From the Research
A 17-year-old male patient is considered at risk after a near-drowning incident in a lake even with normal vitals and clear lung sounds for at least 24 hours following the event. These patients should be observed in a medical setting during this period as delayed pulmonary edema can develop hours after the incident, even when initial assessment appears normal. This delayed response occurs because aspirated water can damage the alveolar-capillary membrane, leading to inflammation and fluid accumulation in the lungs over time, as explained in the study on pulmonary edema pathophysiology and diagnosis 1. Additionally, lake water may contain bacteria and contaminants that can cause pneumonia or other infections that might not manifest immediately. Symptoms to monitor include developing cough, chest pain, shortness of breath, fever, or decreasing oxygen saturation. If the patient is discharged, clear instructions should be provided to return immediately if any respiratory symptoms develop. Prophylactic antibiotics are not routinely recommended unless there are signs of infection or the water was heavily contaminated. It is essential to continue monitoring the patient's vital signs, including the eight vital signs of patient monitoring, which include temperature, pulse, blood pressure, respiratory rate, oxygen saturation, pain, level of consciousness, and urine output, as proposed in the study on critical care 2. The study on acute respiratory distress syndrome diagnosis and management 3 also highlights the importance of early detection and treatment of respiratory complications. Therefore, close observation and monitoring are crucial in the management of near-drowning incidents, even in patients with initial normal vitals and clear lung sounds. The patient's condition can deteriorate rapidly, and prompt medical intervention is necessary to prevent poor outcomes, as emphasized in the study on the clinical neglect of vital signs' assessment 4.