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RES CPR 4 Develop Evidence-Based Drowning Treatment Protocol for EMS

Key area

CPR Rescue

Develop and implement a template for an evidence-based drowning treatment protocol for Emergency Medical Services (EMS) agencies that includes Basic Life Support (BLS), Advanced Life Support (ALS), and other credentialed certification levels.

Spectrum level: Changing Organizational Practices

Evidence level: Low

Implementation levels: Community County National State

Rationale:

Water safety experts agree, EMS protocols nationwide vary greatly, and many do not meet the expected evidence-based treatment elements specific to drowning.

Anticipated Impact:

After implementing this recommendation, you can expect to experience the following outcomes.

  • Formalization of medical response to drowned persons.
  • Standardization of an evidence-based drowning treatment protocol

Evidence:

Water safety experts have identified significant variability in EMS protocols, many of which do not meet the expected evidence-based treatment elements specific to drowning.

National consensus on EMS protocols in other areas of emergency response that have been standardized have led to formalization and enhanced outcomes.

Evidence Sources:

State EMS protocols from across the US

High Risk Populations Addressed:

All populations can benefit from implementation of this recommendation.

Evaluation Metrics:

Indicators of long-term impact:

  • Post-intervention studies of drowning treatment show a reduction in mortality and morbidity related to drowning.
  • Increase in the number of states or jurisdictions that develop local, regional, and state drowning protocols.

Implementation:

Consider the following to ensure successful implementation:

  • Explore the widespread publication of national protocol recommendations in EMS-specific literature and at EMS-specific events.
  • Consider financial, training, and political implications at the local, regional, and state levels.
  • Keep in mind that some state EMS protocols are done through legislative processes, others through medical committees or councils, so the approach to implementation may vary from jurisdiction to jurisdiction.

Challenges to Implementation:

When implementing this recommendation, you might encounter challenges related to the following factors.

  • Agencies may lack the will to implement training.
  • Medical direction to help support new training guidelines may be limited.

Potential Facilitators:

The following factors might facilitate the implementation of this recommendation.

  • Support from national EMS organizations (NAEMSP).
  • The development of a model protocol for adaption by all agencies.

GAP Recommendation:

Further study is needed to degree to which state level EMS protocols may reduce morbidity and mortality.