Drowning

In the region of 600 people died from drowning in the UK in 2017. Countless more will have been involved in an incident that didn’t result in a fatality.

If you’re going to be near water this summer, read on...

The term ‘drowning’ currently refers to any respiratory impairment resulting from submersion or immersion in a liquid, although the 'immersion' part is likely to be dropped in the near future. Whilst death is the worst outcome, drowning also encompasses what we used to call ‘near-drowning’ (usually the inhalation of a significant quantity of water) and ‘secondary drowning’ (caused by the body’s response to the pathogens inhaled with the water).

As with all incidents, safety is the first priority. There are numerous examples of rescuers who have died whilst trying to save others... Can you get them out without committing to the water? Get help from the emergency services unless you’re absolutely sure you can rescue them safely.

Consider the cause of the drowning. Why was the person in the water? Did they fall in? Why? Is there a medical cause? Could they have a spinal or other traumatic injury resulting from the incident?

If the patient is unresponsive and not breathing (or not breathing normally) then they’re in cardiac arrest. Start the Chain of Survival - call 999, send for a defib and start CPR.

Begin with 5 rescue breaths to help oxygenate the lungs and remove any water. If they vomit, roll them over to clear their airway and then carry on. Remember, minimising interruptions to chest compressions, as well as ensuring good quality compressions (depth, recoil and rate) can have a significant impact on their chance of survival.

Cold water has a protective effect on people in cardiac arrest, and resuscitation could be effective even after a person has been submerged in icy-cold water for an hour and a half! Our water isn’t generally that cold in the UK, but the emergency services will still consider starting resuscitation after prolonged submersion.

If the drowning hasn’t resulted in cardiac arrest, but the person has inhaled a significant amount of water, they will still need attention. Manage CABC as normal, and get them to further help. At the very least, they might need antibiotics to deal with any infection in their lungs.

As with all things, prevention is better than cure. But if you do happen to be present when someone drowns, hopefully this will help you to respond well.