Drowning. True (wet) drowning

There are three types of drowning. Drowning can be primary wet, dry and secondary. In addition to drowning, sometimes there is death in the water, caused by various injuries, heart disease, brain disorders, and so on.

Drowning is possible under a variety of circumstances:

1. From an injury received in the water.
2. With sudden cardiac arrest.
3. In case of violation cerebral circulation.
4. Spasm of the larynx and impossibility of inhalation and exhalation:
- out of fear;
- sharp when suddenly hit in very cold water.

Types of drowning.

Primary (true) drowning.

This is the most common type of drowning. A drowning person does not immediately plunge into the water, but tries to stay on the surface; in a panic, he begins to make feverish and erratic movements with his arms and legs. It is the most common type of accident on the water.

With it, the liquid enters the respiratory tract and lungs, and then enters the bloodstream. When inhaling, a drowning person swallows a large amount of water, which overflows the stomach, while falling into the lungs. The person loses consciousness and sinks to the bottom. Oxygen starvation - hypoxia - gives the skin a bluish color, so this type of drowning is also called "blue".

When victims drown in fresh water, blood is quickly diluted with water, the total volume of circulating blood increases, red blood cells are destroyed, and the balance of salts in the body is disturbed. As a result, the oxygen content in the blood drops sharply. After rescuing a drowning person and giving him first aid, the phenomena of pulmonary edema are often noted, in which bloody foam comes out of the mouth.

drowning in sea water in terms of effects on the body of the victim, it is very different from drowning in fresh water. Sea water has a higher salt concentration than human blood plasma. As a result of the ingress of sea water into the human body, the amount of salts in the blood increases and its thickening develops. With true drowning in sea water, pulmonary edema quickly develops, and white “fluffy” foam is released from the mouth.

"Dry" drowning.

Also occurs quite often. With this type of drowning, a reflex spasm of the glottis occurs. Water does not enter the lower respiratory tract, but suffocation occurs. This usually occurs in children and women, and also when the victim enters dirty or chlorinated water. With such drowning, water in large quantities enters the stomach.

Secondary or "pale" drowning.

Occurs due to cardiac arrest when the victim falls into cold water, which is called ice. This is based on the reflex reaction of the body to the ingress of water into the windpipe or ear when there is damage to the eardrum. Secondary drowning is characterized by a pronounced spasm of peripheral blood vessels. Pulmonary edema usually does not develop. Such drownings occur when a person does not try or cannot fight for his life and sinks quickly.

This often happens during shipwrecks at sea, capsizing boats, rafts, when a person plunges into the water in a state of panic fear. If the water is also cold, then this can lead to irritation of the pharynx and larynx, which in turn often leads to sudden cardiac and respiratory arrest. This type of drowning can also occur if a person in the water has a head injury or has already entered the water with it. In this case, there is a rapid loss of consciousness. The skin is characterized by increased pallor, hence the name of the type.

Rescue of the drowning.

When rescuing a drowning person, do not grab him by the hair or head. The most reliable and safest way is to grab it under the armpits, turn it back to you and swim to the shore, trying to keep the victim's head above the water.

The condition of victims of drowning.

It is associated with the duration of being under water, with the type of drowning and the degree of cooling of the body. In mild cases, consciousness is preserved, but excitation, trembling, repeated vomiting are noted. With a long stay in the water, with a true or "dry" drowning, consciousness is impaired or absent altogether, the victims are very excited, there may be convulsions, and the skin is bluish. With secondary drowning, marked pallor of the skin is noted, the pupils are dilated. The victims have wheezing rapid breathing.

When drowning in sea water, pulmonary edema quickly develops, and the heartbeat quickens. When drowning is prolonged and secondary, the victim can be removed from the water in a state of clinical or biological death. True drowning in fresh water can be complicated by impaired kidney function in the form of blood in the urine. During the first day, pneumonia may occur. With a pronounced breakdown of red blood cells in the body, acute renal failure develops.

Urgent care when drowning.

