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This guideline has been adapted for statewide use with the support of the
Victorian Paediatric Clinical Network
See also:
Resuscitation guideline
Cervical spine assessment guideline
Key Points
3. Most cases of drowning result in minimal or no respiratory impairment and don’t require hospital
admission beyond a period of observation.
4. Cervical spine injury is uncommon but should be considered if there is a history of trauma e.g.
diving.
5. The cause of drowning should be fully considered including medical causes or issues around
supervision and safety.
6. Key principles of management are maintaining adequate oxygenation, preventing aspiration and
stabilising body temperature.
Background
Drowning is the process of experiencing respiratory impairment from submersion/immersion in a liquid.
Near drowning is an obsolete term.
Assessment
History:
Consider a medical cause for drowning in children who are competent swimmers.
Including
Seizures
Arrhythmias and Long QT
Intoxication
Inconsistencies in story?
Story incompatible with developmental age?
Timeline
Immersion time
Time to and type of basic life support delivered
Time to first respiratory effort
Details of treatment used
Examination:
Management
Key principles of management are maintaining adequate oxygenation, preventing aspiration and
stabilising body temperature.
Vomiting is common in drowning victims and aspiration of gastric contents is a major complication.
Spontaneously breathing children should initially be placed in the lateral decubitus position.
Hypothermia
Hypothermia is a common consequence of drowning.
Remove wet clothes and dry child
Exposure should be minimised
Active warming should occur if core temperature is less than 34C.
This includes:
Warmed IV Fluids
Humidified oxygen delivery
Forced air warming blankets
Investigations:
Children who are asymptomatic and alert require no investigations.
Further investigations should be guided by the child’s history and clinical condition
Treatment:
Prophylactic antibiotics have no role
https://www.rch.org.au/clinicalguide/guideline_index/Near_Drowning/