During a routine patrol of a residential area in your beat, your dispatcher notifies you a child has been pulled from a pool and is not breathing. Fire and EMS are being dispatched but you are close to the scene. As you jump out of your patrol vehicle and run to the backyard, the family members toss the limp child at you and plead for you to save the child’s life. What you do before fire and EMS arrive could significantly impact how this story turns out.
Drownings can happen in any body of water, at any time of the year, anywhere in the country. According to the CDC, drowning is the leading cause of death in children ages 1-4 and the second leading cause of death in children ages 5-14 years. It is estimated that there are 4,000 fatal drownings and 8,000 nonfatal drownings per year in the United States. That breaks down to approximately 33 drownings per day (11 resulting in fatalities and 22 being nonfatal).
Here are five things police officers need to know about responding to drownings:
1. Water temperature
Victims of drowning can be successfully resuscitated after being in the water for far longer than you would expect. This is especially true in cold bodies of water or in cold temperatures. Unless there are obvious signs of death, such as body decomposition, you should always begin CPR and other resuscitative efforts, as appropriate, until EMS arrives.
2. Safety
Everyone who has joined a branch of public safety joined to make a difference. Police officers often arrive first to emergencies and are faced with difficult decisions. With that in mind, most officers would ignore the dangers and attempt a rescue. So here are some points to think about to prevent becoming a victim yourself:
- Always survey the scene first for hazards such as downed electrical lines, fuel spills and underwater debris that you could become entangled in prior to entering the water to attempt a rescue.
- Venturing out on thin ice can be very risky. Pushing along a small rowboat on the surface of the ice may be the best approach, or extending a ladder over the ice to the victim.
- If the victim is trapped in a vehicle, and the windows are rolled up, a pocket glass breaker/seat belt cutter can come in handy to gain access and to free them.
- Bring a friend (or at least a bystander). Having someone behind you holding your belt to prevent you from slipping or falling while pulling someone to safety could be the difference between a successful operation and needing to be rescued yourself.
- If you are unable to reach someone in swift water or flood waters, all you may be able to do is provide support and instruction through verbal commands.
- Having some kind of rope to either throw or tie yourself off to can aid you in pulling someone to shore or being pulled back to shore should you get in trouble.
- If you enter the water while wearing your duty gear and ballistic vest, you put yourself at significant risk of drowning if you try to swim due to the extra weight dragging you down.
- People struggling in the water can be combative, despite the fact you are trying to help them. Be prepared for this scenario. Water safety training from the Red Cross can be beneficial.
- Attempting a swift water rescue without proper training and gear may result in additional drowning victims, including yourself. Time spent training with your local fire department water rescue/dive team can be very helpful.
- Keep compact, inexpensive “space blankets” in your first aid kit to keep victims from becoming hypothermic.
- There are two types of personal floatation devices you could use. One is throwable and would allow you to get something to a victim who is still responsive. The second would be a wearable PFD. The Type III life jacket can be stored in the trunk of your patrol car and be donned anytime you might be operating near the edge of a body of water.
- Never overestimate your own capabilities, especially if you are not a strong swimmer.
These are, of course, only suggestions and fit a wide parameter of scenarios you might encounter from moving water to a calm lake or frozen lake to a person trapped on top of a flooded car.
3. Treatment of a drowning
- Remove wet clothing and check for a pulse
Only remove clothing if necessary to check for a pulse and then expose the chest to begin chest compressions and attach AED pads.
The assessment should begin with checking responsiveness, checking a pulse and breathing. Do not check for a pulse for longer than 10 seconds. If you don’t feel one or are not sure if you feel one, you should begin chest compressions.
- Check for breathing
If you do feel a pulse, check for breathing. If breathing is not present but a pulse is you should begin rescue breathing with a pocket mask. Slow gentle breaths that just make the chest start to rise will be sufficient. Only give rescue breaths if no breathing or rate/depth is inadequate.
- Apply an AED
During this process, should you have access to an AED, you can have someone retrieve it and help you put it on the victim. Quickly pat dry the patient’s chest before applying the AED pads. Follow the AED prompts to analyze and deliver a shock if indicated.
- Obtain a history to relay to other responders
Any information you can find out about what happened or what you currently are seeing and doing is very useful to relay to the responders coming on fire trucks and ambulances. The condition of the victim comes to mind first, and whether the victim is still in the water or already out. Other useful information would be age (even if you just say pediatric or adult), approximate water temperature if known, and amount of time the victim was, or has been in the water.
- Keep the victim warm
This may be impossible if you are doing CPR because you will need access to the most important parts of the body, however, if you perform rescue breathing or the victim is awake and only requires monitoring until EMS arrives you can most certainly use blankets or other items to keep the patient warm.
If the patient is awake and breathing, depending on water temperature, air temperature and duration of exposure, assist them out of their wet clothing, provide a blanket and consider evacuating them to a warm patrol vehicle or building while waiting for EMS to arrive.
4. The don’ts of all this
It is important to remember that back blows and abdominal thrusts are no longer recommended.
Chest compressions in the water are considered futile and should be withheld till the victim is removed from the water; however, rescue breathing can still be beneficial. Remember the potential importance of a rigid backboard like a stand-up paddleboard or a surfboard.
5. A note on trauma
The old way of doing things required EMS to assume that every drowning victim has a cervical spine injury until proven otherwise. This meant that we spent valuable time securing people to boards and other equipment before or shortly after removing them, making the lifesaving treatment we need to perform more difficult. So, unless you suspect the victim sustained trauma prior to entering the water or upon entering the water (i.e., diving in the shallow end), spinal precautions are no longer necessary. It is better to remove the victim and begin interventions that can be lifesaving.
Quick Guide
- Remove victim from water (if safe to do so)
- Open the airway
- Check breathing and pulse for no more than 10 seconds
- Begin CPR and/or rescue breathing if needed
- Apply AED if available
- Obtain a history of the event
- Update EMS crew through dispatch
Disclaimer: This is intended to guide you should you be faced with this type of emergency. You should, as always, refer to your local policies and procedures. Always follow the proper steps and techniques provided to you in your department-approved CPR/BLS training.
