How to Properly Assist a Drowning Victim

Even if the victim seems okay, your first action should be to call emergency medical services immediately.

Pulling a drowning person out of the water is only half the battle. After what appears to be a successful rescue, the victim may still face life-threatening complications such as cardiac arrest, pulmonary or cerebral edema, or acute kidney failure.

It can take 3 to 5 days after the incident before it’s safe to say the victim is out of danger.

Therefore, we emphasize once again: calling emergency services for someone just rescued from water is mandatory. Meanwhile, you can take immediate action to save a life. Speed is crucial.

1. Identify the Type of Drowning

Rescue experts differentiate two main types based on the victim's skin color immediately after drowning.

"Blue" Drowning

This occurs when a person struggles intensely to survive. It is common among non-swimmers who accidentally find themselves in deep water, children who fall into pools, or swimmers caught in strong currents.

In their desperate bid to survive, they hold their breath for a long time while actively moving underwater. Oxygen depletes rapidly, leading to brain hypoxia. The victim loses consciousness, and water floods the stomach and lungs. The water then enters the bloodstream, diluting it and leaking through vessel walls, causing the skin to turn a characteristic bluish color.

Additional life-threatening complications include:

• Heart strain: The heart struggles to pump the increased blood volume and lacks energy due to oxygen deprivation. Without prompt rescue and resuscitation, cardiac arrest may occur.
• Impaired gas exchange in the lungs: The fluid in the lungs foams, which can be observed as pink frothy sputum from the mouth and nose during exhalation or coughing attempts. A bubbling sound during breathing is another sign. Without timely medical intervention, respiratory failure may result.

"Pale" Drowning

This type happens when the person drowns while unconscious—for example, after slipping and hitting their head on a pool edge, experiencing shock (such as falling through ice), or exposure to highly chlorinated water.

In these cases, a laryngospasm occurs, completely closing the vocal cords. This protective reflex blocks water from entering the lungs. Consequently, the victim does not inhale water, and almost none enters the stomach.

"Pale" drowning has a better prognosis than "blue" drowning. Although breathing and circulation stop, starting resuscitation within 5 minutes after the spasm significantly reduces severe complications.

2. Remove Water from the Victim’s Lungs and Stomach

If dealing with "pale" drowning, proceed to the next step.

For "blue" drowning or if the victim is conscious but has swallowed water, follow these steps:

• Position the victim face down over your knee;
• Open their mouth by gently prying their jaws apart, insert two fingers, and firmly press the base of the tongue to induce a gag reflex.

If vomiting or coughing begins, continue pressing the tongue base for 5–10 minutes until water stops flowing from the mouth and nose. Your goal is to help the victim expel as much water as possible from their lungs and stomach.

If no gag reflex or coughing occurs, or if the case is less severe, continue with the general first aid protocol.

3. Check for Breathing

Lean close to the victim’s face. You should feel their breath on your cheek if they are breathing. Observe chest movements as an additional indicator.

4. Check for a Pulse

Place your fingertips on the victim’s wrist or another artery close to the skin surface (such as the neck), applying gentle pressure to detect pulse beats. Try to find a pulse for at least 10 seconds.

5. Begin Cardiopulmonary Resuscitation (CPR) if Necessary

If the victim is not breathing, start mouth-to-mouth resuscitation immediately.

Harvard Medical School recommends the following steps:

• Lay the victim on their back on a firm surface.
• Ensure the head is slightly tilted back with the chin lifted to allow air into the lungs rather than the stomach.
• Cover the victim’s mouth with a thin cloth or gauze and pinch their nose closed.
• Forcefully exhale air into the victim’s mouth.
• Watch the chest rise and fall to confirm proper ventilation.

If the victim also has no pulse, combine mouth-to-mouth with chest compressions.

Perform chest compressions only if there is no detectable heartbeat. If a pulse is present, do not perform compressions.

• Place the heel of one hand in the center of the chest, on the nipple line.
• Place the other hand on top of the first. For infants, use two fingers instead.
• Press down on the sternum three to four times between breaths. It’s easier if two people work together—one performs rescue breaths, the other does compressions.

6. Continue Resuscitation Until Breathing and Pulse Return or Emergency Help Arrives

Again, calling emergency services is essential. Even if both you and the victim believe the situation is under control after rescue, it’s better to err on the side of caution.

If breathing and pulse are restored and the victim appears stable, place them in the recovery position on their side and wait for medical professionals. They will evaluate the victim’s condition and determine whether hospitalization or further care is necessary.

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