Regardless of the type of drowning, help must be provided immediately, otherwise irreversible changes in the brain occur. With true drowning, this occurs within 4-5 minutes, in other cases after 10-12 minutes. First aid on the shore will be different for blue and pale drowning. In the first case, it is necessary first of all to quickly remove water from the respiratory tract. To do this, standing on one knee, lay the victim on a bent second leg so that the lower part of the chest rests on it, and the upper part of the body and head hang down.

After that, you need to open the victim's mouth with one hand, and with the other, pat him on the back or gently press on the ribs from the back. Repeat these steps until the rapid outflow of water stops. Then perform artificial respiration and closed heart massage. With a pale type of drowning, artificial respiration is immediately necessary, and in case of cardiac arrest, a closed massage. Sometimes in respiratory tract drowned, there are large foreign bodies that get stuck in the larynx, as a result of which the airways become impassable or a persistent spasm of the glottis develops. In this case, a tracheostomy is performed.

With any type of drowning, it is absolutely impossible to turn the head of the victim, as this can cause additional injury with a possible fracture of the spine. To prevent the head from moving, place rolls of tightly rolled clothing on both sides of it, and if necessary, turn the victim over, while one of the assisters should support the head, preventing it from moving on its own.

Resuscitation, in particular artificial respiration, must be continued even if the victim has spontaneous breathing, but there are signs of pulmonary edema. Artificial respiration is also carried out when the victim has a respiratory disorder (i.e., its frequency is more than 40 per 1 minute, irregular breathing and a sharp blue of the skin). If breathing is preserved, then the patient should be allowed to breathe in vapors of ammonia. If the rescue of the victim was successful, but he has a chill, rub the skin, wrap him in warm, dry blankets. You can not use heating pads in the absence or violation of consciousness.

In severe types of drowning, the victim must be taken to the intensive care unit. During transportation, artificial ventilation of the lungs should be continued. Doctor "ambulance" medical care"or the intensive care unit of the hospital in case of impaired breathing and pulmonary edema in the victim, the breathing tube is inserted into the trachea and connected to a device or artificial lung ventilation apparatus.

Beforehand, a probe is inserted into the stomach of the victim. This will prevent stomach contents from entering the respiratory tract. The patient should be transported in the supine position, with the headrest of the stretcher lowered. It is dangerous to prematurely stop artificial ventilation of the lungs. Even if a person has independent respiratory movements, this does not mean the restoration of normal breathing, especially with pulmonary edema.

When drowning in fresh water, the victim in hospital conditions with a sharp blue, swollen neck veins sometimes produce bloodletting. With a pronounced breakdown of erythrocytes, a solution of sodium bicarbonate, erythrocyte mass, and blood plasma are transfused intravenously. To reduce swelling, diuretics, such as furosemide, are administered. A decrease in the level of protein in the body is an indication for the transfusion of concentrated albumin.

With the development of pulmonary edema against the background of arterial hypertension, a 2.5% solution of benzohexonium or a 5% solution of pentamine, glucose solutions are administered intravenously. Apply large doses of hormones: hydrocortisone or prednisolone. Antibiotics are prescribed to prevent pneumonia. To calm down with motor excitation, 20% solutions of sodium hydroxybutyrate, 0.005% fentanyl solution or 0.25% droperidol solution are administered intravenously.

Based on the book "Quick help in emergency situations."
Kashin S.P.

I would like to review the basics first aid for drowning, especially if you are engaged in water tourism, fishing from a boat, or just surviving near a river or sea).

Causes of death by drowning are usually fluid inhalation, hypoxia, pulmonary edema, cardiac arrest cold water, spasm of the glottis.

There are several types of drowning:

True, or wet, blue (primary)
Asphyxic, pale (dry)
Syncope drowning
secondary drowning

First aid for true drowning

The cause of true drowning is the ingress of fluid into the lungs, which happens in more than 70% of drowning cases, due to a long struggle for life with periodic immersion in water and swallowing of water. Often this happens in people who cannot swim.

