On-Scene Management of Drowning Incidents

Drowning is a severe emergency requiring immediate and expert response, especially relevant for educators and students responsible for the safety of others during aquatic activities. The initial few minutes are pivotal, profoundly impacting the individual's survival prospects. This guide delineates the vital procedures to enact promptly at the scene to optimize the likelihood of a positive result. We invite you to share with your students and discuss the importance of these procedures.

Initial Safety and Rescue

  • Assess the Situation Quickly

Before entering the water or attempting any rescue, quickly evaluate the environment's safety. Ensure there are no hazards like strong currents or electrical dangers that could put the rescuer at risk.

  • Immediate Rescue

Once it's safe, remove the victim from the water as quickly as possible. The aim is to get the person to a stable environment where further medical assessment and treatment can be done.

ABCDE Assessment and Immediate Care

  • Airway

After the victim is on stable ground, immediately check the airway to ensure it's open and clear of obstruction. Use a head-tilt-chin-lift technique to open the airway if necessary.

  • Breathing

Check for signs of breathing by observing the chest and listening for breath sounds. If breathing is absent or irregular, initiate rescue breathing or CPR if indicated.

  • Circulation

Check for a pulse at the carotid artery. If no pulse is detected, start CPR immediately. If the person has a pulse but is not breathing effectively, focus on providing adequate ventilation.

  • Disability

Quickly evaluate the victim's level of consciousness using the AVPU scale (Alert, Voice, Pain, Unresponsive). If the victim is unconscious, continue to maintain an open airway and consider spinal precautions if a neck injury is suspected.

  • Exposure

Remove wet clothing to prevent heat loss, and wrap the victim in warm, dry blankets or clothing. Hypothermia can exacerbate an already critical situation.

Cardiopulmonary Resuscitation (CPR)

If the victim lacks a pulse and is not breathing, initiate CPR immediately. The guideline is to perform chest compressions at a rate of 100-120 per minute with a depth of at least 2 inches. Provide ventilation at an approximate rate of one every 5-6 seconds if you are not alone. If you are alone, use a 30:2 compression-to-ventilation ratio.

Basic Life Support Interventions

  • Oxygen Administration

If oxygen equipment is available, administer high-flow oxygen through a mask. Every second counts and oxygen can mitigate some of the damage due to hypoxia.

  • Automated External Defibrillator (AED)

If an AED is available, apply it immediately and follow the prompts. Early defibrillation can be crucial in some drowning cases involving cardiac arrest.

  • Preparing for Professional Medical Assistance

While waiting for emergency services to arrive, continue life support measures and keep the victim warm and comfortable. When EMS arrives, provide a detailed account of the event and interventions taken.

The initial response to a drowning incident is crucial, especially for educators and students who may be first on the scene. Immediate and proficient interventions such as managing the airway, supporting breathing, performing CPR, and early utilization of an AED are life-saving measures. Safety should always be prioritized, and the goal should be to expedite the transfer of the victim to a medical facility for advanced care. 

Simrated offers numerous courses on medical procedures that can benefit students looking to work in water safety jobs or careers in the medical field. 

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Water Emergencies: Prevention and Response