The first priority in managing drowning victims in the ED is to reverse hypoxemia by restoring adequate oxygenation and ventilation. As previously discussed, initial efforts should focus on airway, breathing, and circulation. Oxygen, with or without mechanical ventilation support, is the first line of therapy. Patients who are breathing spontaneously and are able to maintain an oxygen saturation > 90% or a partial pressure of oxygen > 90 mm Hg with a fraction of inspired oxygen of 0.5 may need oxygen therapy alone.20
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