# Adult non-fatal drowning

Support oxygenation and ventilation, assess associated trauma, and use CPAP only in the appropriate conscious patient.

Population: Adult / adolescent. Scope: ALS.
Status: published. Source-linked OCEMS summary.
Summary updated: 2026-09-16.
Source checked: 2026-09-16.
Source version: See the linked OCEMS source for revision and implementation dates..
Canonical page: https://www.ocmedic.com/guides/drowning/
Official source: [SO-E-015 — Non-Fatal Drowning](https://www.ochealthinfo.com/sites/hca/files/import/data/files/12028.pdf)

Independent OC Medic summary. Does not replace the complete policy, current system notices, or clinical judgment.

## Key cautions & base contact

- CPAP requires its own inclusion/exclusion criteria and ongoing reassessment.
- Children have a separate drowning order and destination rule.

## Source documents

- [SO-E-015 — Non-Fatal Drowning](https://www.ochealthinfo.com/sites/hca/files/import/data/files/12028.pdf)
- [PR-120 — Continuous Positive Airway Pressure (CPAP)](https://www.ochealthinfo.com/sites/healthcare/files/2026-04/PR-120%20CPAP%2004-2026.pdf)

## First assessment

- Use spinal motion restriction for a diving or shore-break accident. Assess consciousness, airway patency, breathing, perfusion, and oxygen saturation.
- For SpO₂ below 95%, provide high-flow mask oxygen or nasal cannula at 6 L/min as tolerated. Treat arrest using the adult arrest pathway.

## Ventilation and wheeze

- Monitor and document rhythm. For bradycardia, clear the airway and assist ventilation with BVM and high-flow oxygen.
- For wheezing, albuterol is 5 mg in 6 mL by continuous nebulization as tolerated. Reassess effort and air movement; inadequate ventilation needs ventilatory support.

## Persistent respiratory distress

- A conscious patient with persistent distress after suctioning/coughing to clear the airway may receive CPAP under its separate criteria. Guard against vomiting and reassess continuously.
- If unconscious or unable to protect the airway, follow the advanced-airway pathway and confirm placement. Do not use the conscious-patient CPAP step in someone who cannot protect the airway.

## Transport

- Provide ALS escort to the nearest appropriate ERC. Contact base for suspected spinal injury, other trauma, or additional direction as needed.
- Report mechanism, submersion history if known, respiratory/neurologic findings, oxygen and ventilation support, response, and any vomiting or associated trauma.