Wilderness Medical Society Clinical Practice Guidelines for the Treatment and Prevention of Drowning: 2019 Update

Schmidt, Andrew; Sempsrott, Justin; Hawkins, Seth C.; Arastu, Ali; Cushing, Tracy; Auerbach, Paul S.

doi:10.1016/j.wem.2019.06.007

Cited by 28 publications

(37 citation statements)

References 131 publications

(173 reference statements)

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“…Drowning victims and very young children, however, are specific exclusions to compression-only CPR. According to 2019 WMS Clinical Practice Guidelines, “compression-only CPR is likely to be of little to no benefit in drowning resuscitation.” For programs operating in aquatic environments, every effort should be made to obtain training in full CPR and perform full CPR during a drowning resuscitation (Schmidt et al 2019). It should be noted that some programs now teach a C-A-B algorithm (Circulation-Airway-Breathing), but in a remote drowning situation, the traditional A-B-C algorithm should be utilized, due to the critical importance of rapidly supplying oxygenation and ventilation for these patients (Schmidt et al 2019).…”

Section: Myth 6: Cpr Mythsmentioning

confidence: 99%

“…According to 2019 WMS Clinical Practice Guidelines, “compression-only CPR is likely to be of little to no benefit in drowning resuscitation.” For programs operating in aquatic environments, every effort should be made to obtain training in full CPR and perform full CPR during a drowning resuscitation (Schmidt et al 2019). It should be noted that some programs now teach a C-A-B algorithm (Circulation-Airway-Breathing), but in a remote drowning situation, the traditional A-B-C algorithm should be utilized, due to the critical importance of rapidly supplying oxygenation and ventilation for these patients (Schmidt et al 2019). WMS practice guidelines also recommend that it is reasonable not to initiate rescue (versus body recovery) or resuscitation interventions (including CPR) when there is known submersion time of greater than 30 minutes in warm water (warmer than 6°C/43°F) or 90 minutes in cold water (colder than 6°C/43°F; Schmidt et al 2019).…”

Section: Myth 6: Cpr Mythsmentioning

confidence: 99%

“…It should be noted that some programs now teach a C-A-B algorithm (Circulation-Airway-Breathing), but in a remote drowning situation, the traditional A-B-C algorithm should be utilized, due to the critical importance of rapidly supplying oxygenation and ventilation for these patients (Schmidt et al 2019). WMS practice guidelines also recommend that it is reasonable not to initiate rescue (versus body recovery) or resuscitation interventions (including CPR) when there is known submersion time of greater than 30 minutes in warm water (warmer than 6°C/43°F) or 90 minutes in cold water (colder than 6°C/43°F; Schmidt et al 2019).…”

Section: Myth 6: Cpr Mythsmentioning

confidence: 99%

See 2 more Smart Citations

Ten Myths about Medical Emergencies and Medical Kits

Hawkins

Simon²

2021

Adv. archaeol. pract.

Self Cite

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Wilderness medicine is plagued by myths and dogmatic teachings not supported by evidence. This article focuses particularly on those teachings and tools that would be most likely used in archaeological fieldwork. It lays out 10 of the most common and concerning myths taught in wilderness medicine and wilderness emergency medical services, both in terms of first aid and preparation of medical kits. The myths described are provide a structure for the main purpose of the article: to explain interventions and medical kit contents that are more evidence based and supported by modern understandings of wilderness medicine and fieldwork risk management. The list of top 10 myths includes (1) the use of medications other than epinephrine for anaphylaxis and (2) the availability and proper use of epinephrine auto-injectors, (3) the use of suction devices and tourniquets for snakebites, (4) the use of spinal immobilization for neck injuries, (5) the identification and treatment of heat illnesses, (6) the use of CPR in remote areas, (7) the appropriateness of dislocation reduction in remote areas, (8) the use and choice of tourniquets for arterial bleeding, (9) the initial definition and management of drowning patients, and (10) wound management myths.

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Section: Myth 6: Cpr Mythsmentioning

confidence: 99%

Section: Myth 6: Cpr Mythsmentioning

confidence: 99%

Section: Myth 6: Cpr Mythsmentioning

confidence: 99%

See 1 more Smart Citation

Ten Myths about Medical Emergencies and Medical Kits

Hawkins

Simon²

2021

Adv. archaeol. pract.

Self Cite

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“…Accidental water immersion represents a common cause of death in many countries, with cold water representing a further risk due to the combination of drowning, cold shock response, and hypothermia [1][2][3]. For context, between 1978 and 1998 more than 5300 passengers were killed in ferry accidents around the world, making ferry travel 10 times more dangerous than air travel [4].…”

Section: Introductionmentioning

confidence: 99%

Marine Survival in the Mediterranean: A Pilot Study on the Cognitive and Cardiorespiratory Response to Sudden Cool Water Immersion

Stella

Morrison

2022

IJERPH

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Background and Aim: The Mediterranean is one of the major gateways of human migratory fluxes from Northern Africa, the Middle East, and Central Asia to Europe. Sea accidents have become an urgent humanitarian crisis due to the high number of migrants on the move, but data on the physiological effects to sudden cool water immersion are not as extensive as cold-water studies. We wanted to evaluate to what extent cool water immersion (~18 °C) may detrimentally affect cognitive ability and cardiorespiratory strain compared to the more prevalent cold-water (<10–15 °C) studies. Methods: In this case, 10 active, healthy men participated in this study which consisted of completing one familiarization trial, and then a control (CON) or experimental (EXP) trial in a randomized, repeated-measures, cross-over fashion, separated by at least 7-days. Cognitive function was assessed via the Symbol Digit Modalities Test (SDMT), a code substitution test, performed at baseline, then repeated in either a thermoneutral (~25 °C room air) dry environment, or when immersed to the neck in 18 °C water. Testing consisted of six “Step” time-blocks 45-s each, with a 5-s pause between each Step. Cardiorespiratory measures, continuously recorded, included heart rate (beats per minute), minute ventilation (V˙E, L∙min−1), oxygen consumption (V˙O2, L∙min−1), and respiratory frequency (fR, count∙min−1). Results: Initial responses to cool water (<2 min) found that participants performed ~11% worse on the code substitution test (p = 0.025), consumed 149% greater amounts of oxygen (CI: 5.1 to 9.1 L∙min−1, p < 0.0001) and experienced higher cardiovascular strain (HR CI: 13 to 38 beats per minute, p = 0.001) than during the control trial. Physiological strain was in-line to those observed in much colder water temperature. Conclusion: Sudden, cool water immersion also negatively affects cognitive function and cardiorespiratory strain, especially during the first two minutes of exposure. The magnitude increase in heart rate is strongly associated with poorer cognitive function, even in (relatively) warmer water consistent with temperatures found in the Mediterranean Sea environment.

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“…In results from experiments on sheep, the introduction of 1 to 3 mL of water per kilogram of body weight is sufficient to cause a "precipitous fall and a prolonged depression of arterial oxygen saturation." 5 In dog experiments, the survival rate was inversely proportional to the quantity of fluid aspirated 6 and "the clinical picture is determined predominantly by the amount of water that has been aspirated." 7 There is consensus that introduction of air into the lungs through mouth-to-mouth or other methods of resuscitation leads to effective oxygenation.…”

mentioning

confidence: 99%