Submersion injury and hypothermia — branching viva

Opening (candidate)

This is a profound hypothermic submersion cardiac arrest, and my priorities are to continue high-quality cardiopulmonary resuscitation, manage the ventricular fibrillation by the hypothermic rules, and escalate to extracorporeal rewarming. The core is 25 degrees, which is Swiss stage four, so I continue compressions, deliver a single shock for the ventricular fibrillation, and withhold further shocks and adrenaline until the core rises above thirty degrees. I remove the wet clothes, dry and insulate him, handle him gently, and arrange extracorporeal rewarming as early as the system allows, because nobody is dead until warm and dead. ^{[5] [9]}