Drowning – Board-Style Questions

What this deck covers

Drowning in 18 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 18 cases, in order

1. The first thing on the poolside
2. Still twenty metres out
3. Getting it out again
4. The collar in the bag
5. Pool or sea
6. Halfway through the attempt
7. Coughing at the poolside
8. What to tell them at the door
9. Worse at four hours
10. Setting the ventilator
11. The drug chart on admission
12. Hot on the third day
13. What the parents will ask
14. Why he was in the water at all
15. Alone in the bath
16. Around the pool
17. Two peaks in the year
18. Only a few centimetres

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: Warming her first, with everything else delayed until then, In-water rescue breathing, if the rescuer is trained and it is safe, Abdominal thrusts, repeated until the water comes back up again, Never, because a collar always makes the airway much harder to hold, It makes no difference to the treatment that she needs, A sudden rise in temperature that needs active cooling on the way, A chest film and a blood gas before any decision is made, Any cough in the next fortnight means she must be readmitted, Surfactant is washed out and the alveoli then collapse, Large breaths at a low rate with no pressure at the end, The steroid is right but the antibiotic should be stopped, Tuberculosis, which should be treated while cultures grow, The length of time she spent under the water, A raised white cell count on the blood picture.

Clinical pearls from this deck

• Hypoxic arrest: five breaths before compressions.
• Trained rescuers can breathe for her in the water.
• The water is not the problem: just ventilate her.
• Collar only for a dive, not for every rescue at all.
• Salt or fresh, the treatment is exactly the same.
• Expect vomiting: turn her, suction, and carry on.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all emergency and critical care case decks · pediatric reference values.