by Erik McLaughlin, M.D., M.P.H.

Some watery places have a lifeguard. But not all do. Bystanders often play an important role in water emergencies.

A simple way to remember what to do when attempting a rescue is, “Reach, throw, row, go”—in that order of preference. But first, remember to call for help.

STEP 1: Call 911.

Start getting other people’s attention. Someone should call 911 early. An adult can typically struggle in water for one minute and children maybe 20 seconds or less.

METHOD 1: Reach.

This method works well if the victim is near a dock or edge of a pool. But as simple as it sounds, reaching in can be risky.

• Ensure that you’re in a safe place and not at risk of being pulled in by the victim. A solid stance or lying flat on the ground are two ways to brace. A water-immersion victim will do anything to get out, including unintentionally pulling you in.
  

Quick Reference


Four steps to save someone who's drowning:




1. Call for help from bystanders, who should call 911.
2. Reach, throw, row or go (in that order of preference). Try to limit the victim’s neck movement.
3. Assess the ABCs (airway, breathing, circulation). Again, beware the neck.
4. Possibly perform CPR.
• You can use a tree branch, oar, towel or shepherd’s crook (long pole with a hook at the end, seen around poolsides) to lengthen your reach. Take care not to hit the victim when extending the instrument. Verify the person has grasped the item and pull him or her to a safe location.
  
• If needed, you can enter the water and maintain a firm grasp on the pool edge, steps or dock, while reaching to the victim with your other hand or your feet.

METHOD 2: Throw

Most swimming areas have safety rings attached to a rope. They float and can often be thrown far out of reach of the shore.

• Take care not to hit the person with the ring.
• Instruct him or her to grab it.
• Pull on the rope to get the person to shore.

METHOD 3: Row.

If the victim is too far out for method one or two, the next option is to get a boat.

• Get as close as you can, but be careful not to hit the person.
  
• Instruct the person to grab onto the side of the boat, or perform a reach maneuver to help him or her get secure.
  
• As you get closer, consider throwing out a safety ring to help the person stabilize before you get close enough to reach.

METHOD 4: Go.

Swimming out to rescue a water-immersion victim is risky and should be the last resort. This requires training and competent swimming skills. Drowning victims are often thrashing wildly and pose hazards to their rescuers. They may attempt to climb the rescuer, trying to get themselves as high out of the water as possible. This simply pushes the rescuer under the water and puts him or her at risk for drowning!

When swimming out to rescue someone, bring a towel or shirt with you. Instruct the victim to grab the object, and tow him or her to shore. This allows you to remain a safe distance from the victim.

AFTER THE RESCUE

Once you’ve rescued the person, first aid should be provided. First aid for people with water-immersion injuries is unique and requires special training. The basics center around assuming an underlying cause for the near drowning. Did this person have a seizure while swimming? Did she have a heart attack? Is he intoxicated? Did she fall out of a boat? Most importantly, did he injure his neck before being in the water?

Immediately begin assessing the person’s ABCs: airway, breathing and circulation.

• Ensure the airway is open—that nothing is obstructing it.
  
• Make sure the person is breathing—feel for air moving in and out.
  
• Feel for a pulse on the wrist or side of the neck.

If any of these checks shows a problem, immediately fix that problem before going on to the next check. (No airway means you must fix the airway before checking breathing.) CPR may be required.

This summer, hopefully we’ll all enjoy a fun time swimming and perusing our favorite water sports. Unfortunately, drowning can occur any time and in frighteningly shallow water. Knowing what to do and how to rescue someone safely can help save lives and allow for more summers of fun—especially for the person you rescued!

ERIK MCLAUGHLIN, M.D., M.P.H., is a family-doctor resident in Chicago and former EMT/firefighter. He runs the travel health Web site www.AdventureHealthClinic.com.

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• MyFamilyDoctorMag.com free e-newsletter, with articles from doctors and other experts

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