When to stop the resuscitation (ALS) of drowning victims?

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HMartinho

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I have this doubt. When to stop the resuscitation of drowning victims? I work on portuguese EMS for over 1 year, and I never seen an drowning case. Weird, but true. Whereas hypothermia can preserve neurological function, hence my question.

I read an article wich shows drowning survivors were submerged for more than 30 minutes. Is it true/possible?
 
What is your proximity to the hospital? Because basically, you don't "Call" drowning arrest in the field. Continue working them till they get to the hospital.

I've had extended efforts result in ROSC after deep-tube suctioning of the lungs, to remove that fluid.

But either way, let the hospital call them. Intiate your full-blown ACLS resuscitation, then continue them enroute to the facility.
 
hibiti87 said:
not dead until warm and dead.
Click to expand...

Not necessarily true. Some areas allow for the cessation of resuscitation if the core temp is below a certain point.
 
Drowning? Always thought drownings get full ACLS response and that you continue resuscitation til the hospital. A regular ol' arrest (and certainly a traumatic arrest) could be called if no ROSC on scene, but not so much for drownings, no?
 
Doczilla said:
What is your proximity to the hospital? Because basically, you don't "Call" drowning arrest in the field. Continue working them till they get to the hospital.

I've had extended efforts result in ROSC after deep-tube suctioning of the lungs, to remove that fluid.

But either way, let the hospital call them. Intiate your full-blown ACLS resuscitation, then continue them enroute to the facility.
Click to expand...

20 minutes of basic E.R.
45 minutes of a central and advanced E.R.

I think here is a little bit different of USA. We got pre-hospital rapid response ALS cars, with emergency physicians. Only our pre-hospital physicians can call a code (traumatic (Technically, because in "real life" there are exceptions), sudden, drownings etc).

But how long can a hypothermia preserve the neurological function?
 
There's been some freaky stories dude, especially with kids. There was a case in florida where some girl reanimated on the coroner's table.

For most people with an intact nervous system though, the mammilian diving reflex is what serves to be neroprotective, and cardioprotective against ischemia and the intense inflammatory cascade that occurs from reperfusion.

This is why theraputic hypothermia was introduced into hospitals and some EMS systems for post ROSC management.
 
We can call drownings in the field depending on the circumstances and with orders from a base physician, which in my system, is any ER doc at our 4 hospitals (We technically have 5 but the VA isn't a base facility). With that said unless it was very obvious they were dead, they all get transported.
 
Local protocol had no resuscitation with confirmed time submerged > 1 hour
 
HMartinho said:
I have this doubt. When to stop the resuscitation of drowning victims? I work on portuguese EMS for over 1 year, and I never seen an drowning case. Weird, but true. Whereas hypothermia can preserve neurological function, hence my question.

I read an article wich shows drowning survivors were submerged for more than 30 minutes. Is it true/possible?
Click to expand...

There's drowning, and then there's cold water drowning.
 
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