Know Your Guidelines – Drowning with Cardiac Arrest

Andrea Eberly, MD, MS, FAAEMEmergency Medicine, Guideline Knowledge Check, Medical News

Emergency Medicine Guidelines Knowledge Check Drowning With Cardiac Arrest

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Today's Guideline Knowledge Check question comes from the desk of Med-Challenger Emergency Medicine Editor-in-Chief, Andrea Eberly, MD, FAAEM.

Based on current AHA Resuscitation Guidelines ...

Has the resuscitation of a person in drowning-related cardiac arrest recently changed?

Yes or No?

Try this review question and find out if you're following the most current guideline.

Guideline Review Question

To ensure that health care professionals use consistent terminology, the 2010 American Heart Association (AHA) guidelines for cardiopulmonary resuscitation (CPR) introduced a new, unified definition of drowning that replaced the older, poorly defined terms such as near drowning, warm drowning, or saltwater drowning. This unified definition (unchanged through the 2015 and 2017 AHA resuscitation guideline updates) defines drowning as "a process resulting in primary respiratory impairment from submersion/immersion in a liquid medium." The outcome of the drowning event is captured by a secondary descriptor (eg, drowning with death, drowning with morbidity, drowning without morbidity).

What else do the current AHA guidelines recommend with regards to resuscitation from cardiac arrest after a drowning?

The 2017 guidelines add a new recommendation for use of barbiturates therapeutic hypothermia, and vasopressors for patients who remain comatose after successful resuscitation from drowning.

The 2015 AHA guidelines added a new recommendation for routine stabilization of the cervical spine until the details surrounding the drowning event become known.

The following AHA drowning guideline has not changed since 2010: mouth-to-mouth ventilation performed in the water without cardiac compressions may be helpful when administered by a trained rescuer.

The 2017 AHA drowning guidelines added a new recommendation that trained basic life support responders should perform the Heimlich maneuver once to clear the airway of water prior to proceeding with compression-only-CPR.

Answer Explanation & References:

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About Guideline Knowledge Checks:

With each update of national clinical practice guidelines, some recommendations change and many remain unchanged. Med-Challenger Guideline Knowledge Checks help you know both what is new and what has stayed the same in the most recent guidelines pertinent to various medical specialties.

About the Author:

Andrea Eberly, MD, FAAEM graduated from the David Geffen Medical School of Los Angeles (UCLA) and completed her residency in Emergency Medicine at the University Medical Center, Tucson, Arizona. After working as an attending physician in Tucson, she followed a recruiting call to the island of Guam, where she served in various roles, including as the director of the emergency department, the EMS Medical Director of Guam, and the Director of the 911 Call System. She has maintained her emergency medicine board certification through three cycles of American Board of Emergency Medicine Board Exams (last in 2014), all three with the help of Med-Challenger.

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