When a person is drowning, the air passages close up to prevent water going into the lungs. This also prevents air entering the lungs, depriving the casualty of oxygen and eventually leading to unconciousness and death. Usually, only if the casualty has been unconscious in the water for some time do the lungs fill up with water. More commonly, the water goes into the stomach. A secondary risk for the rescued person is that he or she may choke on vomit as water in the stomach forces the stomach contents upwards. A near-drowning person also faces the risk of hypothermia. Children and young adults are at the greatest risk of drowning.
Rescuing a drowning person
As in all first aid, the key rule is to protect yourself. A person who is drowning will hit out and pull down even the most competent swimmer; dirty water can hide dangers such as metal rubbish with sharp edges; and cold water can cause the muscles to seize up very quickly.
Where possible, reach to the person from the safety of solid ground using a pole, rope or buoyancy aid to enable him to help himself out of the water. If in doubt about your ability to rescue the person safely, call for emergency help.
A person who has nearly drowned is very likely to be sick. Maintain a close watch for this. If the casualty is sick while you are resuscitating him, turn him towards you, and clear out the mouth before turning him on to the back and resuming rescue breaths. If the casualty is sick while in the recovery position, clear out the mouth and keep a close check on breathing to ensure that it has not stopped. If the casualty is conscious and sick, encourage him to lean forward and give support while he is vomiting.
Do not make any effort to remove water from the lungs by applying chest compressions or abdominal thrusts.
The risk of water in the lungs is minimal, while compressing the chest or stomach will increase the risk of the casualty choking on his own vomit.
Treatment of a near-drowning person
Your priority is to ensure an open airway and that the person is breathing.
Hypothermia is a lowering of the body's core temperature and is a very common secondary problem of neardrowning. If untreated, hypothermia leads to the breathing and heart rate slowing down and eventually stopping.
To reduce the risks of hypothermia in a case of near-drowning, place the casualty on a blanket or layer of coats to insulate him from the ground. Remove wet clothing if you are able to replace it quickly with warm and dry clothing; if not, then cover the wet clothing with blankets and coats. Cover the head, as much heat is lost from here. Warm the external environment where possible.
Even in a conscious person, hypothermia can be a risk. Seek medical help as soon as possible. For further information on hypothermia.
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