When a person experiences a near-drowning incident, the inhalation of water into the lungs creates a medical emergency that requires immediate, professional intervention. This situation, often referred to as non-fatal drowning, causes a lack of oxygen, which can rapidly lead to severe health complications, including brain damage and cardiac arrest. The most important action is to call emergency services immediately (such as 911) to dispatch trained medical personnel. Bystander action should provide support and oxygenation until specialized help arrives. This guidance offers immediate steps for responders to take before medical assistance can take over.
Immediate Actions for Rescuers
Securing the scene is the first step, ensuring you do not become a second victim. The person must be safely removed from the water as quickly as possible without putting your own life at risk, using a reaching assist or a flotation device if necessary. Once the victim is on a firm, dry surface, rapidly assess their condition by checking for responsiveness, speaking to them loudly, and gently tapping their shoulder.
If the person is conscious, focus on calming them, keeping them warm, and closely monitoring their breathing until paramedics arrive. Even if they appear to be breathing normally, they should be kept still and observed for signs of respiratory distress. If the person is unconscious and not breathing normally, or is only gasping, begin cardiopulmonary resuscitation (CPR) right away, as the primary threat is a lack of oxygen.
For a suspected drowning victim, the resuscitation sequence begins with ventilation because cardiac arrest is typically caused by a lack of oxygen. Start by giving five initial rescue breaths to introduce oxygen into the lungs before starting chest compressions. To deliver a rescue breath, tilt the head back and lift the chin to open the airway, pinch the nose shut, and blow for one second, ensuring the chest visibly rises.
After the initial rescue breaths, begin chest compressions, pushing hard and fast in the center of the chest at a rate of 100 to 120 compressions per minute. The standard cycle for CPR is 30 compressions followed by two rescue breaths, repeated until emergency help takes over or the person begins to breathe normally. If the victim vomits during resuscitation, quickly turn them onto their side to clear the airway before immediately resuming the 30-to-2 compression-to-breath cycles.
Harmful Techniques to Avoid
A common misconception is that the first priority is to manually remove water from the lungs, often leading to the use of techniques discouraged by medical professionals. Attempts to “drain” the water by hanging the victim upside down or using abdominal thrusts, such as the Heimlich maneuver, are not recommended. These actions waste precious time that should be spent providing oxygen and can cause significant harm.
The body’s natural defense mechanism, called laryngospasm, often causes the vocal cords to seize shut when water is inhaled, meaning only a small amount of water typically enters the lungs. The problem is not the volume of water but the resulting oxygen deprivation. Delaying CPR to attempt drainage directly contributes to brain injury.
Using the Heimlich maneuver or other forceful abdominal compressions on a drowning victim can induce vomiting, which increases the risk of aspiration (stomach contents entering the lungs). Furthermore, such aggressive physical maneuvers carry the risk of causing internal injury or spinal trauma, especially if a neck injury is suspected. The central principle in near-drowning resuscitation is to immediately begin ventilation and oxygenation, not drainage.
Recognizing Symptoms That Require Urgent Medical Care
Even if a person appears to have recovered and is breathing fine immediately following a water incident, they still face the risk of delayed complications. This is sometimes referred to by the public as “secondary drowning” or “dry drowning,” which are not formal medical terms but describe a condition where symptoms appear hours after the initial event. The small amount of water inhaled can irritate the lining of the lungs, causing an inflammatory response and a dangerous condition called pulmonary edema.
It is necessary for every person involved in a near-drowning or significant water struggle to be evaluated by a healthcare professional. This is because the inflammatory process in the lungs can progress silently for hours, with symptoms often appearing between one and 24 hours after the incident. Observing for changes in a person’s condition is a critical step in post-rescue care.
Signs that indicate a medical emergency and require an immediate return to the hospital include:
- Persistent coughing that does not subside.
- Noticeable difficulty in breathing, such as labored or rapid breathing.
- Chest pain.
- An unusual change in energy levels, such as extreme fatigue or lethargy.
- Confusion or irritability.
- Any blue discoloration around the lips or fingers, known as cyanosis, which signals oxygen deprivation.