Drowning (submersion)

Paediatric emergency management · Resuscitation · Emergency

Hypoxia is the primary insult, so early effective ventilation and oxygenation are the priority. Unlike standard arrest, begin with airway and breathing.

At the scene and on arrival

• If not breathing: give 5 initial rescue breaths, then CPR 15:2 — ventilation is the priority in drowning.
• Assume cervical spine injury only if trauma or diving is suspected.
• Remove wet clothing and actively rewarm; continue resuscitation while hypothermic.

• Anticipate ARDS and pulmonary oedema — use early CPAP/PEEP and intubate if needed.
• Routine prophylactic antibiotics and steroids are not beneficial.
• Correct hypothermia, acidosis and arrhythmias.