In near-drowning victims, what is an initial priority in management?

• A. Induced coma
• B. Airway management with mechanical ventilation
• C. Immediate blood transfusion
• D. Cooling measures

Answer: (B)

The most important priority is securing the airway and ensuring adequate ventilation with oxygenation. In near-drowning, inhaled water and inflammatory lung injury can rapidly cause hypoxemia and respiratory failure, so establishing a patent airway and providing breathing support (often with endotracheal intubation and mechanical ventilation) is essential to prevent ongoing brain and organ injury.

Other interventions aren’t the immediate focus: inducing a coma isn’t routinely done at the outset, and a blood transfusion isn’t indicated unless there’s actual blood loss or shock from another cause. Cooling measures may be considered later if there’s evidence of hypoxic-ischemic brain injury after resuscitation, but they don’t take precedence over restoring effective oxygenation and ventilation.