Drowning is defined as respiratory impairment from submersion or immersion in liquid, which can happen swiftly and silently. The initial reaction is often surprise, quickly followed by a rush of panic. This panic triggers the body’s fight-or-flight response, causing disorganized, inefficient movements that rapidly deplete energy reserves. Panic-induced hyperventilation makes controlled breathing nearly impossible, hastening the lack of oxygen and causing confusion and poor coordination. Survival depends on overcoming this initial psychological response to maintain a clear airway and conserve resources.
Immediate Self-Rescue Techniques
The most effective self-rescue technique is the “Float First” principle, which prioritizes keeping the face above water and conserving energy over attempting to swim to safety immediately. By tilting the head back and relaxing, the ears become submerged, allowing the body’s natural buoyancy to take effect. This position, often called the back float, requires minimal exertion to maintain a breathing airway.
Controlling the breath is key, focusing on relaxing the body to move past the initial hyperventilation and establish a controlled, slow breathing pattern. The goal is to maximize the time spent floating motionless, minimizing movement to conserve energy. Treading water requires significantly more energy than floating and should only be used briefly to orient oneself or signal for help.
If a back float is challenging, the “survival floating” technique involves alternating between floating with the face submerged and pushing briefly to the surface for a breath. From a prone position with the face in the water, a person gently presses down with the arms and legs to bring the mouth out of the water, quickly inhaling before returning to the relaxed, submerged float. This action minimizes energy expenditure while still allowing for air exchange.
Once breathing is stabilized and energy is conserved, the swimmer should assess the nearest safe point, such as a boat, shore, or flotation device. Signaling for help should involve controlled, visible actions like waving one arm overhead, which is a recognized distress signal. Shouting is often difficult because an active drowning victim is focused on keeping the mouth above water to breathe, making a verbal call nearly impossible. If a current is present, turning onto the back with feet pointing downstream helps to protect the body from potential impact with rocks or debris.
Safe Procedures for Aiding Others
A bystander’s primary rule is to avoid entering the water to perform a rescue, as a panicked victim can unintentionally pull a rescuer underwater, creating a second victim. The recommended non-contact rescue sequence is “Reach, Throw, Row, Go,” which prioritizes methods that keep the rescuer safe on dry land or a stable platform.
The sequence involves four steps:
- Reach out using an object like a pole, towel, or branch to extend the rescuer’s reach.
- Throw a buoyant object, ideally one with a line attached, such as a life jacket or ring buoy.
- Row toward the victim if a boat is available, using the boat to maintain distance and pull the person to safety.
- Go refers to swimming to the person, which should only be attempted by trained and certified professionals, as it carries the highest risk.
The bystander must call the local emergency number for professional help and keep the victim in constant sight. Recognizing the signs of distress is crucial because drowning is often a quiet event, not frantic splashing. An active drowning victim appears vertical in the water, unable to move forward, and may press down with their arms in an instinctive attempt to keep the mouth above the surface. In contrast, a passive victim is motionless, often floating face-down on the surface or submerged underwater.
Essential Medical Steps After Rescue
Once the person is rescued, immediate assessment of their airway, breathing, and circulation is necessary. If the person is not breathing, rescue breaths must be initiated immediately, as drowning is primarily a respiratory event. For an unresponsive, non-breathing person, five initial rescue breaths should be given before starting chest compressions, following the standard cardiopulmonary resuscitation (CPR) protocol.
If the person is conscious and breathing but has inhaled water, they should be immediately placed in the recovery position. This position—lying on their side with the top knee bent—helps to keep the airway clear and minimizes the risk of aspirating vomit. It is important to avoid maneuvers like the Heimlich or holding the person upside down, as these actions delay oxygen and are not effective for expelling water.
A rescued person requires professional medical evaluation at an emergency room. Even a small amount of aspirated water can damage the lungs, leading to inflammation and a serious condition known as pulmonary edema. This fluid buildup, sometimes referred to as “secondary drowning,” can cause symptoms like persistent coughing, difficulty breathing, or confusion to develop up to eight hours after the incident. Seeking prompt medical care for any symptoms that develop in the hours following a water incident is necessary to ensure proper lung function is restored.