Drowning is respiratory impairment from submersion or immersion in liquid. It can result in death or long-lasting health problems. Immediate action is crucial to restore oxygen to the brain and other vital organs, preventing serious damage and increasing survival chances.
Recognizing Drowning and Ensuring Safety
Identifying a drowning victim can be challenging as it often appears silent and may not involve frantic splashing. A struggling person might be quiet, head low in the water, mouth at water level, or with a blank gaze. They may be gasping, hyperventilating, or struggling to keep their head above water, with their body upright without kicking. Hair covering their face can also be an indicator.
Prioritizing rescuer safety is the first step; never enter the water if it’s unsafe or if you are not trained. Drowning victims can panic and inadvertently pull a rescuer down. Assess the scene for hazards before attempting rescue. Use reach or throw aids to assist the victim from a safe distance. Only enter the water as a last resort and if trained, ideally with a flotation aid and a Personal Flotation Device (PFD).
Initial Steps: Calling for Help and Positioning
Once the victim is safely removed from the water, immediately call emergency services. Provide clear location details and state that a drowning incident has occurred. If a bystander is present, instruct them to call while you begin resuscitation efforts. If you are alone, initiate resuscitation and call for help after approximately two minutes of CPR for adults and children, or immediately for infants.
After calling for help, gently tap and shout to check for responsiveness. Assess for normal breathing by looking for chest rise and fall, listening for breath sounds, and feeling for breath; gasping is not normal breathing. If the person is not breathing normally, carefully move them to a firm, flat surface on their back. Ensure the airway is clear by performing the head-tilt, chin-lift maneuver: place one hand on their forehead and gently tilt the head back while lifting the chin with two fingers to open the airway. Briefly check for any visible foreign objects in the mouth, but avoid blind finger sweeps.
Performing CPR: Rescue Breaths and Chest Compressions
Drowning primarily causes respiratory arrest due to lack of oxygen, making rescue breaths crucial early in resuscitation. Unlike standard CPR, CPR for drowning victims should begin with rescue breaths to address immediate oxygen deprivation.
For rescue breaths, with the airway open, pinch the victim’s nose shut. For adults and children, seal your mouth over theirs and deliver two slow, full breaths, each lasting about one second, watching for the chest to visibly rise. If the chest does not rise, re-tilt the head and try again. For infants, cover both their nose and mouth with your mouth and give two gentle puffs of air.
Immediately after the rescue breaths, begin chest compressions. Place the heel of one hand on the center of the chest, and place your other hand on top, interlocking your fingers. For adults, compress the chest at least two inches deep. For children, compress about two inches (one-third of the chest depth), and for infants, about 1.5 inches deep using two fingers in the center of the chest just below the nipple line. The compression rate for all ages should be 100 to 120 compressions per minute, allowing for full chest recoil after each compression.
The CPR cycle for all ages involves 30 chest compressions followed by two rescue breaths. Continue these cycles consistently until emergency medical services arrive, the victim shows clear signs of life, or a trained professional takes over. If an Automated External Defibrillator (AED) becomes available, use it, but prioritize continuous CPR until the AED is ready. Ensure the victim is moved to a dry surface and their chest is thoroughly dried before attaching AED pads.
Post-Resuscitation Care and What to Expect
If the victim starts breathing normally but remains unconscious, carefully place them in the recovery position. This position helps keep the airway clear and allows fluids to drain, preventing aspiration. Continuously monitor their breathing and responsiveness until emergency medical services arrive.
Understand the concept of delayed symptoms, sometimes referred to as secondary drowning. Even if a person seems fine initially, symptoms like persistent coughing, difficulty breathing, chest pain, or extreme fatigue can appear hours later. These symptoms indicate water in the lungs, which can lead to inflammation and fluid buildup, potentially becoming life-threatening. Medical attention is crucial for any individual involved in a drowning incident, even if they appear to recover fully at the scene.
Rescuers may experience an emotional toll after such an event, and seeking support is important.