The initial period of true drowning is characterized by the fact that the drowning person is conscious, while the majority behave inappropriately, which poses a great danger to the rescuer, since drowning people in this state are able to drown the rescuer, especially if he is not a professional rescuer. The face and neck of a drowning person have a characteristic blue color, which is why this type of drowning is also called blue. A pinkish foam, which is the liquid part of the blood (plasma), can be released from the nose and mouth, which enters the glottis and foams, stopping gas exchange in the lungs, which causes pulmonary edema. Rapid breathing is accompanied severe coughs and vomiting. After some time, the symptoms of true drowning of the initial period quickly disappear.

First aid for the initial period of true drowning: put the victim to rest, warm, and prevent choking when vomiting.

The aginal period of drowning is characterized by the absence of consciousness, but by the presence of a weak pulse and weak breathing. The pulse can only be felt on the carotid arteries. Pinkish foam may come out of the mouth and nose.

First aid for the agonal period of initial drowning:
Ensure airway patency as soon as possible.
Artificial respiration mouth to mouth, if necessary even in water.
Maintain proper circulation by elevating the legs or reclining.
With a loss of pulse, do a closed heart massage.

With aginal drowning, it is necessary to begin ventilation of the lungs with breathing apparatus as soon as possible to increase the concentration of oxygen in the body. It is also necessary to remove fluid from the stomach, for which the victim must be tilted over the knee of the bent leg, pat on the back between the shoulder blades and release the contents of the stomach.

The clinical period is similar to the aginal period, except for the absence of pulse and respiration. The patient's pupils are dilated and do not respond to light.

First aid for the clinical period of true drowning:
Early start cardiopulmonary resuscitation
Exhalations into the nose can be done immediately, as soon as the face of the drowning person is removed from the water.
Breathing from mouth to nose
Closed heart massage
Mandatory hospitalization.

In general, as soon as you have removed the victim from the water, without losing valuable seconds to feel the pulse and examine the pupils, put the victim so that the head is lower than the pelvis and insert two fingers into the mouth and try to remove the contents of the mouth, then press on the root of the tongue to eliciting a gag reflex. If this is followed by vomiting movements, then it is necessary to remove the liquid from the lungs and stomach as soon as possible, for which, for 5-10 minutes, press on the root of the tongue, and pat on the back with the palm of your hand between the shoulder blades. You can intensively press on the chest from the sides a couple of times during exhalation, for better water discharge. After removing water from the body, drown the victim on his side

If, after pressing on the root of the tongue, vomiting and coughing movements do not occur, then it is necessary to immediately shift the victim onto his back and begin cardiopulmonary resuscitation by performing artificial ventilation and indirect heart massage. That is, the first thing is not to remove water, but to reanimate respiratory and cardiac activity. But at the same time, every 3-4 minutes it is necessary to turn the victim on his stomach to partially remove water from the respiratory tract.

This assistance should be carried out within 30-40 minutes, even if there are no signs of effectiveness.

After revival, the appearance of a pulse and breathing, a number of first aid measures for drowning will have to be carried out. The first step is to turn the victim on his stomach again. Further measures should be provided by physicians.

The main causes of death in true drowning are pulmonary edema, cerebral hypoxia, cardiac arrest and renal failure, which manifests itself during the next day.

Pulmonary edema is characterized by bubbling breathing, as if water is gurgling and boiling inside the victim, coughing with pinkish foam. Pulmonary edema is very dangerous and should be treated by doctors, but to help the victim in this case, it is necessary to seat the victim or raise his head, put tourniquets on his hips to drive blood to lower limbs and the pelvis, and to establish the inhalation of oxygen from the oxygen bag through alcohol vapor. To do this, it is enough to put a piece of cotton soaked in alcohol in the mask at the level of the lower lip, which will prevent foaming in the lungs, which occurs with pulmonary edema. Only these manipulations can make a significant contribution to saving the victim with pulmonary edema. The tourniquets must be applied for no more than 40 minutes, removed alternately every 15-20 minutes.

