Drowning is respiratory impairment resulting from submersion or immersion in liquid. Cardiopulmonary resuscitation (CPR) is a life-saving technique. Immediate CPR is important for drowning victims, with specific considerations compared to other types of cardiac arrest.
The Body’s Response to Drowning
When a person experiences drowning, the body undergoes a rapid onset of oxygen deprivation, known as hypoxia. This occurs because water entering the lungs, or a reflex known as laryngospasm, prevents air from reaching the airways. Without sufficient oxygen, brain and organ function rapidly decline, leading to loss of consciousness, cessation of breathing, and eventually, cardiac arrest. The body’s systems depend on a continuous supply of oxygen.
Specifics of CPR for Drowning
CPR for drowning victims has unique considerations because the primary issue is a lack of oxygen throughout the body, rather than an initial heart problem. For this reason, delivering oxygen quickly through rescue breaths is given precedence. Guidelines recommend beginning with five initial rescue breaths before starting chest compressions, which is a key difference from standard CPR protocols. These initial breaths are important to re-oxygenate the blood, addressing the underlying cause of the victim’s collapse.
CPR Steps for a Drowning Victim
- Ensure the scene is safe and to remove the victim from the water.
- Immediately call for emergency medical help, such as dialing 911 or your local emergency number.
- Next, check for responsiveness by gently tapping the victim and asking if they are okay, while also observing for any signs of normal breathing.
- After confirming unresponsiveness and absence of normal breathing, administer five initial rescue breaths. To do this, tilt the victim’s head back slightly, lift their chin to open the airway, and pinch their nose closed. Form a tight seal over their mouth with yours and deliver each breath over about one second, watching for the chest to rise with each breath.
- Following the initial breaths, begin chest compressions. Place the heel of one hand on the center of the victim’s chest, between the nipples, and place your other hand on top. Push down hard and fast, compressing the chest at least 2 inches (5 cm) but no more than 2.4 inches (6 cm) for an adult. Aim for a rate of 100 to 120 compressions per minute.
- Continue cycles of 30 chest compressions followed by two rescue breaths. Continue performing CPR until emergency medical services arrive and take over, the victim shows clear signs of life like breathing normally, or you become too physically exhausted to continue.
Immediate Care After CPR
Even if a drowning victim regains consciousness or starts breathing after CPR, immediate medical evaluation at a hospital is important. Complications can develop hours or even days after the incident, even if the person initially appears to have recovered. These potential complications can include delayed respiratory distress, formerly referred to as “secondary drowning” or “dry drowning,” and other issues such as hypothermia, aspiration pneumonia, or brain damage from oxygen deprivation. Medical professionals need to monitor the victim closely for these delayed effects and provide any necessary treatment.