ENVIRONMENTAL

ResponseDuration of submersion/emersion
Time to life support
Initial rhythm
Details + Duration of ALS
GCS on arrival to ED
Water temp (Cold = protective)
Injuries
General - comorbidities

ResponseSubmersion >5 mins
Time to BLS >10 mins (Delay to CPR)
Arrival in hospital with CPR going
GCS <5 (Coma on arrival to ED)
Rectal temp <30
Arterial pH <7.1 on arrival
Fixed dilated pupils

ResponseConn and Modell (Hint: Kinda the same as motor for GCS)
A - Awake
B - Conscious but obtunded
C - Comatose - C1 = flexion to pain, C2 = extension to pain, C3 = Flaccid

Orlowski scale
Age <3
Submersion >5 mins
No attempted resus in first 10 mins post rescue
Coma on arrival to ED
Met acidosis on ED arrival pH <7.1
<3 factors =90% chance of good recovery, >3 factors 5%

ResponseTrauma (Head/cspine)
Aspiration
Hypothermia
Hypoglycaemia
Hyponatraemia
Hypoxic brain injury

ResponseTemperature
Signs of lung injury/aspiration from drowning
Signs of perfusion/haemodynamics
Neurologic deficit
Signs of C spine injury

ResponseARDS - bilateral coalescing infiltrates
Features in stages 2 and 3 on chest radiographs are usually identical to pulmonary edema from other non-cardiac causes

ResponseNeurologic event - seizure, ICH, CVA
Hypoglycaemia
Cardiac event
Intoxication - drug ingestion or withdrawal
misadventure/foul play
Inadequate supervision
Trauma (Dive in and broke neck)

Response4 phases (according to answer, google sometimes says 3-6…) Answer THPC 2018.1-3 + LITFL + Radiopaedia

1. Voluntary breath holding
2. Involuntary laryngospasm after inhalation of water (> hypoxia, hypercarbia, acidosis)
3. 15% - continue laryngospasm, 85% - laryngospasm abates with worsening hypoxia
4. Continued aspiration + hypoxia, LOC, apnoea.

Mechanism of death: Tachycardia>>Bradycardia>> PEA>>Death

Note: I’m not happy with any answer I have found for this including given answers.

ResponseDepartment - Staffing, patient flow, handover dept to other senior
Resus bay: paeds trolley,
Equipment: IO access, ETT, Heaters
Staff: Resus team with foles assigned (?anaesthetics for paeds aiwrway, SW for mum)
Pre hospital alert to teams
Weight estimation
Drugs: Adrenaline 10 mics/kg, fluid 20 mL/kg, 10% dextrose 2 mL/kg, Electricity 4J/kg, atropine 20 mics/kg

ResponseBVM with O2 and PEEP valve shut - quick initial oxygenation
HFNP start at .21 FiO2 and titrate up. Increasing CPAP effect with increasing flow rate. Paeds is 2L/kg/min but max is 60 L/min
NIV - CPAP/BIPAP high FiO2 - start at 10/5
ETT 5-7 mL/kg TV

ResponseLow volume/ARDS ventilation (ans) which means (LITFL)
Low TV 6 mL/kg (4-8mL/kg) (Then adjust RR to required)
Plateau pressure <30 cm.H2O
pH endpoint is 7.3-7.45
SpO2 endpoint 88-95% (PaO2 55-80 mm.Hg)

ResponseHuge O2 supply required
May delay definitive tx with intubation
Normal NIV cons (claustrophobia, uncomfortable, air insufflation >> emesis, obtunded etc.)

ResponseObserved 8hr from time of drowning (and daylight hours)
Asymptomatic
Normal resp examination
SpO2 >95%
Water safety education provided
No ongoing safety concerns (Paeds)
SW referral if appropriate (Paeds)

ResponseAsystole at 1h and normothermic
K>11