Protocols

Question 1

Procedures for drowning patient

Answer 1

1. Cardiac and AED protocol

Question 2

Guidelines for drowning/near drowning patient

Answer 2

1. Ensure consideration of spinal injury from drowning/near drowning patient.
2. Maintain a patent airway by utilizing oral airway adjunct when necessary and consider possible need for suctioning.
3. Administer high flow oxygen by non-rebreathing mask
4. Assist ventilation
5. ECG monitoring
6. Transportation

Question 3

Symptoms for near drowning patients

Answer 3

1. Confusion
2. Crepitations
3. Cyanosis
4. Cough
5. Chest pain
6. Breathlessness
7. Loss of consciouness
8. Seizure

Question 4

Risk faced by post immersion patient

Answer 4

Some post immersion patient may experience asymptomatically, but there is a risk of pulmonary edema and aspiration following immersion.

Question 5

Indications for drowning protocol

Answer 5

Patient with history of fresh/sea water drowning or near drowning

Question 6

Indication for smoke inhalation protocol

Answer 6

Patient with all burn injury

Question 7

Signs of severe airway obstruction and impending respiratory failure

Answer 7

1. Unable to speak in complete one sentence and gasping for breathe
2. Auscultation demonstrates poor air entry and absence of air entry
3. Disoriented/ restlessness
4. Cyanosis
5. Patient is exhausted.
6. Flapping tremors of outstretched hands
7. Respiratory rate is < 10 or > 30 mins

Question 8

Signs of smoke inhalation

Answer 8

1. Stridor
2. Carbonaceous sputum
3. Singed eyebrow or nostril hair
4. Burns in oropharyngeal area
5. Hoarseness of voice

Question 9

Guidelines for smoke inhalation protocol

Answer 9

1. Prop the patient to 45deg or sitting position.
2. Administer high flow oxygen by non-rebreathing mask at 10-15 ml/min, regardless of age.
3. Auscultation
4. Administer salbutamol nebulisation at 6-8ml/min, max 2 doses
5. If patient is too exhausted, place patient in a supine position and attempt to ventilate patient using BVM or semi-automated oxylator with 100% oxygen
6. ECG monitoring
7. Transport and consider repeating salbutamol neubulization if necessary
8. Standby receiving hospital if neccessary