Please answer BOTH questions! 1) Identify two procedures that might have helped

Question

Please answer BOTH questions!

1) Identify two procedures that might have helped save the couple if they had been found unconscious but still above water and breathing. Do NOT list CPR.

2) In one to two sentences, conclude how you think the Underhill’s died, specifically including the role of alcohol. Make sure to include the disturbance to homeostasis, and failure to compensate for that disturbance.

_ Friday, 7pm: Roma and Clint Underhill had both had a long day. They were the owners of a successful real estate company in Desert Palm. Each had several clients, and the strain of the current real estate market was getting to them. It had been an unusually cool day for January, with temperatures hovering around 60 degrees. On coming home they decided to relax in their hot tub with some wine. While Roma changed from her work clothes, Clint said that he would join her in the hot tub after he took his Lasix. Saturday, 8am "911... Please state your emergency “Ma'am, please calm down and tell me the address." "I think..., yes, OK, it's... it's 2560 Oak Creek Drive." "What is the problem, please?" "I'm the maid for Mr. and Mrs. Underhill and.. and I didn't find them in the house when I came in this morning, so I looked around outside. I just found them in their hot tub out back. They are under the water. Please come, please come now!" "Yes, ma'am, I'm alerting the EMTs and an ambulance will be on the way. Please go out front and wait, so the paramedics can find the address quickly." Saturday, 8:10am: Paramedics Kavita Dickson and Larry Gonzales brought the ambulance to a stop at the end of a long driveway next to an impressive two-story mansion. The maid was on the front steps and quickly directed them to the back patio where the hot tub could be seen. Empty bottles of wine were on the ledge surrounding the hot tub. Kavita quickly climbed up the steps and saw the bodies of the Underhills on the bottom of the hot tub. As she got into the water she exclaimed, "This water seems really hot. Let's see if we can get them out." Larry climbed in after her and together they dragged the bodies out of the hot tub and onto the patio. It was obvious that both had been dead for some time. Kavita called the dispatcher “Listen, Linda, this hot tub case is a DOA, but something is not right. How about sending the medical examiner and a detective out to look the situation over. Tell them to bring a

Explanation / Answer

1.Injections of norepinephrine or elevation of their legs above their heart could be used to save them.

2.The lasix and alcohol reduced the blood volume due to dehydration. Decreased blood volume reduces the strokevolume of the heart and the end systolic and diastolic volumes, which in turn lowered the overall cardiacoutput. The reduced peripheral resistance and cardiac output lowered their overall mean arterial pressure to a dangerously low level. Also During near-drowning, their body would have been cut off from oxygen to the point where major body systems began to shut down from the lack of oxygen flow.

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