Drowned child, what would you do?

neneRN, BSN, RN · Nov 8, 2005

In a situation like this, if no one witnessed the incident- you HAVE to maintain C-spine precautions right along with your ABCs. What if the kid fell and had a spinal injury or cervical Fx? However, if the EMS didn't do this, then I'm assuming someone witnessed to be able to be confident that he didn't fall? You should never "throw someone over your shoulder" if there's any reason at all to be suspicious of a traumatic injury.

Editorial Team / Admin · Nov 8, 2005

This actually happened to me but I am not a peds RN so wonder how you all would handle this scenario:
Responded to a hotel kiddie pool in Baja to discover a young boy, app 6 years old, wearing a bathing suit and on his back, side of the pool. He was found by another child to be in the deep end of the pool at the bottom and brought up a few minutes earlier. His eyes are open, pupils are app 2 cm, fixed and he is non responsive but warm to touch. No parents around by the way.
A young female and her (I assume BF due to matching piercings and tatts) were "working" on him doing what looked like CPR. I knelt and checked for a carotid, ausculated for apical, unable to get finger blanch etc. The CPR was very violent and this kids belly was blowing up with every puff this girl was giving him. Head tilt was creating an abrasion to the back of his head on the hard concrete surface. No chest compressions were in effect at this time.
I told these 2 that I was a nurse and requested that the guy pick this kid up and toss him over his shoulder and squeeze the water and air out of his belly (the tattoed guy, not the kid!) and was basically told to go do something that would be anatomically impossible. I was hesitant to take over this awful scene but my first response would have been different. Unfortunately, these 2 were threatening and I had no choice but await the paramedics.
Here is what I wanted to do, please let me know your thoughts...
Pick the kid up, hold him over my shoulder to get the air and water out of his belly. Place him on a towel and FIRMLY appoint someone to assist me with CPR until EMS arrived. Maybe just be a bit more assertive and take over this situation, I don't know, pull RANK??? I was told that she was an EMT which meansa she has more initials after her name so she outranks me right? (!!!)
Eventually, when EMS arrived, they picked this little guy up, tossed him over the shoulder, removed about 1 liter of fluid and air and started CPR running.
Any input would be appreciated.

I have to agree with the poster above. Never compromise the unknown C-spine. I cannot believe the EMS would do that. Totally inappropriate.

Haunted · Nov 8, 2005

I agree with the posts and they all occured to me, a log roll to the side, etc. however these 2 were grabbing him by the back of the head for vents and had been observed doing that for about 45 seconds prior to my arrival. Whatever damage occured happened before I got there.

It was a nightmare no 2 ways about it. I thought, in my dreams after, that a log roll to compress the air and fluid from his gut and then log roll back, jaw thrust etc. but it fell on deaf ears and I have no idea the outcome of this child. Just wanted an opinion, but yeah, it seemed like the thing to do at the time, put him over the shoulder and pump out his stomach since there were ni witnesses to how it happened.

Editorial Team / Admin · Nov 8, 2005

I agree with the posts and they all occured to me, a log roll to the side, etc. however these 2 were grabbing him by the back of the head for vents and had been observed doing that for about 45 seconds prior to my arrival. Whatever damage occured happened before I got there.
It was a nightmare no 2 ways about it. I thought, in my dreams after, that a log roll to compress the air and fluid from his gut and then log roll back, jaw thrust etc. but it fell on deaf ears and I have no idea the outcome of this child. Just wanted an opinion, but yeah, it seemed like the thing to do at the time, put him over the shoulder and pump out his stomach since there were ni witnesses to how it happened.

You are correct that damage probably had been done, Haunted.

The first step in the resuscitation of a drowning victim would be to always protect the C-spine. If you had been performing CPR on this child even after those people had started and you tossed said child over your shoulders, any C-spine injury would most probably been attributed to you, because you are providing services within your scope of practice and knew the rationale of protecting the C-spine. Think litigation.

BTW, can you provide the final outcome? If you cannot, then that is o.k., we understand.

Haunted · Nov 8, 2005

Outcome? Who knows. No family came forward. No witnesses. No signs of trauma that I could see. Everytime I visit this flea bag hotel something goofy happens. Last visit, and we were not staying there, a male companion got punched in the face by some drunken idiot! I tell ya, I'll take New York any day.

OHmom2boys · Nov 13, 2005

Mom of a near drown here. I seem to remember reading somewhere after my son's accident that in addition to c-spine precautions, you should also not attempt to empty the stomach contents d/t risk of aspiration. Sometimes drowning victims don't actually take a lot of water into the lungs d/t spasms of the larnyx and attempts at emptying water from the stomach may actually result in forcing water into the lungs. I may be wrong though. Maybe I'm thinking of him being extremely hypothermic and the danger of suddenly moving them causing v-fib. Is that even a possibility?? Is that even right?? So much I don't know or remember. Sometimes I think I remember things right, only to find out I was so wrong. Sorry if that's the case now. Just needed to add my 2 piddly cents to this post, I guess.

I'm so sorry you had to witness this baby's drowning. I thank God I didn't have to see my Jacob dead on a creek bank that day. I was at work (guilt and gratefulness there). Unfortunately, that is a memory his dad and his older brother will forever have to live with.

You did what you could for that child. I will pray he has an outcome like Jake did.

Please let me know his condition if you can. I belong to a great support group for parents/families/friends of near drowns and would be happy to give you the link for his family or yourself.

My thoughts are with the child, his family and you.

Kim