In drowning-related cardiac arrest, what is the immediate priority and airway management approach?

• A. Immediate ventilation and intubation using the SALAD technique
• B. Defibrillation first
• C. Administer epinephrine
• D. Evacuate to hospital

Answer: (A)

The immediate priority in drowning-related cardiac arrest is to secure a clear airway and restore ventilation. Water and secretions in the flooded airway make rapid, controlled airway management crucial, so you clear the airway while you visualize and place the tube. The SALAD technique—Suction-Assisted Laryngoscopy and Airway Decontamination—is designed for this situation: you perform laryngoscopy while continuously suctioning to remove water and debris, enabling prompt endotracheal intubation and effective ventilation. By prioritizing airway decontamination and rapid ventilation, you address the main problem causing oxygen deprivation in drowning. Other steps like defibrillation, epinephrine administration, or simply evacuating to hospital don’t fix the immediate issue of a flooded airway and poor gas exchange.