DISABILITY (NEUROLOGIC)

- Initial determination of Glasgow Coma Score should be completed to guide additional resuscitative efforts.
- If circumstances surrounding the drowning are unwitnessed and loss of consciousness is persistent, consider other etiologies other than hypoxemia, such as head injury, intoxication, arterial gas embolism (AGE). This will depend on circumstances surrounding the event (e.g., scuba diver surfacing unconscious or with neuro complaint).12
- If AGE is suspected, begin notification of hyperbaric chamber team (See Appendix B).
- The following have not shown benefit in the unconscious drowning patient: hyperosmolar agents (e.g., mannitol or hypertonic saline), hyperventilation, barbiturate coma, intracranial pressure monitoring.
- Glucose – maintain between 80-140 mg/dL for ventilated patients.