CPR for drowning starts with your eyes, not your hands. Recognising someone is in trouble is the first step towards saving their life, and once you’ve noticed the signs you can have less than a minute to act. What you do between pulling them from the water and the arrival of paramedics can determine whether they survive.
The DRSABCD First Aid Protocol
DRSABCD is the emergency response protocol used across Australia to guide responders through the steps for performing cardiopulmonary resuscitation. The acronym stands for Danger, Response, Send for help, Airway, Breathing, CPR, and Defibrillation.
Assessing the Scene
Drowning does not look like what most people expect. Movies and television often show drowning as a dramatic event with thrashing arms and loud cries for help. In reality, drowning is often silent, with little to no splashing. A drowning person enters what experts call the “instinctive drowning response,” where the body’s need to breathe takes over all other functions, including their need to signal for help.
Signs that someone is drowning may include:
- Head tilted back with mouth open, bobbing at the water level
- Glassy, unfocused eyes or eyes that are closed
- Floating face down
- Arms pushing down on the water as if climbing an invisible ladder
- Inability to respond when asked if they are okay
Do not enter the water if there is Danger present. Strong currents, deep water, submerged obstacles, and distance from the edge can all turn a rescuer into a second victim. In these cases, the safest approach is to reach for the drowning person with your hand or a long object from land or throw them something that floats like a life ring or pool noodle. If attempting the rescue yourself, bring something buoyant with you as a drowning person is panicking and can accidentally pull you under with them as they try to cling to you.
Next call to the person to check for a Response. If they should be able to hear you but are unable to answer then it could be a sign that they are unresponsive and drowning. Next, Send for help by calling Triple Zero or having someone else do it for you.
Assessing the Victim
Roll the person onto their back and place them on a firm, flat surface with their head and body at the same level rather than in a head-down position. Check the person’s Airway for obstructions by opening their mouth and looking for any visible obstructions such as vomit, debris, or foreign material and clearing them using two fingers. If you can’t see anything, do not sweep blindly as this can push the objects further into the airway.
Check for normal Breathing by looking, listening, and feeling for sounds of normal breath. A person who is gasping or breathing abnormally still requires you to begin CPR.
CPR for Drowning Victims
Place the heel of one hand on the centre of their chest, with your other hand on top. Keep your arms straight and your shoulders directly above your hands. Push hard and fast, compressing the chest by about one-third of its depth. Perform 30 chest compressions at a rate of 100-120 compressions per minute, or 1 to 2 each second.
To give rescue breaths, tilt the head back, lift the chin, pinch the nostrils closed, and blow into the person’s mouth, watching for the chest to rise. Repeat this twice for 2 rescue breaths. If the chest does not rise, either their head is not positioned correctly or there are unseen obstructions in the person’s airway. Repeat this cycle of 30 compressions and 2 breaths until the person responds, help arrives, or you are physically unable to continue.
The D in DRSABCD stands for Defibrillation. An automated external defibrillator (AED) should not be used on a drowning victim as they are wet which can make it harmful, but also because they are simply unnecessary. An AED restarts the heart in instances of cardiac arrest, and will not help a drowning victim.
After the Person Responds
If the drowning victim responds and starts breathing normally after you perform CPR for drowning, place them in the recovery position by moving them onto their side with their head tilted slightly back and mouth facing downward to allow any fluid to drain.
CPR for Drowning Infants
Infants under one year old can drown in as little as a few centimetres of water, including bathtubs, buckets, and inflatable pools. CPR for drowning in infants follows the same 30 compressions to 2 rescue breaths cycle, but the technique differs due to their smaller size.
To perform chest compressions on an infant, place two fingers on the centre of the chest, just below the nipple line. Push down about 4 centimetres, or roughly one-third of the chest depth.
For rescue breaths, an infant’s airway is still developing and does not require a head tilt. Cover both the infant’s mouth and nose with your mouth to create a seal, then deliver gentle puffs of air rather than full breaths.
Learn How to Perform CPR
The drowning chain of survival begins with prevention, which means knowing how to respond when prevention fails. CPR for drowning requires both chest compressions and rescue breaths to restore oxygen to a brain that has been starved of it. A CPR course provides hands-on practice and the skills to respond when a drowning person needs you.
FAQs
Can I Hurt Someone By Performing CPR?
Yes, rib fractures can occur during CPR but this is an acceptable outcome given the alternative could be death. A person in cardiac arrest will die without chest compressions, so do not reduce the force or depth of your compressions out of fear of causing injury.
Should I Try to Drain Water From the Lungs Before Starting CPR?
No. Attempts to drain water from the lungs wastes valuable time. The goal of chest compressions in CPR for drowning isn’t just to restart the heart, it’s also to expel water from the lungs.
Should I Remove Wet Clothing Before Starting CPR?
No, removing clothing wastes time and serves no purpose in CPR for drowning.
