A PubMed study shows that drowning-related cardiac arrest cases have similar variables to other OHCA causes. However, in this case, the victim is more likely to have a non-shockable rhythm, which means they cannot be treated with an AED. This makes prompt delivery of CPR and EMS assistance paramount.
Cardiac arrest in drowning is usually secondary to hypoxia, which can lead to hypoxic ischaemic brain injury in severe water accidents. However, CA can also result in permanent brain damage if the victim is left untreated for over 4 minutes.
This article explains water safety measures with emphasis on the role of CPR as one of the life-saving techniques in drowning. If you plan on taking swimming classes or are interested in extreme sports, you will find this article helpful.
Swimming and Cardiac Arrest: How It Happens
Swimming, diving, or any other water activity can lead to cardiac arrest. Water activities require all muscles in the body to fight the density of the water, which can be overwhelming to people without the required stamina to sustain the pressure of a triathlon or other sports goal.
The cold shock response further contributes to cardiac arrest. It is activated during submersion in cold water and results in hyperventilation and accelerated heart rate–two contributors to heart attack and possible cardiac arrest.
A study conducted between 1985-2016 shows that cardiac arrest poses a risk during triathlons, primarily among middle-aged men or older. However, the numbers also point to the fact that underlying heart disease was present in 44% of the death cases.
Luckily, there are ways to mitigate the effects of cardiac arrest during drowning. Below we take a closer look at the CPR procedures:
The Importance of CPR in Drowning Victims
Victims of drowning primarily suffer from respiratory obstructions or lack of ventilation in their system, medically known as asphyxia. As we mentioned, victims of drowning also experience hypoxia (oxygen deficiency).
If a person goes into cardiac arrest but does not drown, it’s important to react immediately and relieve the blocked airways. If the person experiences hypoxia, they will require more help than just heart compressions because the victim has lost a significant amount of oxygen while being underwater. Therefore hands-only CPR is ineffective in this case, and the bystander or rescuer must give rescue breaths.
The American Heart Association suggests the rescuer do the ABCs immediately (we will get to this protocol later in more detail) to confirm the state of the victim. Once they do that, it’s important to continue with heart compressions and rescue breathing to restore the loss of oxygen in their lungs.
CPR in Drowning vs. Regular CPR: The Differences
A sudden cardiac arrest due to drowning requires a slightly different approach than typical CPR for OHCA. Since CPR is the most recommended technique in case of a drowning accident, many bystanders skilled in CPR wonder whether the same cardiopulmonary resuscitation applies to the drowning victim. The answer is: not entirely.
The rescuer offering help to a drowning victim needs to perform regular CPR (hands-only CPR with heart compressions) but also, they need to release the water from the lungs by giving them oxygen through rescue breathing.
Below we explain the entire CPR technique for drowning in detail to help you understand what it takes to successfully execute cardiopulmonary resuscitation on someone who’s drowning:
CPR on a Drowning Victim
When you notice a person losing pulse or consciousness during the water, the first step is always to call 911. You can do it yourself or get someone else to do it for you. After that, pull the victim out of the water and lay them on a hard surface.
Here’s what a rescuer needs to do to help an SCA victim that’s drowning:
- Position the Victim
The first step is to take the victim to safety and place them on a hard floor. Then, you will have to confirm that the person is not breathing in order to proceed with CPR. This step is also known as checking the ABCs – Airway, Breathing, and Circulation.
Therefore, the first step is to make a clear airway by tilting the head back (not too far) and lifting the chin so that the airway is unobstructed. Secondly, you need to lower your head towards the victim’s nose and mouth to see if they are breathing. If you cannot tell, you need to listen to their chest to see if they are breathing and check their pulse. You will have to check for 10 seconds before coming to a conclusion.
If the person is not breathing, begin with chest compressions.
- Start CPR
The sooner you start with the CPR, the better. Make sure you position your hands in the right place. The palms need to be in the middle, just below the nipple line. Place one hand on top of the other and start giving compressions at a depth of about 2 inches – aim for 100-120 compressions per minute.
It’s important to let the chest rise fully after the compressions and continually monitor the victim’s reactions to see if they show any signs of life. Usually, near the 30th push, the person should start showing signs of life and throw up the water in their lungs. If they do so, make sure to position the victim to the side so they don’t choke.
- Administer Rescue Breaths
If the person does not show any signs of life near the 30th heart compression, you should administer rescue breaths. After the 30th heart compression, the person should show some signs of life.
To do so, you need to fix the victim’s head position so that the airway is clear. First, tilt the head back, and lift the chin up. Then, seal the nose by pinching, and place your mouth over the person’s mouth to make a seal. Afterward, you need to blow two times into the person’s mouth, after which you should notice the chest rising. You need to give them only two rescue breaths and continue with the 30 compressions.
The victim should show some signs of life after two series. In case they don’t, continue with rescue breaths and CPR until the emergency response team arrives to take over the case.
How to Learn CPR for Drowning
While CPR is a procedure almost everyone’s familiar with, not many people can perform it step-by-step. If you want to be prepared for future emergencies or seek employment as a rescuer, you should get CPR certification.
The most credible organizations that offer a catalog of courses are the American Heart Association and the Red Cross. The courses they offer are versatile and address every person’s individual needs.
During your course, you’ll learn how to perform CPR step-by-step and how to remain calm during drowning or other kinds of accidents. Finally, you’ll be able to demonstrate your knowledge on a manikin and address any learning difficulties with a professional instructor.
The Role of CPR in Drowning Cases: Key Takeaway
CPR in drowning is vital. A victim undergoing a cardiac arrest underwater faces almost fatal consequences if no one notices and responds immediately. While the person rescuing the victim may be familiar with CPR and the drowning response, they do not necessarily have to have a certification in CPR to assist a victim in need.
To highlight the main points of the article, the cardiopulmonary resuscitation technique is the same in drowning cases; only it involves rescue breaths. During drowning, the victim loses a lot of oxygen while swallowing gulps of water, so it’s essential to help them spit it out.
Start giving CPR right after calling 911. After the 30th compression, check for signs of life. If all is in order and the victim has regained consciousness, proceed to turn them to the side so they don’t choke on the excess water.
SCA affects all people regardless of their lifestyles or age. Cardiopulmonary resuscitation saves lives, and getting CPR-certified is the best way to help contribute to the growing number of successful cases.