If there is a chance for salvation and it is possible to call an ambulance or rescue service, then it is better to do this than to try to transport the victim on random transport, because, on the way, worsening of the condition, cardiac arrest or something like that can happen again. Only in the case when this is not possible, it is necessary to decide on independent transportation, preferably on a large vehicle, so that the victim can be laid on the floor.

First aid for asphyxic drowning

Asphyctic drowning occurs in 10-30% of cases when the victim cannot resist drowning, for example, intoxicated, with a strong blow to the water. Due to the irritating effect of, for example, ice water, a spasm of the glottis occurs, and water does not enter the lungs and stomach. Death occurs due to the same spasm of the glottis, i.e. due to hypoxia. Therefore, asphyxic drowning is called dry.

First aid for asphyxic drowning. Since water has not entered the respiratory tract, cardiopulmonary resuscitation should be started immediately. Some experts believe that with asphyxial drowning in ice water with the onset of clinical death, there are more chances of salvation than with drowning in warm water. This fact is explained by the fact that in the lake water, the body is in a state of severe hypothermia, including the brain, as a result of which metabolism (metabolism) almost stops, due to which the time reserve for rescue increases, with, of course, timely and correctly rendered assistance on the shore.

That is, with asphyxic drowning, in the absence of a pulse and respiration, in ice water, one cannot hesitate for a second, but immediately proceed with resuscitation of the pulse and respiration. Also, with successful resuscitation of the victim, further complications are usually less. After resuscitation, it is necessary to move or, if possible, warm the victim.

First aid for syncopal drowning

Syncopal drowning is characterized by primary cardiac and respiratory arrest, and the onset of clinical death, as a result of, for example, a sharp temperature drop caused by an unexpected dive. The period of clinical death with such drowning is somewhat higher than with other types of drowning, especially in ice water due to deep hypothermia. The main external difference syncopal drowning, is the external pale appearance and the absence of fluid from the respiratory tract.

Conclusion: it is necessary to understand the causes of death in various types of drowning, not to panic, and to provide resuscitation, even if there is no improvement, for at least 40 minutes.

Table of contents of the topic "Acute Respiratory Failure (ARF) with Obstruction of the Airways. Foreign Bodies of the Upper Respiratory Tracts. Thromboembolism pulmonary artery(TELA).":
1. Acute respiratory failure (ARF) with airway obstruction. Laryngospasm. Causes (etiology), pathogenesis of laryngospasm. Emergency care for laryngospasm.
2. Bronchiospasm (bronchial asthma). Causes (etiology), pathogenesis of bronchiolospasm. Emergency care for bronchiolospasm (bronchial asthma).
3. Asthmatic condition. Asthmatic status. Causes (etiology), pathogenesis of status asthmaticus. Stages of status asthmaticus.
4. Principles of treatment of status asthmaticus. Treatment of status asthmaticus stage 1.
5. Treatment of asthmatic status 3 (third) stage. Signs of relief of status asthmaticus. hospitalization issues.
6. Foreign body. Foreign bodies in the upper respiratory tract. Emergency care for foreign bodies.
7. Drowning. True (wet) drowning. Asphyxic (dry) drowning. Syncope type of drowning (death in water). Emergency aid for drowning.
8. Thromboembolism of the pulmonary artery (TELA). Etiology (causes) of thromboembolism. Pathogenesis of pulmonary embolism (PE).
9. Anatomical variants of pulmonary embolism (PE) by localization. Clinical forms of PE. Clinic of pulmonary embolism (TELA).
10. ECG (ecg, electrocardiogram) of pulmonary embolism (PE). X-ray data of TELA. Principles of intensive care for pulmonary embolism (PE). Urgent care. Drowning. True (wet) drowning. Asphyxic (dry) drowning. Syncope type of drowning (death in water). Emergency aid for drowning.

Drowning- an acute pathological condition that develops during accidental or deliberate immersion in a liquid, with the subsequent development of signs of ARF and AHF, the cause of which is the ingress of liquid into the respiratory tract.

