- Breath-holding until eventual involuntary gasp which triggers reflexive laryngospasm. Resultant loss of consciousness may cause laryngeal relaxation and aspiration.
- Fluid aspiration results in decreased surfactant activity and atelectasis. This is complicated by V/Q mismatch and atelectrauma which can lead to ARDS.
- Progressive respiratory distress
- AMS: due to cerebral hypoxia
- Shock: uncommon, consider trauma
- Endotracheal intubation
- Asymptomatic or minor event: observe 2-3 hours
- Mildly symptomatic: observe 4-6 hours
- Hypoxia: admit
- PPV: ICU