g. If the victim is hypothermic (rectal temperature below 84F (28.9C)), stabilize
the body temperature by cutting away wet clothing and replacing it with dry clothing.
DO NOT attempt to rewarm the victim in the field because these attempts may result in
rewarming shock and may bring on cardiac arrhythmias (a variation from the normal
rhythm of the heartbeat).
h. Transport the victim to the hospital, even if he seems to have recovered, as
rapidly as possible.
Section III. HOSPITAL TREATMENT/MANAGEMENT OF THE
NEAR DROWNING VICTIM
RESPIRATORY SYSTEM TREATMENT
a. The first priority in the hospital should be intensive pulmonary care with the
goal of achieving adequate arterial blood-gas and acid-base levels. This can be
achieved by administering oxygen to a spontaneously breathing patient. For a patient
who is not breathing, keep an endotracheal tube inserted with a cuffed tube connected
to a mechanical ventilator. Continue the sodium bicarbonate IV to restore the acid-base
level to normalcy.
b. Follow these general treatment guidelines:
(1) Monitor the blood gases to determine how long to continue administering
bicarbonate (being given by IV) and ventilatory support.
(2) In all cases, continue giving high supplemental levels of oxygen
inhalation until the arterial blood-gas studies show that lower oxygen concentrations are
required. When the oxygen in the arteries and the acid-base levels improve, the person
usually regains consciousness.
(3) A chest x-ray should be taken to check for pneumonia or pulmonary
edema (congestion of the pulmonary air spaces).
(4) If the victim is suffering from bronchospasms, administer a
bronchodilator (an agent that causes expansion of the lumina of the air passages of the
lungs) such as isoproterenol by inhalation or IV injection.
(5) If a near drowning victim is suffering from aspiration pneumonitis,
administer antibiotics to combat the pneumonitis.