Environmental

Question 1

Drowning, good and poor prognostic signs

Answer 1

Good:

• immersion <6 minutes
• time to first spontaneous breath <15-30 minutes
• efficient initial CPR
• GCS15 on arrival to ED
• Rapid neurological recovery within 2-6 hours
• spontaneous breathing and circulation on arrival to ED
• score < 3 on the orlowski scale

Bad:

• immersion time > 5 minutes
• delayed CPR initiation > 10 minutes following rescue
• delayed time to first spontaneous breath 60-120 minutes
• age<3
• comatose on arrival to ED
• pH < 7.1
• remains decorticate, decerebrate, flaccid after 2-6 hours
• CPR>25 minutes
• VF or VT rhythm
• cardiac or respiratory arrest
• GCS =<5
• fixed dilated pupils