Drowning and submersion injuries are highly prevalent, yet preventable, causes of pediatric mortality and morbidity. Prehospital care should focus on restoring normal ventilation and circulation as quickly as possible to limit the extent of hypoxic insult. Diagnostic testing for symptomatic patients may include blood glucose level, arterial blood gas level, complete blood count, electrolyte levels, chest radiography, and cardiorespiratory monitoring with pulse oximetry and a rhythm strip. In this review, passive external, active external, and active internal rewarming techniques for treatment of hypothermic patients are discussed. A systematic approach to treatment and disposition of pediatric drowning victims is provided, and risk factors, caveats in pediatric care, and factors affecting prognosis are also discussed.
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Keywords: drowning, submersion, pediatric, hypothermia, ACLS, PALS, freshwater, saltwater, pools, spas, bathtubs, buckets, NAT, nonaccidental trauma, autonomic conflict, ventilation, circulation, CPR, resuscitation, oxygen, pulse oximetry, internal rewarming, external rewarming, PICU, GCS, PRISM, ECMO, ECC
Janet Semple-Hess, MD
Rachel Long, DO
June 15, 2022
June 15, 2025