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At dock, pool, or the aft deck, drowning a constant concern

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Each year, drowning is responsible for more than half a million deaths worldwide. It is a leading preventable cause of unintentional death.

On dry land, when treating sudden cardiac arrest, hands only CPR is very effective. For a drowning victim, though, lack of oxygen in the blood is often an issue, so the breathing part of CPR is important.

In 2010, the American Heart Association (AHA) guidelines changed for CPR. CPR now begins with chest compressions in a C-A-B sequence: chest compressions, airway, breathing.

However, it is still suggested that maritime professionals use the traditional A-B-C approach for treating drowning victims due to the lack of oxygen in their bloodstream. Victims in respiratory arrest – those who have stopped breathing but their heart is still beating — usually respond after a few rescue breaths.

Yacht crew who discover a person who may be drowning can follow these steps.

Step 1: Recovery from the water.

First, remember your own safety. Can you safely rescue the victim? If so, call for help, send for an AED (Automated External Defibrillator) and get the victim to safety as quickly as possible.

Step 2: Start rescue breathing.

As soon as the unresponsive person is removed from the water, open the airway and check for breathing. If there is no breathing, give two rescue breaths that make the chest rise. Quickly beginning rescue breathing increases the victim’s chance of survival.

There can be dangers to the rescuer when performing mouth-to-mouth. Having a pocket mask or other barrier device along with your other personal protective equipment is an essential part of your first aid kit and should always be close by.

Step 3: Start chest compressions.

After delivery of 2 breaths, if you do not see the person breath on their own, begin chest compressions. You will perform 30 chest compressions followed by two breaths. Continue this process until the person begins to breath or the AED arrives.

On adults, chest compressions will push the sternum at least 2 inches down, and it’s harder than you think. And faster. The rate should exceed 100 compressions a minute. Think “hard, fast and deep” when doing chest compressions.

Step 4: Apply the AED.

Dry (and shave if the person is hairy) the chest area before applying the defibrillation pads. If the victim is in cardiac arrest and the AED is applied quickly, it could shock their heart back into a normal rhythm. Follow the directions of the AED and continue CPR until the AED indicates no shock is required and the patient is breathing.

Once the patient is breathing, roll them onto their side in the recovery position and get them to a hospital as quickly as possible.

The AED should be kept on the patient as the pads will monitor the patient until help arrives. All drowning victims that require any form of resuscitation (including rescue breathing) must be transported to the hospital for evaluation and monitoring. Even if the person appears to be OK they may still need to be checked out by medical professionals.

In the event of a near-drowning with a child, be alert to dry drowning, or secondary drowning, in the hours or even days after the incident.

When water gets into the lungs, the lungs become irritated and produce fluid, which can lead to coughing, chest pain and trouble breathing. Watch for children who may become extremely tired or lethargic, or irritable after a near-drowning. Those may be warning signs of a decrease in oxygen to the brain.

Never let your guard down with young children around water as it does not take much water to drown. As with adults, a child with a near-drowning experience should get professional medical attention. If you are not near professional medical care, call a physician and get their advice. It’s always better to be safe than sorry.

This information is not a substitute for hands on classroom training and certification, nor is it a substitute for professional medical care. Always make certain to have current, valid CPR certification cards and always call for emergency medical assistance when possible.

Keith Murray, a former firefighter EMT, owns The CPR School, a first-aid training company. He provides onboard training for yacht captains and crew and sells and services AEDs. Contact him at 877-6-AED-CPR, 877-623-3277 or www.TheCPRSchool.com. Comments on this column are welcome at editorial@the-triton.com.

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