What other interventions are indicated in the treatment of drowning patients?

Updated: Jun 19, 2019
  • Author: G Patricia Cantwell, MD, FCCM; Chief Editor: Joe Alcock, MD, MS  more...
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Answer

Nasogastric tube placement can be used for removal of swallowed water and debris. Use the orogastric route if head or facial trauma is suggested.

Bronchoscopy may be needed to remove foreign material, such as aspirated debris or vomitus plugs from the airway.

Efficacy of surfactant therapy has been reported in selected case reports. [94, 95] The routine administration of surfactant is not supported by present evidence. Use should be reserved for those with severe hypoxemic respiratory failure.

The mainstay of neuromonitoring is achieved by frequent neurologic examinations. Deterioration of brainstem function does not bode well for favorable recovery. Continuous EEG monitoring may be helpful in the assessment of subclinical seizures. No evidence supports that intracranial pressure monitoring affects the outcome in drowning victims. One could surmise the potential utility of intracranial pressure monitoring in the case of severe ARDS in order to monitor the impact of permissive hypercarbia and the effect of PEEP.


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