- Drowning
Drowning is a common cause of accidental death. The most important detrimental consequence of drowning is hypoxia. Cardiac arrest is usually a secondary event.
Immediate action
The duration of hypoxia is a critical factor in determining the
victim’s outcome; therefore, oxygenation, ventilation and perfusion should be restored as rapidly as possible.
Immediate resuscitation at the scene is essential for survival and neurological recovery after drowning. This will require bystander provision of CPR plus immediate activation of the EMS system.
Patients who have spontaneous circulation and breathing when they reach hospital usually recover with good outcomes.
Decision to resuscitate
Deciding whether to start or stop resuscitation of a drowning victim is notoriously difficult. No single factor predicts prognosis accurately.
Start and continue resuscitation unless there is clear evidence that resuscitation attempts are futile (e.g. massive traumatic injuries, rigor mortis, putrefaction, etc.) or timely evacuation to a medical facility is not possible.
Neurologically-intact survival has been reported in several victims submerged for up to 60 min.
Remember, some patients may have had a primary cardiac arrest (e.g. caused by myocardial infarction whilst swimming).
Death from drowning is more common in young males and is the leading cause of accidental death in Europe in this group.
