Someone drowning doesn't shout or wave their arms. They're upright, silent, and they go under in less than a minute.
ACT
Don't go into the water if you can do otherwise. The improvised rescuer who drowns is a documented and common scenario.
- Talk. Many people in difficulty can still act if you tell them what to do.
- Reach out with a pole, a branch or a piece of clothing, while staying anchored to the ground.
- Throw something that floats: an empty closed jerrycan, a cool box, a board, a lifebuoy, a dry bag full of air.
- Row out if you have a boat.
- Swim only as a last resort, with something that floats in front of you so you can never be grabbed.
Once the person is out:
- Don't waste time trying to get water out of the lungs. There's almost never enough to matter, and it delays what counts.
- Check breathing. Head tilted back, chin lifted, ten seconds.
- They're breathing: recovery position, covered, watched constantly.
- They're not breathing, or breathing abnormally: start resuscitation. In drowning, you first give five rescue breaths, before compressions, unlike a usual cardiac arrest. Then alternate compressions and breaths. The general sequence is in Unconscious person.
- Have someone call for help while you act.
- Deal with the cold as soon as breathing is secured. Remove wet clothes, insulate from the ground, wrap them up, and handle them gently — see Hypothermia.
Anyone pulled out of the water after being submerged must be seen by a doctor, even if they seem perfectly fine.
ADAPT
It's fast-flowing water. Never go down into the current. The danger isn't the depth but the force, and underwater obstacles — a fallen tree catches a body and holds it under the surface. The full approach is in Franchir un cours d'eau.
It's under ice. Approach lying flat to spread your weight, hold out an object, and never go near the edge of the break standing up. Someone in icy water loses the strength in their hands within minutes: soon they won't be able to hold on.
You're the one going under. Stop fighting, roll onto your back, fill your lungs with air and let yourself float. Floating on your back takes very little energy and buys you a lot of time. Then call out, or swim slowly towards the nearest edge.
It's cold and the person was under for a long time. Never conclude they're dead. Immersion in cold water slows the metabolism, and very long resuscitations have brought people back after long immersions, especially children. Resuscitate, and keep going.
There are several victims. First pull out the ones who no longer move and float face down, not the ones thrashing. The one thrashing is still breathing.
UNDERSTAND
Why nobody sees it
The picture of someone shouting and waving is wrong. The instinctive drowning response is involuntary and silent: the mouth breaks the surface just enough to breathe in, never enough to speak; the arms spread out sideways and press down on the water to keep the head up, which stops them from signalling. The body stays upright and doesn't move forward.
This phase lasts very little time in an adult, even less in a child. A drowning child makes less noise than a child at play — sudden silence is the signal.
What kills
It isn't water in the lungs, or very little. It's lack of oxygen. The larynx closes by reflex when water touches it, which stops water getting in and air getting through. Loss of consciousness follows, then cardiac arrest.
That's why the resuscitation sequence is reversed for drowning: the problem starts in the breathing, so you give air first, whereas in a heart-related cardiac arrest you prioritise circulation.
Cold shock
Sudden immersion in cold water triggers an uncontrollable reflex gasp — dangerous if the head is under water — then hyperventilation, then a gradual loss of grip strength. You can be fully conscious and unable to hold on to anything. That's what explains good swimmers drowning, and why the first minute is the most dangerous.
Delayed drowning
Lung damage can show up several hours after an immersion, in someone who seemed fine. A persistent cough, breathlessness, unusual tiredness, confusion: these are reasons to seek help, even late.