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Post-immersion (drowning) observation — DIPIMC MCQ

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HardEnvironmental MedicinePost-immersion (drowning) observationDIPIMCDipIMC

A 7-year-old was briefly submerged, was removed awake and now has normal oxygen saturation, respiratory examination, mental state and temperature. After appropriate observation and repeated normal assessments, their caregiver is reliable and can return promptly. What is the most appropriate disposition principle?

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Correct answer: C — Discharge with safety-netting after local asymptomatic criteria are met

The best answer is “Discharge with safety-netting after local asymptomatic criteria are met”. A normal child after a submersion event still needs structured assessment and observation, but current paediatric pathways do not require automatic admission solely because water was involved. When serial observations and examination meet the local asymptomatic discharge criteria, mobility is normal and the caregiver can return if symptoms develop, discharge with clear safety-netting can be appropriate. Respiratory symptoms, hypoxia, abnormal consciousness or safeguarding concerns change that pathway.

Reference: NHS Tayside, Paediatric drowning and hypothermia protocol: https://www.rightdecisions.scot.nhs.uk/nhs-tayside-ed-guidance/paediatrics/paediatric-drowning-and-hypothermia-protocol/