Cardiopulmonary Resuscitation (CPR) is a life-saving technique performed when a person’s breathing or heart stops. It involves chest compressions and rescue breaths to circulate blood and oxygen. In drowning incidents, immediate CPR is important because lack of oxygen can rapidly lead to severe complications. Drowning is a medical emergency requiring prompt action.
First Steps for a Drowning Victim
Before initiating CPR, ensure the safety of both the victim and rescuer. The person should be safely removed from the water and placed on a firm, flat surface. Once out of the water, check for responsiveness by shouting and gently tapping their shoulder. If there is no response, immediately call emergency services, such as 911. If alone, begin CPR and then call for help after two minutes of resuscitation.
Why Drowning Requires Different CPR
CPR for a drowning victim differs from standard protocols due to the underlying physiological issue. In most cardiac arrest scenarios, the heart stops first, followed by oxygen deprivation. In drowning, however, the primary problem is hypoxia, caused by water entering the lungs. This leads to respiratory arrest, where breathing ceases, before the heart stops beating.
Water in the lungs displaces air, preventing oxygen from reaching the bloodstream. This severe oxygen deprivation rapidly affects vital organs, particularly the brain, which is highly sensitive to oxygen levels. Consequently, the immediate focus in drowning CPR is to provide oxygen through rescue breaths to address this hypoxia. While chest compressions are still necessary to circulate any available oxygen, the emphasis on initial breathing distinguishes drowning CPR.
Performing Drowning CPR
Once the drowning victim is on a stable surface, and emergency services have been called, CPR should begin. For an adult, open the airway by tilting the head back and lifting the chin. Deliver five initial rescue breaths, each lasting about one second, ensuring the chest visibly rises. These initial breaths re-oxygenate the victim’s lungs.
Following these breaths, perform 30 chest compressions. Place the heel of one hand in the center of the victim’s chest, with the other hand on top, interlocking fingers. Press down hard and fast, compressing the chest at least two inches deep at a rate of 100 to 120 compressions per minute. Allow the chest to fully recoil between compressions. After 30 compressions, give two more rescue breaths, continuing this 30:2 ratio until help arrives or the victim shows signs of life.
After Initial Resuscitation
CPR should be continued without interruption until medical help arrives. Alternatively, CPR can be stopped if the victim shows clear signs of life, such as normal breathing or purposeful movement, or if the rescuer becomes physically exhausted. Even if the victim appears to recover, continuous monitoring is necessary.
Drowning victims, even those who seem to recover, require immediate medical evaluation in a hospital setting. Secondary complications, such as pulmonary edema or neurological damage from oxygen deprivation, can develop hours or even days after the incident. Vomiting is common during resuscitation efforts; if it occurs, roll the victim onto their side to clear the airway before resuming CPR.