Drowning results from respiratory impairment due to submersion or immersion in liquid, leading to severe injury or death. This emergency demands immediate action, as the window for successful intervention is brief. Bystanders can save a life, but effective rescue depends on understanding the proper sequence of safety measures and intervention techniques. Knowing the steps to safely assist a person in the water is paramount.
Prioritizing Rescuer Safety and Recognition
Ensuring the safety of the rescuer is the primary principle in any rescue situation. Before intervention, quickly survey the environment for hazards such as strong currents, underwater debris, or electrical power lines. If the area presents a danger, do not enter the water; instead, call for professional help immediately and employ non-contact methods.
A person in distress rarely fits the dramatic image of frantic splashing. The instinctive drowning response is a quiet, physiological reaction focused on breathing. Signs include the head low in the water with the mouth at water level, or the head tilted back with the mouth open.
The body will often appear vertical in the water, with no visible leg kick. The arms move laterally, pressing down on the water to lift the mouth for a quick breath. Because the respiratory system prioritizes inhaling air, the person is physiologically unable to call out for help. This struggle on the surface typically lasts only 20 to 60 seconds before submersion occurs.
Non-Contact Rescue Methods
The safest approach for an untrained bystander is a non-contact rescue, which avoids entering the water. These methods, summarized by “Reach, Throw, Row, Don’t Go,” prioritize the rescuer’s position on a stable surface like the shore, a dock, or a boat. Reaching assists are effective when the victim is close to the edge of the water.
To execute a reaching rescue, lie flat on the bank or dock to maintain a low center of gravity and prevent being pulled in. Extend a long, rigid object, such as a pole, branch, or even a sturdy towel or article of clothing, for the victim to grasp. If the victim is beyond reach, a throwing assist is the next safest option.
Throwing rescues involve tossing a buoyant object with a line attached, such as a ring buoy, a throw bag, or a makeshift flotation device like a sealed plastic jug. Aim the throw so the floating item lands slightly beyond the person, allowing them to pull the line across their body and grab it. Once the victim has a firm hold, slowly and steadily pull them toward the safety of the shore, keeping your body low and braced.
Wading is only an option if the water is shallow, stable, and less than chest deep, and you are certain of the bottom conditions. If you must wade, take a flotation device and use an object like a pole to test the depth and maintain balance. A wading rescue is typically used to move close enough to execute a reaching or throwing assist, not to make direct contact with the victim.
Contact Rescue Techniques (Last Resort)
Entering the water to make physical contact should only be considered as a last resort, ideally only by trained individuals. A panicked victim can instinctively grab onto anything, including a rescuer, in a desperate attempt to stay afloat. This behavior creates a high risk of the rescuer being dragged under, potentially leading to a double drowning.
If a contact rescue is unavoidable and you are a strong swimmer, you must bring a flotation device, such as a life jacket, kickboard, or rescue tube, to place between you and the victim immediately upon contact. This barrier provides a secure point of buoyancy for the victim and helps prevent them from grabbing you directly. Always approach the person from behind, if possible, to minimize the chance of being seized.
Once contact is made, the goal is to stabilize the victim face-up and tow them to safety. A common technique is the single armpit tow: approach from the victim’s back, loop one arm under their armpit, and grasp their shoulder. This position allows you to pull the person, keeping their head above the water, while using a sidestroke or scissor kick to propel both of you toward the exit point.
Immediate Post-Rescue Care and Emergency Response
The moment the victim is safely removed from the water, immediately call emergency medical services. Even if the person appears conscious and is breathing, prompt professional medical evaluation is necessary. Once the call is made, assess the victim’s responsiveness and breathing.
If the victim is breathing and conscious, focus on keeping them calm and warm. Remove any wet clothing and cover them with blankets to counteract the effects of hypothermia. An unconscious person who is still breathing should be carefully placed in the recovery position. This involves rolling them onto their side with the head tilted back, allowing any residual water or vomit to drain from the airway, preventing aspiration.
If the person is not breathing, initiate cardiopulmonary resuscitation (CPR) immediately. Since the primary issue in drowning is lack of oxygen, the rescue sequence prioritizes ventilation. For a layperson, begin with five initial rescue breaths before starting chest compressions, followed by the standard cycle of 30 compressions to two breaths. Avoid attempting to expel water using maneuvers like the Heimlich, as this delays oxygen delivery and increases the risk of vomiting.
All victims of a water-related incident require medical attention, even those who seem to recover fully, due to the risk of delayed symptoms. Secondary drowning is a complication where a small amount of aspirated water irritates the lung lining, causing fluid to build up in the lungs (pulmonary edema) hours after the event. Be vigilant for signs like persistent coughing, difficulty breathing, chest pain, or unusual lethargy for up to 48 hours following the rescue.