Distinguish 3 types of drowning in water:
1. True (wet).
2. Asphyxia (dry).
3. Death in water (syncope type of drowning).

Etiology. True drowning. It is based on the ingress of water into the alveoli. Depending on the water in which drowning occurred (fresh or sea), there will be a different pathogenesis. Fresh water, due to the difference in the osmotic gradient with blood, quickly leaves the alveoli and enters the vascular bed (see Fig. 10a). This leads to an increase in BCC and hemodilution, pulmonary edema, hemolysis of erythrocytes, a decrease in the concentration of sodium, chloride and calcium ions in plasma, as well as plasma proteins. When drowning in sea water, as a result of the difference in the osmotic gradient between blood and sea water, and here there is a clear predominance of the sea water gradient over blood, part of the plasma leaves the vascular bed. In this regard, the mass of circulating blood decreases (up to 45 ml / kg), the hematocrit increases (V. A. Negovsky, 1977).

Rice. ten. The pathogenesis of drowning in fresh (a) and sea (b) water.

Asphyxial drowning occurs without aspiration of water. The basis of this pathology is reflex laryngospasm. The glottis does not allow water to pass through, but it also does not allow air to pass through. Death occurs from mechanical asphyxia.

Syncope type of drowning (death in water) occurs as a result of reflex cardiac arrest and respiration. The most common variant of this type of drowning occurs when the victim is suddenly immersed in cold water.

Clinic. At true drowning distinguish 3 periods: initial, agonal and clinical death. The state of consciousness depends on the period of drowning and its type. Respiratory failure is possible from noisy to atonal. There is cyanosis, chills, goose bumps. When drowning in fresh water, there is a clinic of pulmonary edema, arterial and venous hypertension, tachycardia, arrhythmia. From the upper respiratory tract, foam, sometimes with a pink tinge, may be released as a result of hemolysis of red blood cells. When drowning in sea water, arterial hypotension and bradycardia are more characteristic.

Urgent care. Regardless of the water in which drowning occurred, when breathing and cardiac activity stop, the victim must carry out a complex resuscitation. Before performing artificial respiration, the upper respiratory tract (URT) should be freed from water and foreign bodies (river sand, algae, silt, etc.). The best way to release the upper respiratory tract, especially in children, is to lift the victim by the legs. If it is impossible to perform this manual, it is recommended to lay the victim on the bent knee of the person providing resuscitation, and wait for the fluid to flow out of the upper respiratory tract (see Fig. 11). This procedure should take no more than 5-10 seconds, after which it is necessary to proceed to resuscitation.

Treatment in a hospital setting is syndromic in nature and consists of the following areas:
1. Carrying out a complex of resuscitation measures and transferring the patient to mechanical ventilation (according to indications).
2. Sanitation of the tracheobronchial tree, therapy of bronchiolospasm, pulmonary edema.
3. Cupping OSSN.
4. Correction of acid-base balance and electrolytes.
5. Prevention of pneumonia and kidney failure.

First aid video for drowning patient

Drowning first aid scheme

C23.550.260.393 C23.550.260.393

drowning mechanism

When drowning in fresh water, blood thins. This is due to the flow of water from the lungs into bloodstream. Occurs due to the difference in osmotic pressure of fresh water and blood plasma. Due to blood thinning and a sharp increase in blood volume in the body, cardiac arrest occurs (the heart is not able to pump such a huge volume). Another consequence of blood thinning that can cause complications and death is hemolysis, which occurs due to the difference in osmotic pressures of the blood plasma and the cytoplasm of red blood cells, their swelling and rupture. As a result, anemia, hyperkalemia develops, and a large number of cell membranes, cell contents and hemoglobin enter the bloodstream at a time, which, being excreted through the kidneys, can lead to acute renal failure.

When drowning in salt water, the exact opposite process occurs - blood clotting (hemoconcentration).

