In near-drowning victims, what is an initial priority in management?

In near-drowning victims, what is an initial priority in management?

• A. Induced coma
• B. Airway management with mechanical ventilation
• C. Immediate blood transfusion
• D. Cooling measures

Answer: (B)

The most important priority is securing the airway and ensuring adequate ventilation with oxygenation. In near-drowning, inhaled water and inflammatory lung injury can rapidly cause hypoxemia and respiratory failure, so establishing a patent airway and providing breathing support (often with endotracheal intubation and mechanical ventilation) is essential to prevent ongoing brain and organ injury. Other interventions aren’t the immediate focus: inducing a coma isn’t routinely done at the outset, and a blood transfusion isn’t indicated unless there’s actual blood loss or shock from another cause. Cooling measures may be considered later if there’s evidence of hypoxic-ischemic brain injury after resuscitation, but they don’t take precedence over restoring effective oxygenation and ventilation.

The most important priority is securing the airway and ensuring adequate ventilation with oxygenation. In near-drowning, inhaled water and inflammatory lung injury can rapidly cause hypoxemia and respiratory failure, so establishing a patent airway and providing breathing support (often with endotracheal intubation and mechanical ventilation) is essential to prevent ongoing brain and organ injury.

Other interventions aren’t the immediate focus: inducing a coma isn’t routinely done at the outset, and a blood transfusion isn’t indicated unless there’s actual blood loss or shock from another cause. Cooling measures may be considered later if there’s evidence of hypoxic-ischemic brain injury after resuscitation, but they don’t take precedence over restoring effective oxygenation and ventilation.