In adult non-fatal drowning with pulmonary edema for patients greater than 30 kg, what CPAR pressure is recommended?

• A. 5 cm H2O
• B. 15 cm H2O
• C. 20 cm H2O
• D. 10 cm H2O

Answer: (D)

CPAP helps by delivering a steady positive pressure that keeps at least some of the flooded alveoli open, improving oxygen exchange and reducing the work of breathing in pulmonary edema, a common issue after non-fatal drowning in adults. For someone over 30 kg, a moderate target of 10 cm H2O provides enough airway recruitment to improve oxygenation without imposing excessive pressure that could cause discomfort, gastric insufflation, or drop in blood pressure.

Starting at 5 cm H2O might not recruit enough alveoli to significantly improve gas exchange, while pressures of 15 or 20 cm H2O can be harder for the patient to tolerate and raise the risk of adverse hemodynamic effects. Thus, 10 cm H2O offers a balanced, effective level for this scenario.