What are the immediate steps I should take in the emergency management of a patient who has experienced a drowning incident?

Immediate steps in the emergency management of a drowning patient begin with ensuring the safety of the rescuer and removing the patient from the water as quickly and safely as possible ¹. Once out of the water, assess the patient's airway, breathing, and circulation (the ABCs) immediately, as hypoxia is the primary threat in drowning incidents ¹. If the patient is unresponsive and not breathing normally, start cardiopulmonary resuscitation (CPR) without delay, prioritising effective ventilation to address hypoxia, as oxygenation is critical in brain resuscitation after drowning (Topjian et al., 2012). Provide high-flow oxygen as soon as possible, even if spontaneous breathing returns, to optimise oxygen delivery and reduce secondary brain injury ¹; (Topjian et al., 2012).

Simultaneously, monitor vital signs and prepare for advanced airway management if necessary, including endotracheal intubation, especially if the patient has a decreased level of consciousness or inadequate ventilation (Topjian et al., 2012). Avoid aggressive fluid resuscitation unless there is evidence of hypovolaemia or shock, as pulmonary oedema is common in drowning and fluid overload may worsen respiratory function ¹.

Transport the patient urgently to an emergency facility with capabilities for advanced respiratory and neurological support. Continuous monitoring and supportive care should focus on preventing hypoxia, managing hypothermia, and treating any complications such as aspiration pneumonia or cardiac arrhythmias ¹; (Topjian et al., 2012).

In summary, the immediate management prioritises rapid removal from water, airway and breathing support with effective ventilation, oxygen therapy, and prompt transfer for advanced care to minimise hypoxic brain injury and other complications ¹; (Topjian et al., 2012).