From the Guidelines
In case of a near drowning involving a 2-year-old, immediately remove the child from the water and call emergency services (911) as stated in the 2024 guidelines 1. The most critical step is to remove the child from the water safely without putting yourself in danger, as emphasized in the 2010 American Heart Association guidelines 1.
Key Steps to Follow:
- Check if the child is breathing and responsive. If not breathing, begin CPR immediately: give 30 chest compressions followed by 2 rescue breaths, following the standard pediatric basic life support (BLS) guidelines 1.
- Continue CPR until help arrives or the child starts breathing. It's crucial to prioritize airway management and ventilation due to the continuum from respiratory arrest to cardiac arrest following drowning 1.
- Even if the child seems fine after being rescued, medical evaluation is essential as complications like "secondary drowning" can occur hours later due to water in the lungs.
- Keep the child warm with dry blankets to prevent hypothermia and position the child on their side if they're breathing but unconscious to prevent choking if they vomit.
- Never delay seeking medical help even if the child appears to recover, as respiratory problems, brain damage from oxygen deprivation, and other complications can develop, as highlighted in the 2024 update 1.
Importance of Immediate Action:
The immediate initiation of rescue breathing by trained rescuers and the use of an automated external defibrillator (AED) after initiation of high-quality CPR can be lifesaving in cardiac arrests following drowning 1. All near-drowning victims require hospital evaluation regardless of their immediate condition, as lung damage and other serious effects may not be immediately apparent, emphasizing the need for prompt medical attention 1.
From the Research
Immediate Response to Near Drowning
In the event of a 2-year-old near drowning, it is crucial to act quickly and follow established protocols for resuscitation and care. The key steps include:
- Removing the child from the water immediately
- Checking for breathing and pulse
- Starting cardiopulmonary resuscitation (CPR) if the child is unresponsive or not breathing, as emphasized by studies 2, 3, 4
- Continuing CPR for at least 30 minutes if necessary, especially in cases where the child has been submerged for an extended period or is hypothermic, as suggested by 5, 3
Importance of Prompt Medical Attention
After initiating CPR, it is vital to get the child to a medical facility as soon as possible. Even if the child appears to be recovering or is asymptomatic after the incident, medical evaluation is necessary to assess for any potential complications, such as respiratory failure or neurological impairment, as highlighted in 2, 6.
Role of Medical Professionals
Medical professionals play a critical role in the management of near drowning cases. This includes:
- Providing advanced life support, including intubation and ventilation, as needed
- Monitoring for signs of respiratory or cardiac complications
- Implementing strategies to prevent further brain injury, such as maintaining adequate oxygenation and blood pressure
- Considering the duration of CPR and the potential for favorable neurologic outcomes, as discussed in 5
Prevention and Education
Prevention of drowning is a significant public health issue. Education on water safety, supervision, and the importance of learning CPR can help reduce the incidence of near drowning cases, as emphasized by 2, 3.