Drowning is the process of respiratory impairment due to submersion or immersion in a liquid. Unlike dramatic depictions in movies, drowning is often a quick and silent event, with little splashing or yelling for help. Because of the rapid onset of oxygen deprivation, immediate and correct action is important to saving a life. Before any direct action is taken, prioritizing the safety of the rescuer is essential to prevent a second tragedy.
Recognizing Signs of Drowning Distress
A person who is drowning cannot shout for help because the respiratory system prioritizes breathing over speaking. This silent struggle is characterized by the Instinctive Drowning Response. The body assumes a vertical position in the water with little or no effective leg kick to propel them forward.
The arms are instinctively extended laterally, pressing down on the water’s surface to leverage the body upward for a quick breath. Their mouth alternately sinks below and quickly reappears above the surface, and they are usually unable to focus their eyes or grab a rescue device. This struggle often lasts only 20 to 60 seconds before submersion occurs. A person who can still wave their arms, call out, or kick their legs is in distress, but not yet in the final, silent stages of drowning.
Prioritizing Rescuer Safety and Non-Contact Methods
Ensuring the rescuer does not become a second victim is the primary principle in any water rescue. The safest and most effective approach for an untrained bystander follows the “Reach, Throw, Row, Go” sequence. The first step is to shout for help and immediately call emergency services, stating the location and situation.
If the person is close to the edge, a Reach rescue is the safest option, extending a long, firm object like a fishing pole, branch, or shepherd’s crook for them to grab. If the person is too far to reach, the next step is to Throw something buoyant to them, such as a life jacket, a throw bag with rope, or a cooler. Throwing past the person allows them to pull the device toward themselves.
If the person is further out, a Row rescue involves using a boat or paddleboard to approach. Always offer a flotation device from a safe distance before attempting to pull them aboard. Go is the last resort, and should only be attempted by trained individuals or if the victim is a child or too far for other methods. Entering the water without training is dangerous because a panicked victim can unintentionally grab and pull a rescuer underwater.
Safe In-Water Rescue and Transport
If entering the water is unavoidable, the rescuer must bring a flotation aid. This device supports both the rescuer and the person in distress, preventing a panicked grab that could compromise safety. The safest approach is always from behind, moving slowly and communicating calmly that help is present.
If the person is conscious, the flotation device should be presented for them to hold onto while the rescuer tows them back to safety. If the person is unconscious, the rescuer should use the flotation aid to support the victim’s head and keep the airway above the water line. Transporting the victim should keep their head supported and airway clear, often by towing them on the rescuer’s back or side while kicking toward shore.
Immediate Post-Rescue Care and Emergency Response
Once the person is removed from the water, reconfirm that emergency services are on the way. The victim must be placed on a firm, flat surface where consciousness and breathing can be quickly assessed. If the person is unconscious but breathing, they should be immediately placed in the recovery position. This involves turning them onto their side with the top knee bent to keep the position stable. This lateral position allows any fluid or vomit to drain from the mouth, preventing aspiration.
If the person is not breathing or is only gasping, Cardiopulmonary Resuscitation (CPR) must be started immediately. Drowning is a respiratory event caused by lack of oxygen, so rescue breaths are prioritized over chest compressions. The sequence should begin with five initial rescue breaths. The rescuer then proceeds with cycles of 30 chest compressions followed by two rescue breaths.
It is important to avoid attempts to drain water from the stomach or lungs with the Heimlich maneuver or by holding the person upside down. This delays ventilation and increases the risk of vomiting. Finally, the person should be covered with blankets or dry clothing to manage potential hypothermia, as water conducts heat away from the body 25 times faster than air.