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Drowning Cardiac Rhythm — RACP Paediatrics MCQ

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ModerateEmergency PaediatricsDrowning Cardiac RhythmRACP Paediatrics

A 4-year-old is found floating face-down in a backyard pool. He has been submerged for an unknown duration. He is pulseless and apnoeic on arrival. CPR is commenced. After 2 minutes of CPR, a shockable rhythm is unlikely. What is the most common initial cardiac rhythm in paediatric drowning?

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Correct answer: B — Asystole or pulseless electrical activity

In paediatric drowning-related cardiac arrest, the most common initial rhythm is asystole or PEA (non-shockable). VF is uncommon (<10%). CPR with emphasis on ventilation is the priority (as drowning is a hypoxic arrest). Hypothermia may be neuroprotective. Prolonged resuscitation is warranted in cold-water submersion.

Reference: Australian Resuscitation Council – 2025 – Drowning Resuscitation