Saving a life in the water when no flotation device is available is an extremely high-risk action that should be considered a last resort. Drowning is a rapid process, with brain damage beginning within four to six minutes without oxygen, underscoring the urgency of fast action. This situation demands a clear, sequenced, and disciplined approach to prevent the rescuer from becoming a second victim. While professional training is always recommended for water rescue, understanding these techniques can provide a framework for immediate intervention. The primary focus must be on maintaining the rescuer’s safety while executing a swift and effective extraction.
Prioritizing Rescuer Safety: The Non-Contact Rescue Principle
The safest and most recommended method of water rescue is always a non-contact approach. This principle prioritizes the rescuer’s safety by avoiding entry into the water, which is a significant danger given the panic of a drowning person. A struggling victim’s survival instinct can cause them to grab onto anything, including a rescuer, potentially pushing them underwater.
The “Reach, Throw, Row, Go” sequence outlines this priority, where “Go” (entering the water) is the final, most hazardous step. If the person is close to a stable edge, the “Reach” step involves extending an object like a pole, branch, or even a towel to pull them to safety. The rescuer should lie flat or maintain a secure anchor point to avoid being pulled in.
If the person is further away, the “Throw” step requires launching an improvised flotation aid toward them. This could be a cooler, an empty plastic container, or any buoyant item that can be grabbed and pulled. Providing a floating object buys time, allowing the rescuer to pull the victim to the side without making physical contact.
Safe Water Entry and Approach Techniques
If non-contact methods have failed and the decision to enter the water is made, it must be done with extreme caution and only as a last resort. The entry method should be based on the environment; a sliding entry is preferred in unknown or shallow water to prevent injury, while a shallow dive may be appropriate in open, deep water. Before entering, remove heavy clothing and footwear that could impair swimming.
Once in the water, the approach must be controlled and deliberate, maintaining a safe distance of six to eight feet from the victim. The primary objective is to approach the struggling person from behind, which prevents them from making a frontal, panic-driven grasp. A panicked victim will instinctively try to climb on top of anything for leverage.
The rescuer should swim quickly and stay low in the water, only breaking the surface to breathe and make visual contact. If the victim is flailing, the rescuer can use a momentary underwater approach to surface directly behind the victim. This rear approach is paramount, as it allows the rescuer to establish a secure hold before the victim realizes they are being touched.
Securing and Towing the Victim Without Equipment
This phase requires quick action to secure the victim and begin the tow, recognizing that the lack of flotation means the rescuer must bear the full weight and potential struggle of the person. If the victim attempts to grab the rescuer, the rescuer must immediately submerge or push them away using a defensive block, such as a strong kick, to break the hold. A momentary dunking can sometimes disrupt the victim’s panic and allow the rescuer to gain control.
Cross-Chest Carry
Once behind the victim, the rescuer can execute a Cross-Chest Carry, which is highly effective for a struggling person. The rescuer reaches one arm across the victim’s chest and secures their hand under the opposite armpit, while the rescuer’s hip is positioned against the victim’s back for stability. This hold keeps the victim’s face out of the water and allows the rescuer to use a sidestroke or scissor kick to propel both toward safety.
Chin or Head Support Tow
For a victim who is unconscious or compliant, the Chin Support Tow or Head Support Tow is appropriate. In the Chin Support Tow, the rescuer positions their hands on either side of the victim’s jaw and ears, with the arms extended or bent to keep the person’s head above the surface. This hold is designed to keep the airway open while the rescuer swims backward using a powerful kick.
Hair or Head Tow
The Hair or Head Tow is another method where the rescuer grips the victim’s hair at the crown of the head or cups the back of the head firmly with both hands. This technique allows the victim to be towed face-up, with the rescuer using a backstroke or breaststroke kick for propulsion. Throughout any tow, the rescuer must continuously reassure the victim, using the towing arm to control their position and keeping their own body positioned to minimize drag.
Immediate Actions After Extraction
The moment the victim is safely removed from the water or brought to a stable, shallow area, the focus immediately shifts to medical intervention. The first step is to call local emergency services, such as 911, or to direct a bystander to do so. Providing an accurate location and a brief description of the incident can expedite the arrival of professional help.
Next, the rescuer must quickly assess the victim’s airway, breathing, and responsiveness. If the victim is unresponsive and not breathing, the rescuer must initiate cardiopulmonary resuscitation (CPR). Drowning victims primarily suffer from a lack of oxygen, so CPR protocols emphasize beginning with rescue breaths before chest compressions.
For an adult drowning victim, the sequence is two initial rescue breaths, followed by cycles of 30 chest compressions and two breaths. While waiting for emergency services, the rescuer must treat the victim for shock and hypothermia. This involves removing wet clothing and covering the person with blankets or dry towels to conserve body heat, even on warm days, as water rapidly lowers core body temperature.