UMEM Educational Pearls

Category: Critical Care

Title: Care of the Drowning Patient

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.