What are the discharge criteria for drowning patients treated in the ED?

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

Patient disposition depends on the history, presence of associated injuries, and degree of immersion injury. Patients can be safely discharged from the ED after 6-8 hours of observation if they meet the following criteria:

  • Able to relay a good history of minor immersion injury

  • No evidence of significant injury

  • No change in mental status or behavior

  • No evidence of bronchospasm or tachypnea/dyspnea

  • No evidence of inadequate oxygenation (by ABG analysis and pulse oximetry)

Be cautious with early ED discharge in older individuals or in those with underlying medical conditions that might place them at increased risk of hypoxic injury. Victims of mild to moderately severe submersion, who only have mild symptoms that improve during observation and have no abnormalities on ABG analysis or pulse oximetry and chest radiograph, should be observed for a more prolonged period of time in the ED or observation unit.

Instruct discharged patients to return immediately if they develop dyspnea, cough, and/or fever.


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