Introduction: Drowning represents respiratory impairment due to submersion or immersion in liquid, with hypoxemia due to fluid aspiration being the primary mechanism by which victims deteriorate into cardiac arrest. It is the third leading cause of unintentional injury death worldwide.
Aim: This article aims to review recent evidence and provide practical guidance for lay rescuers, trained first aiders, and emergency medical personnel in managing cardiac arrest due to drowning in the prehospital setting.
Materials and methods: A comprehensive literature review was conducted by analysing scientific research from evidence-based sources such as guidelines from the European Resuscitation Council, American Heart Association, Wilderness Medicine Society, point-of-care medical resource software UpToDate as well as journal articles and textbooks.
Results: Based on the conducted literature review we suggest that to improve survival, drowning victims should be extricated from water within ten minutes. Once the victim is out of the water, all rescuers should assess the need for cardiopulmonary resuscitation and start it as soon as possible. In-water resuscitation should only be performed by highly trained rescuers. Automatic external defibrillators are safe and should be used in cardiac arrest due to drowning. Rescuers should initiate basic manoeuvres to limit heat loss and commence rewarming alongside cardiopulmonary resuscitation, especially in hypothermic casualties.
Conclusion: Timely rescue and effective resuscitation by lay people and emergency medical personnel can significantly enhance the prognosis of drowning victims. The traditional Airway-Breathing-Circulation model of resuscitation should be employed when managing cardiac arrest due to drowning.
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