Round 21 (Drowning)

CAUTION: THESE NOTES CONTAIN SPOILERS!!!



Case Introduction



You are working a shift at EM Clerkship General when EMS calls you on the radio… “Hey doc we’re bringing a young female who drowned in a pool ETA 1 minute”.



Initial Vitals



* Temp 95.0F* HR 55* RR 5-6* BP 110/82* O2 90%



Critical Actions



* Evaluate for traumatic injury (and/or place C-Collar)* Intubate the patient* Identify Long QT Syndrome on ECG* Treat Pulseless Polymorphic VTach with defibrillation and IV magnesium* Treat Polymorphic VTach (pulse present) with overdrive pacing (transcutaneous pacing or isoproterenol)



Further Reading



Torsades de Pointes – EMCrit