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Medical Author:

Benjamin Wedro, MD, FACEP, FAAEM

Benjamin Wedro, MD, FACEP, FAAEM

Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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In a drowning emergency, the sooner the victim is removed from the water and first aid is administered, the greater opportunity the victim has for surviving.

First aid for a drowning victim

The focus of the first aid for a drowning victim in the water is to get oxygen into the lungs. Depending upon the circumstances, if a neck injury is a possibility (for example, a diving accident) care should be taken to minimize movement of the neck or to immobilize it.

When assessing a drowning victim, the first steps for care follow the initial American Heart Association guidelines.

• Is the victim awake?
• Are they breathing on their own?
• Do they have a heartbeat?

Rescue breathing can begin in the water, but all other care requires that the victim be safely out of the water. If other people are available, send one to get help and call 911. Send another to get an automated external defibrillator (AED).

If the victim is breathing, he or she should be placed on their side in the recovery position to prevent potential aspiration should vomiting occur.

If the victim is not breathing and has no pulse, begin cardiopulmonary resuscitation (CPR).

There are some controversies in medical research that potentially might confuse bystanders who are willing to help. It is important to remember that a drowning victim who is not breathing and does not have a pulse is effectively dead, and any attempts at helping are appropriate.

Recently, chest compression only resuscitation has been endorsed by the American Heart Association and the American College of Cardiology, and rescue breathing is not recommended. This is not the case with drowning, since the initial insult to the body is lack of oxygen. This requires providing oxygen to the victim as soon as possible. A patient who collapses on dry land, usually has a heart rhythm disturbance and adequate oxygen levels are present in the blood for a few minutes.

It is usually recommended to start rewarming drowning victims by removing wet clothing and covering them in warm blankets. The recent medical approach to patients who have been resuscitated from cardiac arrest is to keep them cool to increase survival rates.

More research is required to determine what new approaches might be applicable to effectively treat drowning victims.

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