Question 1

A child is rescued from the water after submersion of approximately 3 minutes. They are coughing and conscious on recovery. What are the additional considerations for paediatric near-drowning?

Accepted Answer

Children can develop delayed respiratory distress (secondary drowning / pulmonary oedema) up to 24 hours after submersion — even if fully recovered immediately, all paediatric near-drowning patients must be assessed in hospital; do not assume recovery is complete Secondary drowning (post-immersion syndrome): fluid aspirated into the lungs causes progressive pulmonary oedema (fluid on the lungs) and respiratory failure over 4-24 hours — even after initial apparent recovery. It is relatively rare but can be fatal. ALL children rescued from submersion must be assessed in hospital regardless of initial appearance. Signs of deterioration: increasing breathlessness, cough, frothy sputum, cyanosis, confusion. Paediatric CPR: modified ratios (15:2 for two rescuers, 30:2 for one).

Question 2

A crew member recovered from cold water is shivering violently, confused, and pale. What stage of hypothermia is this and what is the correct treatment?

Accepted Answer

Mild to moderate hypothermia (core temp ~32–35°C) — remove wet clothing, insulate from wind and cold, warm with blankets and foil, give warm sweet drinks if conscious and no injury suspected, handle gently and do NOT rub limbs Shivering with confusion = mild-moderate hypothermia. Treatment: protect from environment; remove wet clothing (avoid vigorous movement — cold blood from extremities flushing to core can cause cardiac arrest); insulate; warm externally; do NOT rub limbs; give warm fluids only if conscious and uninjured. Severe hypothermia (rigid, no shivering) — treat as cardiac arrest, CPR may be needed.

Question 3

A near-drowning casualty has been recovered from the water. They are unconscious and not breathing. What is the immediate priority?

Accepted Answer

Start rescue breaths (5 initial breaths) immediately, then begin standard CPR (30 compressions : 2 breaths) — airway and breathing take priority as drowning is a hypoxic event Drowning is a hypoxic (oxygen deprivation) emergency. Unlike cardiac arrest in adults, rescue breaths are critical — give 5 initial rescue breaths, then 30:2 CPR. Continue until breathing resumes or help arrives. If on a vessel with no AED, focus on quality CPR with rescue breaths. Do NOT attempt to drain water from the lungs — it delays oxygenation and is ineffective.