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

References