FIELD REFERENCE
Full criteria & treatment guidance
Key cautions & base contact
- Use the pediatric destination rule and obtain base direction.
- Do not apply the adult drowning CPAP step automatically to a child.
Initial care
- Confirm the airway is clear and patent. Use spinal motion restriction for a diving or ocean shore-break mechanism.
- For room-air SpO₂ below 95%, provide high-flow mask oxygen or nasal cannula/direct blow-by at 6 L/min as tolerated. Assess ventilatory effort, mental status, perfusion, and temperature.
Respiratory or cardiac compromise
- Treat cardiopulmonary arrest using SO-P-040. Monitor and document the rhythm.
- For bradycardia, assist ventilation with high-flow oxygen by BVM. Do not let a monitor task delay ventilation.
Wheezing
- If wheezing is present and ventilatory effort is adequate, give albuterol 5 mg in 6 mL by continuous nebulization as tolerated.
- Stop nebulization if the child continually coughs or resists treatment. Reassess air movement and effort; nebulization does not replace assisted ventilation.
Contact and transport
- Base contact is required, with a pediatric-capable base preferred. SO-P-100 directs base designation to CHOC, or the nearest appropriate ERC when CHOC transport time exceeds 20 minutes.
- Provide ALS escort. Report the event/mechanism, submersion history if known, airway and ventilation support, response to treatment, and any associated trauma.
UNDERSTAND THE CARE
Why the pediatric destination decision stays separate
Assess the child’s breathing, interaction, circulation and temperature after rescue and obtain the mechanism and submersion history when known. Diving and shore-break mechanisms require consideration of spinal injury. Bradycardia in this pathway calls for attention to ventilation rather than letting rhythm documentation delay support.
Applying the guidance
Wheeze treatment fits only the described clinical conditions and cannot replace assisted ventilation. Continue reassessment during packaging and transport, watching treatment tolerance and changing respiratory effort. The local pediatric drowning destination rule is specific, so communicate transport time and obtain base designation rather than copying the adult destination language.
Putting it together
Teaching example: a child stops tolerating the nebulizer and respiratory effort becomes inadequate. Reassess airway and ventilation immediately and report the evolving need for support while coordinating the pediatric destination.
Diagram text & teaching checkpoints
- Event
- Mechanism and submersion history.
- Ventilation
- Clear airway and support inadequate breathing.
- Response
- Watch effort, air movement and tolerance.
- Destination
- Pediatric base direction and transport-time rule.
Sources for this explanation
Original OCMedic teaching synthesis of the references below. Educational expansion updated ; this is not a new independent clinical-review date. Source-specific dates and limitations remain in the full guidance.