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Sections Drowning
- Overview
- Presentation
- DDx
- Workup
- Treatment
- Approach Considerations
- Prehospital Care
- Emergency Department Care - Transition to the ICU
- Treatment of Volume Depletion and Acidosis
- Other Interventions
- Guidelines for Treating Cold-Water Drowning
- Other Treatment Considerations
- Patient Disposition
- Transfer
- Deterrence/Prevention
- Consultations
- Long-Term Monitoring
- Outcomes
- Show All
- Medication
- Questions & Answers
- References
Medication Summary
Cold-induced bronchorrhea or irritation of the tracheobronchial tree by inhaled water or particulate material can produce cough and bronchospasm. Manage these aggressively because they may worsen hypoxia. The drug of choice is an inhaled beta-agonist bronchodilator.
Corticosteroids have been shown to be of no benefit in the management of submersion injuries. Routine antibiotic prophylaxis is not indicated unless the patient was submerged in grossly contaminated water or sewage.
Sympathomimetic Agents
Class Summary
These agents relax bronchial smooth muscle during bronchospasms.
Albuterol (Proventil HFA, Ventolin HFA, VoSpire)
Albuterol relaxes bronchial smooth muscle by action on beta 2-receptors and has little effect on cardiac muscle contractility.
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Mechanism of hypoxia in submersion injury.
Tables
G Patricia Cantwell, MD, FCCM Professor of Clinical Pediatrics, Chief, Division of Pediatric Critical Care Medicine, University of Miami Leonard M Miller School of Medicine/ Holtz Children's Hospital, Jackson Memorial Medical Center; Medical Director, Palliative Care Team, Holtz Children's Hospital; Medical Manager, FEMA, South Florida Urban Search and Rescue, Task Force 2
G Patricia Cantwell, MD, FCCM is a member of the following medical societies: American Academy of Hospice and Palliative Medicine, American Academy of Pediatrics, American Heart Association, American Trauma Society, National Association of EMS Physicians, Society of Critical Care Medicine, Wilderness Medical Society
Disclosure: Nothing to disclose.
Michael J Verive, MD, FAAP Pediatrician, UP Health System Portage
Michael J Verive, MD, FAAP is a member of the following medical societies: American Academy of Pediatrics
Disclosure: Nothing to disclose.
Joe Alcock, MD, MS Associate Professor, Department of Emergency Medicine, University of New Mexico Health Sciences Center
Joe Alcock, MD, MS is a member of the following medical societies: American Academy of Emergency Medicine
Disclosure: Nothing to disclose.
Suzanne Moore Shepherd, MD, MS, DTM&H, FACEP, FAAEM Professor of Emergency Medicine, Education Officer, Department of Emergency Medicine, Hospital of the University of Pennsylvania; Director of Education and Research, PENN Travel Medicine; Medical Director, Fast Track, Department of Emergency Medicine
Suzanne Moore Shepherd, MD, MS, DTM&H, FACEP, FAAEM is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American Society of Tropical Medicine and Hygiene, International Society of Travel Medicine, Society for Academic Emergency Medicine, Wilderness Medical Society
Disclosure: Nothing to disclose.
William H Shoff, MD, DTM&H Former Director, PENN Travel Medicine; Former Associate Professor, Department of Emergency Medicine, Hospital of the University of Pennsylvania, University of Pennsylvania School of Medicine
William H Shoff, MD, DTM&H is a member of the following medical societies: American College of Physicians, American Society of Tropical Medicine and Hygiene, International Society of Travel Medicine, Society for Academic Emergency Medicine, Wilderness Medical Society
Disclosure: Nothing to disclose.
Barry J Evans, MD Assistant Professor of Pediatrics, Temple University Medical School; Director of Pediatric Critical Care and Pulmonology, Associate Chair for Pediatric Education, Temple University Children's Medical Center
Barry J Evans, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, American Thoracic Society, and Society of Critical Care Medicine
Disclosure: Nothing to disclose.
Eddy S Lang, MDCM, CCFP(EM), CSPQ Associate Professor, Senior Researcher, Division of Emergency Medicine, Department of Family Medicine, University of Calgary Faculty of Medicine; Assistant Professor, Department of Family Medicine, McGill University Faculty of Medicine, Canada
Eddy S Lang, MDCM, CCFP(EM), CSPQ is a member of the following medical societies: American College of Emergency Physicians, Canadian Association of Emergency Physicians, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.
James Martin, MD Fellow, Department of Emergency Medicine, Division of Hyperbaric Medicine, Hospital of the University of Pennsylvania
Disclosure: Nothing to disclose.
Robert L Norris, MD Professor, Department of Surgery, Chief, Division of Emergency Medicine, Stanford University Medical Center
Robert L Norris, MD is a member of the following medical societies: American College of Emergency Physicians, American Medical Association, California Medical Association, International Society of Toxinology, Society for Academic Emergency Medicine, and Wilderness Medical Society
Disclosure: Nothing to disclose.
Suzanne Moore Shepherd, MD, MS, DTM&H, FACEP, FAAEM Professor of Emergency Medicine, Education Officer, Department of Emergency Medicine, Hospital of the University of Pennsylvania; Director of Education and Research, PENN Travel Medicine; Medical Director, Fast Track, Department of Emergency Medicine
Suzanne Moore Shepherd is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American Society of Tropical Medicine and Hygiene, International Society of Travel Medicine, Society for Academic Emergency Medicine, and Wilderness Medical Society
Disclosure: Nothing to disclose.
Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference
Disclosure: Medscape Salary Employment
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Sections Drowning
- Overview
- Presentation
- DDx
- Workup
- Treatment
- Approach Considerations
- Prehospital Care
- Emergency Department Care - Transition to the ICU
- Treatment of Volume Depletion and Acidosis
- Other Interventions
- Guidelines for Treating Cold-Water Drowning
- Other Treatment Considerations
- Patient Disposition
- Transfer
- Deterrence/Prevention
- Consultations
- Long-Term Monitoring
- Outcomes
- Show All
- Medication
- Questions & Answers
- References
