Which combination may be seen in near-drowning respiratory distress?

• A. Bradypnea and tachycardia
• B. Tachypnea and apnea
• C. Normal breathing
• D. Hyperventilation with calm mental status

Answer: (B)

In near-drowning respiratory distress, the pattern of breathing often reflects alternating hypoxic drive and CNS effects from submersion. The body tries to compensate for low oxygen by increasing breathing effort, so tachypnea appears. At the same time, central nervous system depression or airway irritation from the incident can produce intermittent pauses in breathing, i.e., apnea. Putting those together, a patient may show rapid breathing with occasional pauses, which fits the scenario described.

Bradypnea would suggest a reduced respiratory drive rather than distress; normal breathing would not indicate a problem; hyperventilation with a calm mental status clashes with the expected hypoxic and CNS-impairment state after near-drowning.