Emergency MedicineAnaesthesia & ICU
Drowning / Submersion Injury
ERC 2021 — primary respiratory pathology, in-water rescue breaths, modified ALS, no role for routine c-spine immobilisation.
Source: ERC 2021 Drowning
Step 1 of ~6
info
Initial Assessment
Drowning is primarily a respiratory emergency. Pull from water as soon as safe; horizontal position not required. Ventilation is priority — give 5 rescue breaths before chest compressions (oxygen-deficiency arrest). Routine cervical spine immobilisation not indicated unless clear mechanism of injury (diving, fall from height, alcohol).
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
- Doxapram hydrochloride · Respiratory stimulant
- Hydrocortisone (Oral Replacement) · Glucocorticoid Replacement
- Morphine (Oral) · Strong Opioid Analgesic — Step 3 WHO Ladder
- Oxycodone · Strong Opioid Analgesic — Step 3 WHO Ladder
- Ascorbic Acid (Vitamin C) · Water-Soluble Vitamin (Vitamin C)
- Donanemab (Anti-Amyloid Monoclonal Antibody) · Anti-Amyloid Immunotherapy (IgG1 — Targets Pyroglutamate-Modified Amyloid-β)
Pathways
- Difficult Airway Algorithm (DAS) · DAS 2015; Royal College of Anaesthetists
- Major Haemorrhage Protocol · NICE NG24; UK MHP guidelines
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
Featured in these MRCEM clinical pathways
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Decision support only. Always apply local guidelines and clinical judgement.