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Drowning with hypoxaemia — RCPSC EM MCQ

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HardEnvironmental emergenciesDrowning with hypoxaemiaRCPSC EM

A 16-year-old swimmer is pulled from a lake after submersion. He is coughing, hypoxic and confused. Oxygen saturation is 86% on high-flow oxygen, chest radiograph shows bilateral infiltrates and temperature is 34.8°C. What is the most appropriate next step?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Provide oxygenation and ventilatory support, rewarm and observe/admit because of hypoxaemia and altered mental status

Symptomatic drowning with hypoxaemia, altered mental status, infiltrates and hypothermia requires supportive respiratory care, rewarming and admission or prolonged observation. Routine prophylactic antibiotics are not standard.

Reference: Wilderness Medical Society drowning guidance; Canadian emergency medicine textbooks