these occurrences, and suggestions for primary prevention and associated nursing interventions.

Responding to summer emergencies.

Summer's arrival ushers in health hazards ranging from bee stings to lightning strikes. This article discusses preventive measures and provides first aid and ongoing care instructions for common summertime emergencies.

Seconds count: the Kenny and Jeremy stories.

In this era of health care reform and restraint, there is a resurgence of interest in health promotion and injury prevention. This renewal has added another dimension to the practice of nursing--the expectation that health teaching is included in our interactions with families. This paper will explore submersion injuries in children which, according to Brill, (1987) are uniquely preventable. The ultimate aim of discussing this topic is an increased commitment by nurses to the prevention of submersion injuries.