Cardiac arrest in drowning

Submersion duration is the strongest predictor of outcome

differences in resuscitation

extrication + c-spine

  • Treat as trauma
  • Extricate horizontally

post-ROSC care

  • rewarm for 24h, remove wet clothing
  • CVS: SIRS, cold diuresis → hypovolaemia. cardiac output monitoring.
  • RESP: pneumonitis, ARDS → lung protective ventilation, inhaled pulmonary vasodilators, ECMO
  • NEURO: neuro-protective measures like any post-ROSC

poor prognostic factors

  • submersion >5 min