- Prompt rescue, bystander CPR, and cerebral reperfusion/oxygenation are most important for survival.
- Hypoxia and Acidosis are main mediators of injury, and most important to treat.
- No cervical collar unless there is trauma.
- Keep an open mind: check glucose, UDS, ETOH and consider antecedent events like MI or seizure!
- You’re not dead until you’re warm and dead (34°C), but then consider cooling the comatose.
- No empiric antibiotics, steroids, barbiturate comas, or ICP monitoring.
- Survival highly unlikely with >25 minutes of resuscitation.
- Asymptomatic patients can be observed for 4-6 hours and discharged.
Additional coverage of Submersion Topics:
See PedEMMorsels - Submersion Basics
See PedEMMorsels - C-Spine Injuries and Submersions
See PedEMMorsels - Prolonged QTc and Submersions
See PedEMMorsels - Submersion Prevention