If you spend a lot of time at the beach or pool, then performing drowning first aid could one day fall on your shoulders. When someone is pulled from the water and is not breathing, the people nearby are the only ones who can keep them alive until paramedics arrive. Being able to help means knowing first aid for drowning before you need it. Not knowing ahead of time leaves you unable to help a potential drowning victim.
Signs of Drowning
Movies and television misleadingly depict drowning victims splashing wildly and screaming for help. In reality, drowning is often silent; a drowning victim’s body enters the “Instinctive Drowning Response,” where their entire focus shifts to getting air, leaving them without the ability to call for help.
Someone who is drowning will have their head low in the water, often tilted back with their mouth at or just below the surface. Their eyes may appear glassy, empty, or closed, and their hair will fall over their forehead or eyes without them brushing it away. The person remains vertical in the water without kicking their legs, and their arms press down on the water’s surface in a “climbing ladder” motion as they try to lift their nose and mouth above the waterline. A swimmer in this state typically has less than 60 seconds before they submerge completely.
If you suspect someone is drowning, call out to them. A person who can respond verbally is likely not in immediate danger. If they return a blank stare or cannot answer, they need help now.
How to Perform an Open Water Rescue from a Drowning Incident
The goal during a drowning incident is to remove the casualty from the water so you can begin drowning first aid as quickly as possible without becoming a second victim yourself. The safest approach follows the “Reach, Throw, Row, Go” sequence, which prioritises methods that keep you on dry land.
Reach works when the drowning person is close to the edge of a pool, dock, or shore. Lie flat to lower your centre of gravity, then extend a long object such as a pole, branch, oar, towel, or pool noodle. Have the person grab the object while you pull them to safety. If nothing is available and they are within arm’s reach, grab their wrist rather than their hand, as a wrist grip is harder to break.
Throw applies when the person is too far to reach. Throw a flotation aid such as a life ring, rescue rope, life jacket, or any buoyant object. An empty cooler or even a foam pool toy can provide enough buoyancy to keep someone afloat.
Row applies when the person is outside of throwing reach and you have access to a boat. Bring the back of the boat toward the person and use an oar or paddle to pull them to the stern.
Go means entering the water yourself, and this option should only be attempted by trained rescuers. If you must enter the water, take a flotation aid with you and approach the drowning person from behind to avoid being grabbed. Offer the flotation device rather than making direct physical contact as a panicked drowning person can easily overpower even a strong swimmer and drag them down too.
Drowning First Aid: The DRSABCD Response
DRSABCD is the first aid action plan used across Australia for life-threatening emergencies, including drowning first aid. The acronym stands for Danger, Response, Send for help, Airway, Breathing, CPR, and Defibrillation.
Danger
Before rushing to help, check for dangers to yourself, bystanders, and the casualty. If the drowning occurred in open water such as a river, lake, or the ocean, additional dangers may include cold water, waves, marine life, or submerged obstacles. Do not attempt a rescue beyond your ability, as becoming a second victim complicates the emergency and diverts resources from the original casualty.
Response
Once the person has been removed from the water, place them on their back on a firm, flat surface. Check for responsiveness by talking loudly and tapping their shoulders. Ask “Can you hear me?” and “Open your eyes.” If there is no response, the person is unresponsive and requires immediate first aid intervention.
If they are breathing normally, place them in the recovery position. Kneel beside them and place their nearest arm out at a right angle with the palm facing up. Take their far hand and press the back of it against their cheek closest to you, then hold it there. Bend their far knee so the foot sits flat on the ground. Use that bent knee to roll them toward you onto their side. Tilt their head back to keep their airway open.
Send for Help
Call triple zero (000) as early as possible. If bystanders are present, direct someone specific to make the call while you continue providing first aid.
Airway
Look inside their mouth for any visible obstructions. If you can see debris, vomit, or other blockages turn them onto their side and clear the mouth with a finger sweep. Never perform a blind sweep as this can push any unseen objects deeper.
Breathing
Check for breathing by looking for chest movement, listening for breath sounds, and feeling for air on your cheek. f the person is not breathing normally, they require immediate resuscitation.
CPR (Cardiopulmonary Resuscitation)
If they remain unresponsive and not breathing normally begin cardiopulmonary resuscitation. Place the heel of one hand on the centre of the chest, between the nipples. Place your other hand on top with fingers interlaced. Position yourself directly over the casualty with your shoulders above your hands, and keep your arms straight.
Push hard and fast, compressing the chest to a depth of approximately 5 centimetres for adults. Deliver 30 chest compressions at a rate of 100 to 120 compressions per minute, or 1 to 2 each second. After 30 compressions, give two rescue breaths, by tilting their head back, pinching their nose shut, sealing your mouth over theirs, and blowing until you see the chest rise.
Repeat these two steps in a cycle without stopping until emergency services take over, the person starts to show signs of responsiveness such as coughing, moving, or breathing normally, or you are physically unable to continue.
Defibrillation
Defibrillation from an automated external defibrillator (AED) is used to restart the heart as part of CPR in instances of cardiac arrest. Drowning victims will not have a shockable heart rhythm and so an AED will not be useful, and can even be dangerous due to the victim being wet.
Water Safety and Drowning Prevention Tips
Prevention remains the most effective intervention against drowning, and it starts long before drowning first aid becomes necessary. Taking these steps reduces the chance you’ll ever need to follow drowning first aid advice in the first place:
Lock the pool gate. Barriers matter more than supervision. Royal Life Saving Australia found that most children who drowned in backyard pools accessed them through a gate that had not been closed properly.
Floaties and water wings are not safety devices. These toys create a false sense of security and teach children to float upright, which is not a survival position. They should not be relied on to keep children safe outside of swimming lessons.
Take one deep breath. If you feel yourself going under, take one deep breath instead of several deep ones. While trained free divers use hyperventilation to hold their breath for longer, it can cause ordinary people to suddenly pass out and drown quicker.
Check your medications. Drugs that affect balance, coordination, or judgement increase your drowning risk. If you take medications that say not to drive or operate machinery, treat the water the same way.
Learn First Aid For Drowning Victims
Drowning first aid can be the difference between life and death when someone is pulled from the water unresponsive and not breathing. Quick action and proper technique during a drowning emergency preserve brain function and give the casualty their best chance of survival. The skills and muscle memory that make this response possible come from hands-on CPR training, and taking a HLTAID009 Provide Cardiopulmonary Resuscitation course.
FAQs
Should I Remove Water from a Drowning Person's Lungs Before Starting CPR?
No. Attempts to drain water from someone’s lungs wastes valuable time. With drowning first aid, chest compressions should help expel any water from the body in addition to helping pump blood.
What is Secondary Drowning?
What people call “secondary drowning” can develop after a non-fatal near-drowning incident when water enters the lungs and causes inflammation and fluid build-up. Symptoms like persistent coughing, difficulty breathing, fatigue, or behaviour changes typically appear within 4 to 8 hours. Anyone who develops these symptoms after a water incident should go to the emergency department straight away.
Can You Get Hypothermia from Drowning?
Yes. Cold water immersion has four stages. The first is cold shock, which causes gasping that can pull water into the lungs. The second is swim failure, which happens when muscles lose coordination and you can no longer keep your head above water. Hypothermia is the third stage, typically setting in after thirty minutes or more. Drowning is the fourth stage.
