What type of respiratory and hemodynamic support should physicians consider for pediatric drowning patients?

First and foremost, we want to correct hypoxia.

So in an alert child who looks well, we can start with nasal cannula and escalate potentially to high-flow nasal cannula.

But for patients who have altered mental status, they may require an endotracheal intubation or positive pressure ventilation.

Children don't tend to tolerate BiPAP and CPAP as well as adults, so depending on the age of the child, this might be something that intubating is the best way to deliver positive pressure ventilation if it's really needed, or they might need some sedation to tolerate something like a RAM cannula.

But ventilatory support is the first priority.

If they have some circulatory dysfunction or shock, then we wanna start with fluids, but escalate to pressors as needed if they develop cardiogenic shock.

Now, what about generally reducing risk on drowning? How can we as physicians identify opportunities to counsel patients and families for at-risk patients?