Title: Care of the Drowning Patient<br/>Author: Feras Khan<br/><a href='http://umem.org/profiles/faculty/1145/'>[Click to email author]</a><hr/><p>
<strong>Care of Drowning Patients in the ED</strong></p>
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500,000 worldwide deaths per year/10 per day in US on average</li>
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Main goal of resuscitation is to reverse hypoxemia: endotracheal intubation, mouth-to-mouth, BVM depending on setting</li>
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In water resuscitation can be considered (mouth-to-mouth only) while the patient is being actively rescued</li>
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CPR with Airway emphasis- five rescue breaths, 30 compressions, then 2 breaths/30 compressions until the airway can be secured</li>
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Turning the patient over and performing abdominal thrusts or back blows is not helpful</li>
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ARDSnet protocol is generally used when intubated</li>
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No steroids or prophylactic antibiotics are indicated</li>
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Consider trauma (CT head and C-spine precautions based on history/exam)</li>
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Warm up your patient as needed--assume hypothermia on presentation</li>
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Can consider therapeutic hypothermia after ROSC and when rewarmed---no clear benefit here</li>
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<fieldset><legend>References</legend>
<p>
<strong style="margin: 0px; padding: 0px; border: 0px; outline: 0px; font-size: 13.9200000762939px; font-family: Verdana, Geneva, sans-serif; line-height: 22.2719993591309px;">Szpillman D et al. Current Concepts: Drowning. <a href="http://www.nejm.org/doi/full/10.1056/NEJMra1013317" style="margin: 0px; padding: 0px; border: 0px; outline: 0px; font-size: 13.9200000762939px; text-decoration: none; color: rgb(69, 93, 143);" target="_blank">NEJM 2012;366:2102-2110.</a> </strong></p>
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