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Near drowning

Drowning - near

"Near drowning" means a person almost died from not being able to breathe (suffocating) under water.

If a person has been rescued from a near-drowning situation, quick first aid and medical attention are very important.

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Drowning rescue, throw assist
Drowning rescue on ice, board assist
Drowning rescue, reaching assist
Drowning rescue, board assist
Drowning rescue on the ice, human chain

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Considerations

Causes

Symptoms

Symptoms can vary, but may include:

First Aid

When someone is drowning:

If the person's breathing has stopped, begin rescue breathing as soon as you can. This often means starting the rescue breathing process as soon as the rescuer can get to a flotation device such as a boat, raft, or surf board, or reaches water where it is shallow enough to stand.

Continue to breathe for the person every few seconds while moving them to dry land. Once on land, give CPR as needed. A person needs CPR if they are unconscious and you can't feel a pulse.

Always use caution when moving a person who is drowning. Neck injuries are uncommon in people who survive near drowning unless they have been struck in the head or show other signs of injury, such as bleeding and cuts. However, neck and spine injuries may occur when a person dives into water that is too shallow. Because of this, the American Heart Association guidelines recommend against strictly immobilizing the spine unless there are obvious head injuries. Doing so can make it more difficult to perform rescue breathing on the victim. However, you should try to keep the person's head and neck stable and aligned with the body as much as possible during the rescue from the water and CPR. You can tape the head to a backboard or stretcher, or secure the neck by placing rolled towels or other objects around it.

Follow these additional steps:

Do Not

Important safety tips:

The Heimlich maneuver is NOT part of the routine rescue of near drownings. DO NOT perform the Heimlich maneuver unless repeated attempts to position the airway and rescue breathing have failed, and you think the person's airway is blocked. Performing the Heimlich maneuver increases the chances that an unconscious person will vomit and then choke on the vomit.

When to Contact a Medical Professional

Call 911 or your local emergency number if you can't rescue the drowning person without putting yourself in danger. If you are trained and able to rescue the person, do so, but always call for medical help as soon as possible.

All people who have experienced a near drowning should be checked by a health care provider. Even though the person may quickly seem OK at the scene, lung complications are common. Fluid and body chemical (electrolyte) imbalances may develop. Other traumatic injuries may be present, and irregular heart rhythms can occur.

All people who have experienced a near drowning who require any form of resuscitation, including rescue breathing alone, should be transported to the hospital for evaluation. This should be done even if the person appears alert with good breathing and a strong pulse.

Prevention

Some tips to help prevent near drowning are:

References

Hargarten SW, Frazer T. Injuries and injury prevention. In: Keystone JS, Kozarsky PE, Connor BA, Nothdurft HD, Mendelson M, Leder, K, eds. Travel Medicine. 4th ed. Philadelphia, PA: Elsevier; 2019:chap 50.

Merchant RM, Topjian AA, Panchal AR, et al. Adult basic and advanced life support, pediatric basic and advanced life support, neonatal life support, resuscitation education science, and systems of care writing groups. part 1: executive summary: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2020;142(16_suppl_2):S337-S357. PMID: 33081530 pubmed.ncbi.nlm.nih.gov/33081530.

Richards DB. Drowning. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 137.

Thomas AA, Caglar D. Drowning and submersion injury. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 91.

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Review Date: 11/13/2021  

Reviewed By: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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