Near-Drowning: Treatment

Treatment begins with removing the victim from the water and performing cardiopulmonary resuscitation (CPR). One purpose of CPR—which, of course, should be attempted only by people trained in its use—is to bring oxygen to the lungs, heart, brain, and other organs by breathing into the victim's mouth. When the victim's heart has stopped, CPR also attempts to get the heart pumping again by pressing down on the victim's chest. After CPR has been performed and emergency medical help has arrived on the scene, oxygen is administered to the victim. If the victim's breathing has stopped or is otherwise impaired, a tube is inserted into the windpipe (trachea) to maintain the airway (this is called endotracheal intubation). The victim is also checked for head, neck, and other injuries, and fluids are given intravenously. Hypothermia cases require careful handling to protect the heart.

In the emergency department, victims continue receiving oxygen until blood tests show a return to normal. About one-third are intubated and initially need mechanical support to breathe. Rewarming is undertaken when hypothermia is present. Victims may arrive needing treatment for cardiac arrest or cardiac dysrhythmias. Comatose patients present a special problem: although various treatment approaches have been tried, none have proved beneficial. Patients can be discharged from the emergency department after four to six hours if their blood oxygen level is normal and no signs or symptoms of near-drowning are present. But because lung problems can arise 12 or more hours after submersion, the medical staff must first be satisfied that the patients are willing and able to seek further medical help if necessary. Admission to a hospital for at least 24 hours for further observation and treatment is a must for patients who do not appear to recover fully in the emergency department.

— Howard Baker