Decide
Why do drowning casualties get rescue breaths before compressions?
The lesson in plain words
- Why drowning is different
- Drowning means breathing problems from being under or in water.
- In most cardiac arrests the heart fails first.
- In drowning the lungs fail first: water blocks breathing, oxygen runs out, and only then does the heart stop.
- That is why getting oxygen in, through rescue breaths, matters more here than after a sudden collapse on deck.
- Rescue without becoming a casualty
- Do not jump in unless you are trained, equipped and it is safe.
- Reach with a boathook, throw a line or a lifebuoy, and keep pointing at the person.
- Recovery manoeuvres are taught in the Emergencies module.
- Five breaths, then CPR
- Once the casualty is aboard, check response.
- If they are unresponsive, open the airway and check breathing.
- If it is absent or abnormal, give 5 initial rescue breaths. Then start CPR at 30:2.
- Compressions alone help less in drowning because the problem is oxygen, but they are still better than nothing.
- Give breaths in the water only if trained in this technique and it is safe.
- Water and vomit
- Do not try to drain water from the lungs or press on the stomach: it wastes time and makes vomiting more likely.
- Vomiting during CPR is common.
- Turn the casualty onto their side, let the mouth drain, roll them back and carry on.
- Dry the chest before you attach AED pads, and move the casualty out of standing water if you can.
- Everyone gets checked
- Anyone who inhaled water needs medical assessment, even if they seem well.
- Get radio medical advice and keep watching their breathing.
- Persistent coughing, breathlessness, drowsiness or confusion needs urgent help.
- Anyone who needed rescue breaths or CPR needs hospital care.
Key data
- Initial rescue breaths
- 5
- Then
- CPR at 30:2 and an AED
- AED pads
- Dry the chest first; keep out of standing water
- After rescue
- Medical check for anyone who inhaled water
Key points
- In drowning the lungs fail first, so oxygen is the priority.
- Unresponsive and not breathing normally: 5 rescue breaths, then CPR at 30:2.
- Never try to drain water from the lungs; manage vomit by turning to the side.
- Dry the chest before attaching AED pads.
- Anyone who inhaled water needs medical assessment, even if they seem well.
Check what you have read
How many initial rescue breaths do you give a drowning casualty who is not breathing?
True or false?
Decide each statement before you see the answer.
Worry about ‘dry’ or ‘secondary’ drowning days later.
Unresponsive and not breathing normally: 5 rescue breaths, then CPR at 30:2.
Give compressions only, as for any collapse.
Never try to drain water from the lungs; manage vomit by turning to the side.
Hold the casualty upside down or push on the stomach to get the water out.
Dry the chest before attaching AED pads.
Practice case & exam keys
Situation
You pull a swimmer onto your boarding ladder after several minutes face down near the anchorage. On the cockpit floor she does not respond and is not breathing. Your crew has the AED from the chart table.
Show the answer
Send a crew member to call for help by VHF. Open her airway and give 5 rescue breaths, then start CPR at 30:2. If she vomits, turn her on her side, let the mouth drain, roll her back and continue. Dry her chest, move her out of any standing water, attach the AED and follow the prompts. She needs hospital care even if she recovers.
Exam keys
- Drowning arrest is caused by lack of oxygen: 5 initial rescue breaths, then 30:2.
- Do not try to drain water from the lungs.
- Dry the chest before using an AED.
- Every casualty who inhaled water needs a medical check.