Interpretation of the updated 2019 Wilderness Medical Society Clinical Practice Guidelines for the Treatment and Prevention of Drowning_West China Medical Journal

Authors：

WU Shanshan ^1,2 , XIAO Dongqiong ^1,2 ,  LI Xihong ^1,2

1. Department of Emergency, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

LI Xihong, Email: hilixihong@163.com

Keywords：

Drowning; Emergency treatment; Prevention

DOI：

10.7507/1002-0179.202007091

Video：

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As a global accidental injury, drowning has a huge spiritual and economic impact on patients, families and society. In order to improve the quality of pre-hospital and in-hospital emergency treatment of drowning, improve the prognosis, improve survival rate, and reduce the burden of drowning, in 2016, the Wilderness Medical Society drafted practice guidelines related to drowning. The first update of this guide was released in June 2019. The updated guide covers the terms of drowning, rescue and resuscitation, emergency treatment, preventive measures and other aspects. This article interprets the updated guidelines in order to provide recommendations for the first aid of drowning.

Citation： WU Shanshan, XIAO Dongqiong, LI Xihong. Interpretation of the updated 2019 Wilderness Medical Society Clinical Practice Guidelines for the Treatment and Prevention of Drowning. West China Medical Journal, 2020, 35(11): 1338-1343. doi: 10.7507/1002-0179.202007091 Copy

1.	World Health Organization. Preventing drowning: an implementation guide. Geneva: World Health Organization, 2017.
2.	Schmidt AC, Sempsrott JR, Hawkins SC, et al. Wilderness Medical Society clinical practice guidelines for the treatment and prevention of drowning: 2019 update. Wilderness Environ Med, 2019, 30(4S): S70-S86.
3.	Falk JL, Escowitz HE, Falk JL, et al. Submersion injuries in children and adults. Semin Respir Crit Care Med, 2002, 23(1): 47-55.
4.	Schmidt AC, Sempsrott JR, Hawkins SC, et al. Wilderness Medical Society practice guidelines for the prevention and treatment of drowning. Wilderness Environ Med, 2016, 27(2): 236-251.
5.	McDonald GK, Giesbrecht GG. Vehicle submersion: a review of the problem, associated risks, and survival information. Aviat Space Environ Med, 2013, 84(5): 498-510.
6.	Giesbrecht GG, Mcdonald GK. My car is sinking: automobile submersion, lessons in vehicle escape. Aviat Space Environ Med, 2010, 81(8): 779-784.
7.	Ghaphery JL. In-water resuscitation. JAMA, 1981, 245(8): 821.
8.	Winkler BE, Eff AM, Eff S, et al. Efficacy of ventilation and ventilation adjuncts during in-water-resuscitation--a randomized cross-over trial. Resuscitation, 2013, 84(8): 1137-1142.
9.	Dow J, Giesbrecht GG, Danzl DF, et al. Wilderness Medical Society clinical practice guidelines for the out-of-hospital evaluation and treatment of accidental hypothermia: 2019 update. Wilderness Environ Med, 2019, 30(4S): S47-S69.
10.	Lavonas EJ, Drennan IR, Gabrielli A, et al. Part 10: Special Circumstances of Resuscitation: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015, 132(18 Suppl 2): S501-S518.
11.	Spindelboeck W, Schindler O, Moser A, et al. Increasing arterial oxygen partial pressure during cardiopulmonary resuscitation is associated with improved rates of hospital admission. Resuscitation, 2013, 84(6): 770-775.
