What rescue time limit is recommended for children or drowning incidents in icy cold water

A call comes over the radio and you are informed that the child has been rescued by the Fire Service but they are currently starting BLS. The location is 5 minutes from your RV point and you start making your way to them. Control informs you that further RRV back up is 10 minutes away. You pull up to see the Fire service staff conducting BLS on the 8-year-old child. You are able to park your vehicle next to the patient. Your colleague says they’ll get a stretcher out quickly while you take over the arrest.

The Firefighters give a quick handover that they have rescued the child and started chest compressions. Their automatic defib has said no shock advised. There has been no response from the child and no pulse throughout. Within the drowning ALS response, what should be your first action

As your initiate 5 rescue breaths with O2, your colleague has come out with the stretcher and scoop. With plenty of hands available, you get the patient into the back of the ambulance with no interruption to CPR. 2 Firefighters continue 2-minute cycles of compressions while you maintain the airway/breathing, and your colleague starts on other areas. Swapping the defib pads to your device, you see an Asystole rhythm on the screen. With the movement of the patient, a lot of water has started to collect in his airway and is restricting your ventilation. What action can you do next

You suction the airway but you still feel some resistance on ventilation. Under general drowning ALS guidelines, what can be considered early within the stepwise airway approach

In your Trust the ability to intubate paediatrics was removed several years ago, but using a SGA and regular suction, you manage effective ventilations. What ventilation rate should you maintain with an SGA and effective ventilations in a drowning scenario

Control informs you a BASICS Dr is 2 minutes from your location, and your colleague has successfully gained IV access. The Firefighters continue their chest compression cycles, rotating regularly to maintain efficiency, and the child has been covered with blankets with the heaters on in the back. Your colleague goes to administer adrenaline 1:10000, what should be checked prior to its administration

The temperature reading comes back at 33.2°C meaning you can administer medications at double intervals. What is the dose of Adrenaline 1:10000 in an 8-year-old patient

Your colleague administers the Adrenaline while you continue to manage airway and ventilations. Your further rhythm checks remain as Asystole. There’s a knock at the door and the BASICS Dr enters the ambulance. They introduce themselves and you handover the events and treatment so far. The Dr takes over the airway and with your assistance, intubates the patient. With successful intubation, you discuss rapid transport to the nearest A&E. The 2 Firefighters are happy to remain in the back doing compression cycles, the Dr will continue to manage airway, your colleague will drive, and you will manage medications and assist where needed. You start travelling to hospital with a pre-alert put in. In this scenario, what is the dosage interval of your Adrenaline 1:10000