Action
Apply Passive External Rewarming (Class Il)
- Remove wet clothing
- Insulate with warm blankets/forced-air warming blankets
Consider Active External Rewarming (Class II)
- Hot packs and heat lamps to trunk of body only
- Heated air blower
Active Internal Rewarming (If Core Temperature <30°C)
- Warmed intravenous fluids (40°C-44°C)
- Warmed humidified oxygen (42°C-46°C)
- Peritoneal lavage (potassium-chloride-free fluid)
- Thoracic lavage with intravenous fluids (39°C-41°C)
- Bladder lavage
Additionally:
- Oxygen
- Cardiorespiratory monitoring with pulse oximetry and rhythm strip
- Obtain ABG (pH)
- Consider obtaining: (Class III)
- Blood glucose
- Electrolytes
- CBC
- Chest x-ray
- ECG
Decision
Does the patient have continued altered neurological status or abnormal respiratory status?
Yes
- Admit
- Consider social work consultation for all drowning victims who present to the ED.
No
- GCS score improved to 15 after 4-8 hours, with normal respiratory status and normal vital signs (Class II)
- Clear cervical spine, if not already completed and patient has history of trauma
- Discharge home
- Consider social work consultation for all drowning victims who present to the ED.
