## Immediate Management of Drowning Victim ### Assessment & Resuscitation Priority **Key Point:** A drowning victim who is unconscious and apnoeic requires immediate cardiopulmonary resuscitation (CPR) regardless of the duration of submersion. The priority is restoration of oxygenation and perfusion. ### Rationale for Correct Answer This child is: - Unconscious (unresponsive) - Cyanosed (hypoxic) - Apnoeic (not breathing) These signs indicate cardiac arrest. Immediate CPR with a 30:2 compression-to-ventilation ratio (or continuous chest compressions if untrained) is the standard of care. Even in cold-water drowning, resuscitation should not be delayed pending rewarming. **High-Yield:** The phrase "never say never dead" in drowning reflects the potential for recovery even after prolonged submersion, especially in cold water. However, this does NOT delay CPR initiation — it justifies continuing resuscitation efforts. ### Sequence of Actions 1. **Airway:** Open airway, clear visible obstructions (do NOT perform abdominal thrusts routinely) 2. **Breathing:** Initiate rescue breathing (2 breaths after 30 compressions) 3. **Circulation:** Start chest compressions immediately 4. **Defibrillation:** Attach AED/defibrillator as soon as available 5. **Advanced Life Support:** Establish IV access, administer epinephrine per ACLS protocol **Clinical Pearl:** Water aspiration ("wet drowning") occurs in ~80% of cases; laryngeal spasm ("dry drowning") in ~20%. Both result in hypoxia and require identical resuscitation. ### Why Water Removal Is NOT the Priority - Abdominal thrusts are NOT recommended in drowning (risk of aspiration, gastric rupture) - Small amounts of water in the airway do not significantly impair ventilation - Oxygenation and perfusion take absolute priority **Warning:** Delays in CPR initiation to "drain" the lungs or perform maneuvers to expel water reduce survival. Time is brain — begin compressions immediately.
Sign up free to access AI-powered MCQ practice with detailed explanations and adaptive learning.