Once the drowning victim is rescued from the water, he or she should be placed horizontally on his or her back so that the airway can be opened and breathing can be checked.
If breathing does not resume independently, cardiopulmonary resuscitation must be started immediately. The procedure is as follows:
Start with five ventilations (mouth-to-mouth or by means of ventilationaids) (usually by first responders).This is followed by chest compressions (exerting pressure on the chest).The ratio of chest compressions to ventilation should be 15: 2 for children and 30: 2 for adults.
When emergency medical and rescue services arrive, the drowned person is intubated (insertion of a plastic tube into the trachea for ventilation) and given controlled positive pressure ventilation.
Most drowning victims have swallowed a lot of water, so a feeding tube is placed to relieve the pressure on the stomach.
Most drowning victims are hypothermic (hypothermic). The tympanic temperature (measured in the ear) is then below 35 °C. Hypothermia poses a risk of cardiac arrhythmias (HRS). If the body temperature falls below 30 °C, ventricular fibrillation may occur → defibrillations. The application of epinephrine is recommended only above a core body temperature of 30 °C, since epinephrine is not effective “at the coldheart“.
If a drowning victim has been in the water for a prolonged period, hydrostatic pressure may cause hypovolemia (volume deficiency), necessitating the administration of a full electrolyte solution.
The drowning victim should be moved very little.
Wet clothing must be completely and gently removed. Then the whole body must be well dried and slowly warmed.
If resuscitation at the scene of the accident is not successful, the drowning victim is driven under continued resuscitation to a hospital or special center. Here, special procedures such as “Extracorporal Life Support (ECLS)” or “Extracorporeal Membrane Oxygenation (ECMO)” are available for resuscitation and rewarming.
