INITIAL RESUSCITATION

- Call for help and encourage patient to move away from danger.16-17
- Place the patient so that the head and feet are at the same level. If rescuing a patient from the shoreline, place them parallel to the shoreline.
- Airway, Breathing, Circulation. If unconscious and not breathing, begin with 5 rescue breaths, then continue with traditional basic life support utilizing a ratio of 30 compressions and 2 rescue breaths. Five breaths are used initially as a recruitment maneuver. Drowning patients without circulatory arrest will often respond to rescue breaths alone.10
- Ventilation support with available tools (oxygen, bag valve mask (BVM), etc.).
- Rescue breaths and CPR represent significant risk of emesis in drowning victims (65% of those requiring rescue and 88% of those receiving chest compressions).10 Placing patients in the recovery position as able can reduce the risk of subsequent aspiration.
- Prepare for transportation to a higher echelon of care. All victims of drowning who require resuscitation (including rescue breathing alone) should be transported to the hospital for evaluation and monitoring, even those who are alert and demonstrate hemodynamic and respiratory stability at the scene of initial injury.