Always ensure basic safety around water. Children should always be supervised as they can drown in surprisingly small amounts of water. They should never be left alone in a bath, even for a short time. Be vigilant around pools and ponds which should have safety features, such as fencing and gates. Drowning can happen quickly and quietly (unlike in films) and causes a frightening number of fatalities every year.
Generally, drowning casualties do not inhale large amounts of water. Most deaths from drowning are caused from secondary drowning (see below), or from a muscle spasm in the throat that causes the airway to block. However, drowning casualties do tend to swallow large amounts of water and are thus very likely to vomit. When resuscitating, you should be aware of this and that you may need to turn them onto their side periodically to ensure that they do not inhale vomit into their lungs.
If Someone is Drowning
- If they are unconscious in water, remove them from it as quickly as you can, but never put yourself in danger. Do not enter the water to rescue a drowning casualty unless you have been trained to do so. Throw a lifebelt or rope if possible, otherwise get help fast.
- As soon as you get onto dry land, turn them on their back, tilt the head and lift the chin to clear the airway. If there is a defibrillator available, use it immediately.
- Check for breathing and if there isn’t any, start resuscitation immediately.
- For a child or baby, start with 5 rescue breaths then alternate 30 compressions and 2 breaths, as with adults. If at any point you are aware the casualty may have vomited, briefly turn them onto their side to remove it and then roll them onto their back again to resume resuscitation.
- If it is warm and they haven’t been in the water very long, you may find they start to regain consciousness quickly. If this happens, swiftly put them into the recovery position to help them drain water and vomit. Keep checking they’re still breathing.
- If it is cold, they will not start to regain consciousness until their body is warm enough.
- Do 30 compressions to 2 breaths and keep going – grab a coat or something to put over them.
- Call for the emergency services and keep going.
If you are a qualified lifeguard, you will have been taught to give 5 rescue breaths first whether you are rescuing an adult or child – this is a specific modification to the training for lifeguards.
Anyone who has been unconscious in the water should be assessed in hospital as there is a real risk of suffering secondary drowning. Secondary drowning can occur due to even a small amount of water entering the lungs. The lungs become inflamed and irritated and start drawing fluid from the blood supplying the lungs into the alveoli (the air pockets of the lungs).
This reaction can happen up to 72 hours after the casualty appeared to have recovered and is life-threatening. The casualty may deteriorate suddenly and develop severe difficulty breathing. If this happens, phone an ambulance immediately.
NOTE: for lifeguards and those trained in water rescue, if you have been trained to give rescue breaths before compressions, continue with this protocol.
First Aid for Life provides this information for guidance and it is not in any way a substitute for medical advice. First Aid for Life is not responsible or liable for any diagnosis made or actions taken based on this information. The best way to be prepared for action in an emergency is to attend a practical first aid course or do one online.