12.	Prancesco F, Fielding R, Wernicke PG, et al. Sub-diaphragmatic thrusts and drowned persons. Int J Aquatic Res Educ, 2010, 4: 81.
13.	Ten Brinke JG, Groen SR, Dehnad M, et al. Prehospital care of spinal injuries: a historical quest for reasoning and evidence. Eur Spine J, 2018, 27(12): 2999-3006.
14.	Hawkins SC, Williams J, Bennett BL, et al. Wilderness Medical Society clinical practice guidelines for spinal cord protection. Wilderness Environ Med, 2019, 30(4S): S87-S99.
15.	Michelet P, Bouzana F, Charmensat O, et al. Acute respiratory failure after drowning: a retrospective multicenter survey. EurJ Emerg Med, 2017, 24(4): 295-300.
16.	Brennan CE, Hong T, Wang VJ. Predictors of safe discharge for pediatric drowning patients in the emergency department. AmJ Emerg Med, 2018, 36(9): 1619-1623.
17.	Rafaat KT, Spear RM, Kuelbs C, et al. Cranial computed tomographic findings in a large group of children with drowning: diagnostic, prognostic, and forensic implications. Pediatr Crit Care Med, 2008, 9(6): 567-572.
18.	Tadié JM, Heming N, Serve E, et al. Drowning associated pneumonia: a descriptive cohort. Resuscitation, 2012, 83(3): 399-401.
19.	Foex BA, Boyd R. Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Corticosteroids in the management of near-drowning. Emerg Med J, 2001, 18(6): 465-466.
20.	Topjian AA, Berg RA, Bierens JJ, et al. Brain resuscitation in the drowning victim. Neurocrit Care, 2012, 17(3): 441-467.
21.	Callaway CW, Donnino MW, Fink EL, et al. Part 8: Post-Cardiac Arrest Care: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation, 2015, 132(18 Suppl 2): S465-S482.
22.	Szpilman D. Near-drowning and drowning classification:a proposal to stratify mortality based on the analysis of 1, 831 cases. Chest, 1997, 112(3): 660-665.
23.	Kieboom JK, Verkade HJ, Burgerhof JG, et al. Outcome after resuscitation beyond 30 minutes in drowned children with cardiac arrest and hypothermia: Dutch nationwide retrospective cohort study. BMJ, 2015, 350: 418.
24.	Tipton MJ, Golden FS. A proposed decision-making guide for the search, rescue and resuscitation of submersion (head under) victims based on expert opinion. Resuscitation, 2011, 82(7): 819-824.
25.	Shenoi RP, Allahabadi S, Rubalcava DM, et al. The pediatric submersion score predicts children at low risk for injury following submersions. Acad Emerg Med, 2017, 24(12): 1491-1500.
26.	Albertella L, Crawford J, Skinner JR. Presentation and outcome of water-related events in children with long QT syndrome. Arch Dis Child, 2011, 96(8): 704-707.
27.	Choi G, Kopplin LJ, Tester DJ, et al. Spectrum and frequency of cardiac channel defects in swimming-triggered arrhythmia syndromes. Circulation, 2004, 110(15): 2119-2124.
28.	Moran K, Stanley T. Parental perceptions of toddler water safety, swimming ability and swimming lessons. Int J Inj Contr Saf Promot, 2006, 13(3): 139-143.
29.	Driscoll TR, Harrison JA, Steenkamp M. Review of the role of alcohol in drowning associated with recreational aquatic activity. Inj Prev, 2004, 10(2): 107-113.
30.	Ducharme MB, Lounsbury DS. Self-rescue swimming in cold water: the latest advice. Appl Physiol Nutr Metab, 2007, 32(4): 799-807.

