Submersion/Drowning (HB)

Submersion injuries/drowning can occur when the patient replaces the air in their lungs with water. This can happen when they go underwater in a stream or lake or get trapped in a water bucket.

Drowning can happen very rapidly if the patient gasped and inhaled water–which is more likely the colder the water is.

The two biggest problems related to a “submersion injury” are hypoxic brain injury from deprivation, and from pulmonary edema related to damaged lung tissue.

Treatment

Patients that have a submersion injury need positive pressure ventilations. If the submersion was short, the patient is not likely in cardiac arrest and will respond well to rescue breathing if they can.

Patients that have been submerged longer have a lower chance of survival, but we should still attempt CPR if the time underwater was less than an hour–especially if the water was cold.

Regardless of the time underwater and the current status of the patient after successful resuscitation, you should consider them at high risk for lung injury from water infiltration and brain injury from hypoxia.