Asphyxial deaths: secondary drowning management: practice question

A Forensic Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Forensic Medicine · Asphyxial deaths: secondary drowning management

Sample item

A 6-year-old is pulled out of a pool, coughs, and appears well. Six hours later she has breathlessness, cyanosis, bilateral crepitations and diffuse infiltrates on chest radiograph. What is the most appropriate management?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Hospital admission with oxygen and ventilatory support with PEEP if hypoxia persists

Near-drowning victims can develop delayed pulmonary oedema and ARDS from surfactant washout and alveolar injury, so they need monitoring. Treatment is supportive: oxygen, CPAP or mechanical ventilation with PEEP. Steroids and prophylactic antibiotics are not routinely beneficial.

Option by option

  • A. Prophylactic corticosteroids

    Corticosteroids have no proven benefit in drowning lung injury.

  • B. Hospital admission with oxygen and ventilatory support with PEEP if hypoxia persists (correct)

    Correct. Supportive ventilation is the mainstay in post-drowning ARDS.

  • C. Reassurance and discharge

    Discharge is dangerous in the face of established respiratory failure.

  • D. Diuretics to treat haemodilution

    Diuretics are not indicated and may worsen hypovolaemia.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Forensic Medicine question

What is the answer to this Forensic Medicine question?

The best answer is B, Hospital admission with oxygen and ventilatory support with PEEP if hypoxia persists. Near-drowning victims can develop delayed pulmonary oedema and ARDS from surfactant washout and alveolar injury, so they need monitoring.

Why is "Prophylactic corticosteroids" not the answer?

Corticosteroids have no proven benefit in drowning lung injury.

Why is "Reassurance and discharge" not the answer?

Discharge is dangerous in the face of established respiratory failure.

Why is "Diuretics to treat haemodilution" not the answer?

Diuretics are not indicated and may worsen hypovolaemia.

What concept does this question test?

It tests Asphyxial deaths: secondary drowning management in Forensic Medicine. Treatment is supportive: oxygen, CPAP or mechanical ventilation with PEEP. Steroids and prophylactic antibiotics are not routinely beneficial.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Asphyxial deaths: secondary drowning management?

Learn postmortem changes with their timelines, and toxicology as poison, sign, test and antidote. Then use the flashcards and the other Forensic Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.