When Someone’s Drowning: 4 Post-Rescue Tips. (Some May Surprise You.) | The Survival Doctor

by James Hubbard, MD, MPH

This is part 2 of my drowning series. See part 1, about essential swimming skills and rescuing drowning victims, here

Once you pull someone drowning to safety, what next? If they’re unresponsive and not breathing, three things should be done at once if there are enough people around to do them: Call 911, start CPR, look for an AED machine.

In a survival situation, if you can’t call 911 and there’s no AED machine, do CPR until you’re exhausted. But know that CPR alone rarely revives a person. (It pumps blood to the brain to prevent damage until expert help arrives but rarely restarts the heart. An AED—automatic external defibrillator—can restart the heart. More and more public swimming areas are stocking one.)

If you’re alone, make a judgment call about which of the three steps to do first. I’d take no more than 30 seconds to look for an AED machine. CPR needs to be started as soon as possible.

>> Special circumstances: Click here for special instructions for resuscitating someone who was drowning in cold water.

Those are the basics. But a few of the specific guidelines for drowning resuscitation may surprise you:

1. Old-fashioned CPR is still recommended for drownings.  Nowadays, unless you’re specially trained, CPR is usually supposed to be chest compressions only—no mouth-to-mouth. But there are exceptions. Old-fashioned CPR—with respirations—is still recommended for victims who are prepubescent children or have hypothermia or who are near-drowning victims. If the victim is still in the water you can even start mouth-to-mouth then. As soon as you get to dry land or in a boat, start chest compressions also.


These days, mouth-to-mouth is called mouth-to-barrier, reminding you to put a barrier between your mouth and the victim’s to protect yourself from infectious secretions. Commercial barriers are cheap, but if you don’t have one, a piece of plastic or duct tape with a hole in the middle for your mouth is better than nothing. It doesn’t provide the one-way valve protection the commercial barriers do, but at least it’s something. My new book, Duct Tape 911, gives instructions for making your own barrier.

2. Even for a drowning, you should protect the neck. When you see a collapsed person on land, it’s important not to move their head because they could have hit it and injured their spine. Moving the head just a little could result in paralysis. The same is true for drowning victims. Though water may seem unlikely to injure bones, there are plenty of opportunities to sustain such trauma—hitting the head while diving or on rocks, or experiencing a long fall or trauma prior to falling in the water. So unless you’re sure there’s no chance the person could have injured their head, neck, or back, try to keep the neck from moving. You have to do what you have to do to get the person out of the water, but at least when you start respirations do the jaw thrust instead of tilting the head back. (Click here for jaw-thrust instructions; see “The ABCs of CPR.”)

3. You don’t need to obsess over water in the lungs. Other than maybe turning the victim on their side for a couple of seconds, you’re wasting your time trying to get water out. Abdominal or chest thrusts to try to expel water have not been shown to increase survival. If you do turn the person, try not to move the neck. Roll the person using the log roll technique. This involves rolling the head and body as if they were both attached to one plank. You can see an example in this video, starting at about 2:25.

4. An AED could save the victim but hurt you. Just be careful. Remember that the AED has electricity. Before using one, move the victim out of standing water, take off wet clothes, and wipe and dry the chest area where the pads will go. Anyone around the victim should also make sure they’re not standing in water. An AED is extremely easy to use. Just open it up, and press the power button. The computer will instruct you from there.

Do you know how to perform CPR? Do a log roll? If not, take a hands-on course. Soon, to refresh your mind, I’ll have a more detailed demonstration video on resuscitation and moving victims.