TABLE 4

Who needs further medical help after rescue from the water?

Send to hospital
 Any patient who lost consciousness, even for a brief period
Any patient who required expired air resuscitation (rescue breathing)
Any patient who required cardiopulmonary resuscitation
Any patient in whom a serious condition is suspected, such as heart attack, spinal injury, other injury, asthma, epilepsy, jellyfish stings, intoxication, delirium, etc.
Consider for release from care at the scene
 If, after 10–15 min of careful observation, while being warmed with blankets or other coverings as required, the patient has ALL of the following:
   No cough
  Normal rate of breathing
  Normal circulation as measured by pulse strength and rate and blood pressure (if available)
  Normal colour and skin perfusion
  No shivering
  Fully conscious, awake and alert
In such cases, it is unwise for the patient to drive a vehicle and the patient should be so advised If any of these conditions do not apply or if the lifesaver has any doubt, then the patient should be advised to seek early medical attention
There is always a risk of delayed lung complications
 All immersion victims should therefore be warned that if they later develop cough, breathlessness, fever or any other worrying symptom, they should seek medical advice immediately. It is preferable that these cases do not return to a home environment where they are alone for the next 24 h