DROWNING OR SUBMERSION: 10.0
All Providers
- Focused history and physical exam
- Cardiac monitor, ETCO2, pulse oximetry
- Treatment Plan
- Safely remove patient from the water, place supine
- Remove wet clothing and wrap in blankets, ensure patient warmth
- If concern for spinal injury: Selective Spinal Immobilization Protocol
- Key Considerations
- Airway maintenance is the primary consideration
- Co-existing conditions may exist including trauma, hypothermia, intoxication
- Hypotension is associated with worse outcome, monitor and use Shock and Fluid Therapy
protocol
- In-water ventilations may increase survival
- Notify receiving facility if hypothermia is suspected so that appropriate resources can
be mobilized
ADULT
EMT
- If breathing spontaneously apply oxygen at 15 lpm via NRB mask to maintain oxygen saturations
>93%
- Ventilate with BVM if apneic or exhibiting respiratory distress. Consider nasal or oral airway.
- Initiate cardiocerebral resuscitation if indicated
- albuterol MDI with spacer: 4 puffs q 5 minutes for wheezing until symptoms subside
- CPAP @ 5cm H20 (oxygen @ 10lpm)
- Consider when the patient is awake but needs assistance with oxygenation and veltilation
- Consider advanced airway
AEMT
- Vasular access and fluid therapy per IV/IO Access and Fluid Therapy protocol
- Use Respriatory Distress protocol for CPAP/BiPAP
Paramedic
Pediatric
EMT
- If breathing spontaneously apply oxygen at 15 lpm via NRB mask to maintain oxygen
saturations >93%
- Ventilate with BVM if apneic or exhibiting respiratory distress. Consider nasal or oral
airway.
- Initiate cardiocerebral resuscitation if indicated
- albuterol MDI with spacer: 2 puffs q 5 minutes for wheezing until symptoms subside
- CPAP @ 5cm H20 (oxygen @ 10lpm)
- Consider when the patient is awake but needs assistance with oxygenation and
veltilation
- Consider advanced airway
AEMT
- Vasular access and fluid therapy per IV/IO Access and Fluid Therapy protocol
- Use Respriatory Distress protocol for CPAP/BiPAP
Paramedic