[Out-of-hospital treatment in case of drowning].

Abstract

INTRODUCTION: Drowning is a leading preventable cause of unintentional morbidity and mortality. The dominant pathophysiological mechanism of drowning includes the development of acute hypoxia. FIRST AID: The rescue procedure of a drowning person includes careful pulling the victim out of the water, examination, maintenance of the airways passable and urgent transfer to hospital. BASIC LIFE SUPPORT: The first and most important treatment option of a drowning victim is the provision of ventilation which increases the chances of survival. As soon as the unresponsive victim is removed from the water, the lay rescuer should immediately begin chest compressions and provide cycles of ventilations and compressions. Some recent investigations have revealed that exterior compression of the chest is a necessary measure even in a situation when bystanders cannot provide airway. It is recommended to train bystanders to provide basic life support and apply automated external defibrillator in a drowning person whenever indicated and as early as possible. ADVANCED LIFE SUPPORT: In drowning, the victim with cardiac arrest requires advanced life support, including an early intubation. Extended medical measures, which are primarily provided by medical professionals, include cervical spine immobilization in case a spinal injury is suspected, or, establishment of the ventilation with oxygen, emergency transport, application of reanimation and advanced vital support measures.