During observation of a 22-year-old drowning accident survivor who is breathing spontaneously, which assessment is most important?

In assessing a drowning accident survivor who is breathing spontaneously, auscultating breath sounds is critical. Following an incident of drowning, there is a high risk of pulmonary complications, such as aspiration of water or other substances, which can lead to acute respiratory distress and other issues related to gas exchange.

Auscultation of breath sounds allows the clinician to evaluate lung function and detect any abnormalities, such as crackles or wheezing, that may indicate fluid in the lungs or other obstructive processes. This assessment is particularly important because airway and lung health is a priority in managing the aftermath of drowning; prompt identification of any respiratory distress can guide timely interventions.

While checking mental orientation, assessing heart sounds, or palpating peripheral pulses are important in a comprehensive assessment, they are secondary to ensuring adequate respiratory function, especially in a patient with potential lung injury due to drowning. Therefore, auscultating breath sounds directly addresses one of the most immediate and life-threatening concerns following an incident involving drowning.