UMEM Educational Pearls

Title: Care of the Drowning Patient

Category: Critical Care

Keywords: drowning, critical care, swimming, swim, water (PubMed Search)

Posted: 7/21/2015 by Feras Khan, MD
Click here to contact Feras Khan, MD

Care of Drowning Patients in the ED

500,000 worldwide deaths per year/10 per day in US on average
Main goal of resuscitation is to reverse hypoxemia: endotracheal intubation, mouth-to-mouth, BVM depending on setting
In water resuscitation can be considered (mouth-to-mouth only) while the patient is being actively rescued
CPR with Airway emphasis- five rescue breaths, 30 compressions, then 2 breaths/30 compressions until the airway can be secured
Turning the patient over and performing abdominal thrusts or back blows is not helpful
ARDSnet protocol is generally used when intubated
No steroids or prophylactic antibiotics are indicated
Consider trauma (CT head and C-spine precautions based on history/exam)
Warm up your patient as needed--assume hypothermia on presentation
Can consider therapeutic hypothermia after ROSC and when rewarmed---no clear benefit here

Szpillman D et al. Current Concepts: Drowning. NEJM 2012;366:2102-2110.