What medical treatment would paramedics give to a person who's car went into the ocean?

Question

Say the water was in the upper 50s F. The person was possibily in shock. What actions would be taken? Would they cover the person with a blanket to keep them warm? Would they give them an medicine. If so, what? What other actions might they take?

The person was able to extract themselves from the car after impact. She spent maybe forty minutes in the water trying to rescue the car's other occupants who did not survive. The water was around twenty feet deep and they were either knock unconscious on impact or suffocated unable to find an air pocket. There appears to be no injuries beyond bumps and bruises. When she is rescued from the water she seems to be only cold, exhausted and in shock.

Answer 1

You haven't given enough information about the scenario to get a definite answer. Was it necessary to extricate the person from the submerged car or had the victim gotten out on their own? You have several issues to deal with:
1) possible drowning
2) possible cervical spine injury
3) possible hypothermia

You'd have to get to the scene and see which of these issues was involved before you could suggest a specific course of treatment. If someone has stopped breathing due to taking in water, getting them breathing again is priority number 1 and thus CPR and intubation would take place ASAP. If breathing isn't an issue, protecting the cervical spine from further injury would be the next priority, probably floating a backboard to the car, putting a cervical collar on the victim and extricating the victim onto the board and from the board to the ambulance.

Then the question is whether hypothermia is involved. Certainly you'd start an IV line with warmed saline solution which would help with both the shock and hypothermia problems. Would be on a cardiac monitor as soon as the victim was dry enough not to shock everyone. Blanket? Sure. Medication? Only if the cardiac monitor indicated that the heart was not beating correctly.

In some areas, if signs of decompensated shock were clear, they might use MAST trousers to squeeze blood from the lower body to the critical organs in the top half of the body which need the blood more than the feet do.

Answer 2

A few minutes in water that temperature shouldn't be a problem, but I suppose you could get hypothermic if you spent hours there. Slowly warming hypothermic patients is the best way to go. Other interventions would depend on the person's condition. After any trauma, the priorities go like this:

Airway
Breathing
Circulation
Neurologic Disability

If the person can talk to you, chances are you don't need to worry about these. If there was potential for a spinal injury, the back and neck should be immobilized until it's absolutely proven that no spinal injury occured (usually requires some kind of imaging). Otherwise, it's always a good idea to stop by a hospital after an accident to make sure there aren't any occult injuries that could become life-threatening.

Answer 3

if as you stated, this person spent 40 minutes trying to rescue the other occupants, then you can probably assume her ABC's are fine- that is, her airway, breathing, and circulation. that's not to say you shouldn't evaluate them- just that they're probably fine. however, 40 minutes in 50 degree water is more than enough to cause life-threatening hypothermia. absolutely, this patient should be actively warmed. there's no medication that can be given specifically to counteract effects of cold, with the following exceptions:

1. demerol can be given to counteract shivering
2. if cardiac dysrythmias occur due to hypothermia, then obviously those need to be treated appropriately.

one more catch- in cases of neurological injury, they may opt NOT to warm up the patient as cold has a neuroprotective effect. things like spinal cord injuries and brain injuries (due to strokes, etc...) are less severe when the patient is hypothermic.

Answer 4

It depends upon how long they can hold their breath.