Abstract
Immersion incidents are one of the commonest causes of accidental death in children. Death occurs usually from hypoxia due to inhaled water or stomach contents. However, in cold water, even strong swimmers can become incapacitated by hypothermia and drown as they start to lose consciousness. Treatment should therefore be aimed at relieving hypoxia in the shortest possible time. Ideally, anyone who has suffered inhalation should be closely monitored in an Intensive Care Unit. Common findings are hypoxia, acidosis, hypotension and hypothermia. Achieving cardio-respiratory stability in the shortest possible time is paramount. Providing treatment can be started before cardiac arrest has occurred the prognosis is excellent. Even in those children who have apparently suffered cardiac arrest after immersion in cold water, death should not be assumed without the aid of a history and the benefit of an ECG and central temperature recording.
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