Abstract
Survival after drowning depends on a well-functioning chain of survival, starting outside the hospital and continuing in-hospital during the post-resuscitation phase. Prehospital care personnel provide the opportunity to perform rapid rescue from submersion events. Reestablishing ventilation before cardiac arrest nearly assures no long-term neurological sequelae [1, 2]. However, if the drowning victim sustains cardiac arrest, CPR provides the best chance of neurological recovery. Controversy exists over the optimal method for performing CPR. Research suggests that bystander chest compressions alone may be better than rescue breathing combined with chest compressions (standard CPR) for resuscitating patients with sudden cardiac death [3]. These studies excluded drowning victims and others with an asphyxial cause of cardiac arrest. Unlike sudden cardiac death, drowning victims asphyxiate which leads to cardiac arrest, so maximizing oxygenation in addition to perfusion during CPR may improve outcome [4, 5]. Two prospective, population-based cohort studies support performing standard CPR for drowning victims (rescue breathing and chest compressions) [6, 7] and bystanders may play an important role [8]. Thus, it is recommended that drowning victims with no signs of life be provided chest compressions with rescue breathing rather than compression CPR alone.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Quan L, Wentz KR, Gore EJ et al (1990) Outcome and predictors of outcome in pediatric submersion victims receiving prehospital care in King County, Washington. Pediatrics 86:586–593
March NF, Matthews RC (1980) Feasibility study of CPR in the water. Undersea Biomed Res 7:141–148
Hupfl M, Selig HF, Nagele P (2010) Chest-compression-only versus standard cardiopulmonary resuscitation: a meta-analysis. Lancet 376:1552–1557
Layon AJ, Modell JH (2009) Drowning: update 2009. Anesthesiology 110:1390–1401
Modell JH (1978) Biology of drowning. Annu Rev Med 29:1–8
Kitamura T, Iwami T, Kawamura T et al (2010) Bystander-initiated rescue breathing for out-of-hospital cardiac arrests of noncardiac origin. Circulation 122:293–299
Kitamura T, Iwami T, Kawamura T et al (2010) Conventional and chest-compression-only cardiopulmonary resuscitation by bystanders for children who have out-of-hospital cardiac arrests: a prospective, nationwide, population-based cohort study. Lancet 375:1347–1354
Venema AM, Groothoff JW, Bierens JJ (2010) The role of bystanders during rescue and resuscitation of drowning victims. Resuscitation 81:434–439
Baker PA, Webber JB (2011) Failure to ventilate with supraglottic airways after drowning. Anaesth Intensive Care 39:675–677
Dottorini M, Eslami A, Baglioni S et al (1996) Nasal-continuous positive airway pressure in the treatment of near-drowning in freshwater. Chest 110:1122–1124
Poponick JM, Renston JP, Bennett RP et al (1999) Use of a ventilatory support system (BiPAP) for acute respiratory failure in the emergency department. Chest 116:166–171
Montenij LJ, de Vries W, Schwarte L et al (2011) Feasibility of pulse oximetry in the initial prehospital management of victims of drowning: a preliminary study. Resuscitation 82:1235–1238
Kleinman ME, Chameides L, Schexnayder SM et al (2010) Part 14: pediatric advanced life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 122:S876–S908
Trzeciak S, Jones AE, Kilgannon JH et al (2009) Significance of arterial hypotension after resuscitation from cardiac arrest. Crit Care Med 37:2895–2903, quiz 2904
Chochinov AH, Baydock BM, Bristow GK et al (1998) Recovery of a 62-year-old man from prolonged cold water submersion. Ann Emerg Med 31:127–131
Siebke H, Rod T, Breivik H et al (1975) Survival after 40 minutes; submersion without cerebral sequelae. Lancet 1:1275–1277
Gilbert M, Busund R, Skagseth A et al (2000) Resuscitation from accidental hypothermia of 13.7 Degrees C with circulatory arrest [letter]. Lancet 355:375–376
Cabanas JG, Brice JH, De Maio VJ et al (2011) Field-induced therapeutic hypothermia for neuroprotection after out-of hospital cardiac arrest: a systematic review of the literature. J Emerg Med 40:400–409
Wolff B, Machill K, Schumacher D et al (2009) Early achievement of mild therapeutic hypothermia and the neurologic outcome after cardiac arrest. Int J Cardiol 133:223–228
Werman HA, Falcone RA, Shaner S et al (1999) Helicopter transport of patients to tertiary care centers after cardiac arrest. Am J Emerg Med 17:130–134
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2014 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Katz, L. (2014). Pre-hospital Management. In: Bierens, J. (eds) Drowning. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-04253-9_119
Download citation
DOI: https://doi.org/10.1007/978-3-642-04253-9_119
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-04252-2
Online ISBN: 978-3-642-04253-9
eBook Packages: MedicineMedicine (R0)