Guidance For MOB Casualty Once Recovered

Airway clearance and ventilation are the first priorities. Adequate ventilation and oxygenation may restore cardiac activity in drowning, so are worthy of major effort. Changes in haemodynamics after water immersion make positional hypotension likely and blood pressure fall when the patient is raised vertically from the water. Rescuers must always attempt to maintain the victim flat and avoid vertical removal from water. Patients recovered from water should be resuscitated and conveyed to hospital unless submergence is >3 hours in adults. Survival from prolonged immersion is well documented. Alcohol/drugs are likely to induce vomiting and should not be used. Rather keep casualty warm with blankets etc.

Secondary Drowning

Secondary drowning occurs usually within 4 hours of near-drowning and can also prove fatal. These cases can be present up to 24 hours following immersion. Hence, anyone who is remotely suspected of having nearly drowned, or been rescued from water, however well they appear, MUST BE REMOVED TO HOSPITAL. The common problems of secondary drowning are:

● ARDS – Acute Respiratory Distress Syndrome

● cerebral oedema

● renal (kidney) failure

● infection

● disturbance of electrolytes, acid-base balance, and lung function, along with hypothermia, is the main problems, and there is little to separate sea from fresh water exposure as a particular issue. Treatment is aimed at preventing Cardiac Arrest. If this occurs, survival rate decreased from approximately 70-90% to approximately 15%