1. World Health Organization. Preventing drowning: an implementation guide. Geneva: World Health Organization, 2017.
2. Schmidt AC, Sempsrott JR, Hawkins SC, et al. Wilderness Medical Society clinical practice guidelines for the treatment and prevention of drowning: 2019 update. Wilderness Environ Med, 2019, 30(4S): S70-S86.
3. Falk JL, Escowitz HE, Falk JL, et al. Submersion injuries in children and adults. Semin Respir Crit Care Med, 2002, 23(1): 47-55.
4. Schmidt AC, Sempsrott JR, Hawkins SC, et al. Wilderness Medical Society practice guidelines for the prevention and treatment of drowning. Wilderness Environ Med, 2016, 27(2): 236-251.
5. McDonald GK, Giesbrecht GG. Vehicle submersion: a review of the problem, associated risks, and survival information. Aviat Space Environ Med, 2013, 84(5): 498-510.
6. Giesbrecht GG, Mcdonald GK. My car is sinking: automobile submersion, lessons in vehicle escape. Aviat Space Environ Med, 2010, 81(8): 779-784.
7. Ghaphery JL. In-water resuscitation. JAMA, 1981, 245(8): 821.
8. Winkler BE, Eff AM, Eff S, et al. Efficacy of ventilation and ventilation adjuncts during in-water-resuscitation--a randomized cross-over trial. Resuscitation, 2013, 84(8): 1137-1142.
9. Dow J, Giesbrecht GG, Danzl DF, et al. Wilderness Medical Society clinical practice guidelines for the out-of-hospital evaluation and treatment of accidental hypothermia: 2019 update. Wilderness Environ Med, 2019, 30(4S): S47-S69.
10. Lavonas EJ, Drennan IR, Gabrielli A, et al. Part 10: Special Circumstances of Resuscitation: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015, 132(18 Suppl 2): S501-S518.
11. Spindelboeck W, Schindler O, Moser A, et al. Increasing arterial oxygen partial pressure during cardiopulmonary resuscitation is associated with improved rates of hospital admission. Resuscitation, 2013, 84(6): 770-775.
12. Prancesco F, Fielding R, Wernicke PG, et al. Sub-diaphragmatic thrusts and drowned persons. Int J Aquatic Res Educ, 2010, 4: 81.
13. Ten Brinke JG, Groen SR, Dehnad M, et al. Prehospital care of spinal injuries: a historical quest for reasoning and evidence. Eur Spine J, 2018, 27(12): 2999-3006.
14. Hawkins SC, Williams J, Bennett BL, et al. Wilderness Medical Society clinical practice guidelines for spinal cord protection. Wilderness Environ Med, 2019, 30(4S): S87-S99.
15. Michelet P, Bouzana F, Charmensat O, et al. Acute respiratory failure after drowning: a retrospective multicenter survey. EurJ Emerg Med, 2017, 24(4): 295-300.
16. Brennan CE, Hong T, Wang VJ. Predictors of safe discharge for pediatric drowning patients in the emergency department. AmJ Emerg Med, 2018, 36(9): 1619-1623.
17. Rafaat KT, Spear RM, Kuelbs C, et al. Cranial computed tomographic findings in a large group of children with drowning: diagnostic, prognostic, and forensic implications. Pediatr Crit Care Med, 2008, 9(6): 567-572.
18. Tadié JM, Heming N, Serve E, et al. Drowning associated pneumonia: a descriptive cohort. Resuscitation, 2012, 83(3): 399-401.
19. Foex BA, Boyd R. Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Corticosteroids in the management of near-drowning. Emerg Med J, 2001, 18(6): 465-466.
20. Topjian AA, Berg RA, Bierens JJ, et al. Brain resuscitation in the drowning victim. Neurocrit Care, 2012, 17(3): 441-467.
21. Callaway CW, Donnino MW, Fink EL, et al. Part 8: Post-Cardiac Arrest Care: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation, 2015, 132(18 Suppl 2): S465-S482.
22. Szpilman D. Near-drowning and drowning classification:a proposal to stratify mortality based on the analysis of 1, 831 cases. Chest, 1997, 112(3): 660-665.
23. Kieboom JK, Verkade HJ, Burgerhof JG, et al. Outcome after resuscitation beyond 30 minutes in drowned children with cardiac arrest and hypothermia: Dutch nationwide retrospective cohort study. BMJ, 2015, 350: 418.
24. Tipton MJ, Golden FS. A proposed decision-making guide for the search, rescue and resuscitation of submersion (head under) victims based on expert opinion. Resuscitation, 2011, 82(7): 819-824.
25. Shenoi RP, Allahabadi S, Rubalcava DM, et al. The pediatric submersion score predicts children at low risk for injury following submersions. Acad Emerg Med, 2017, 24(12): 1491-1500.
26. Albertella L, Crawford J, Skinner JR. Presentation and outcome of water-related events in children with long QT syndrome. Arch Dis Child, 2011, 96(8): 704-707.
27. Choi G, Kopplin LJ, Tester DJ, et al. Spectrum and frequency of cardiac channel defects in swimming-triggered arrhythmia syndromes. Circulation, 2004, 110(15): 2119-2124.
28. Moran K, Stanley T. Parental perceptions of toddler water safety, swimming ability and swimming lessons. Int J Inj Contr Saf Promot, 2006, 13(3): 139-143.
29. Driscoll TR, Harrison JA, Steenkamp M. Review of the role of alcohol in drowning associated with recreational aquatic activity. Inj Prev, 2004, 10(2): 107-113.
30. Ducharme MB, Lounsbury DS. Self-rescue swimming in cold water: the latest advice. Appl Physiol Nutr Metab, 2007, 32(4): 799-807.

West China Medical Journal

Interpretation of the updated 2019 Wilderness Medical Society Clinical Practice Guidelines for the Treatment and Prevention of Drowning

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