The usual mechanism for drowning is as follows: a non-swimmer who has fallen into the water takes deep breaths while fighting for his life. As a result, a certain amount of water enters the lungs and loss of consciousness occurs. Since the human body is completely immersed in water and respiratory movements continue, the lungs are gradually completely filled with water. At this time, spasms of the muscles of the body can occur. After a while, cardiac arrest occurs. A few minutes later, irreversible changes in the cerebral cortex begin. With an active struggle for its life, the body needs more oxygen, thus. hypoxia intensifies and death occurs in a shorter time.

When drowning in cold water, especially in children with low body weight and high regenerative capacity of the body, it is sometimes possible to fully or partially restore brain functions after 20-30 minutes after drowning.

Causes of drowning

Drowning occurs for various reasons. Often people drown, neglecting elementary precautions (do not swim behind the buoys, do not swim while intoxicated, do not swim in questionable reservoirs, do not swim in a storm). When drowning, the fear factor plays a big role.

So, often those who cannot swim, who accidentally find themselves in the water at great depths, begin to row their arms and legs chaotically, shouting “Save me, I'm drowning!”. Thus, they release air from the lungs and inevitably sink into the water.

Drowning can also occur among diving enthusiasts. Sometimes it is even more dangerous than simple drowning, especially if you dive alone. Often the drowning of scuba divers is accompanied by the so-called "caisson disease".

Forensic-medical examination

Forensic medical diagnosis of drowning, as well as other causes of death, is carried out on the basis of establishing a set of signs detected both during a sectional study and with the help of additional methods research and depending on the type of drowning. The true ("pale", "wet") type of drowning is characterized by the presence of persistent whitish finely bubbling foam at the openings of the mouth and nose, acute swelling of the lungs, hemorrhages under the pulmonary pleura, detection of a fluid from the drowning environment in the sinus of the sphenoid bone, diatom plankton in the internal organs and bone marrow and some other signs.

In the pathogenesis of asphyxic (“blue”, “dry”) type of drowning, the leading link is an acute disorder of external respiration, and therefore, when examining a corpse, diffuse, saturated cadaveric spots of cyanotic-violet color, cyanosis and puffiness of the face and neck, hemorrhages in the conjunctiva are noted , pronounced swelling of the lungs with a significant increase in their volume and airiness.

The reflex type of drowning is characterized by signs of a rapidly occurring death, the most pronounced of which are diffuse, saturated bluish-violet cadaveric spots, a liquid state of blood in the cavities of the heart and large vessels in the absence of signs of other types of drowning.

In addition to signs that directly or indirectly indicate drowning, there are signs of a corpse being in water: pallor of the skin, the so-called. "goosebumps", wrinkling of the skin of the scrotum and in the nipple area, maceration of the skin (the time and degree of which depend on many factors - water temperature, age of the victim, etc.). The final signs of maceration are the spontaneous separation of the epidermis of the hands along with the nails (the so-called "gloves of death"). This can make it difficult to identify the corpse. On the feet, the skin of only the plantar surfaces exfoliates. In the process of putrefactive changes in the corpse, hair is separated. Under the influence of water, the hair loses its connection with the skin. Wet clothing, skin and hair of the corpse, the presence of sand, silt, algae on them also indicate the presence of the corpse in the water.

Often death in water occurs not from drowning, but from various diseases(sudden death in the water), injuries, etc. The corpse or parts of it can be thrown into the water in order to cover up the murder. It is very difficult to establish the true cause of death, especially when the body has been in water for a long time, and in some cases it is impossible. It should be noted that the forensic expert establishes, in particular, the cause of death (for example, mechanical asphyxia as a result of closing the airways with water during drowning). Establishing the type of violent death (murder, suicide, accident) is not within the competence of a forensic medical expert; law enforcement officers are engaged in resolving this issue, taking into account, among other things, the data of a forensic medical examination.

Rescue of the drowning

You can save a drowning person in the first 3-6 minutes from the start of drowning. However, when drowning in very cold water, in some cases this period reaches 20-30 minutes.

In the practice of forensic medicine, cases have been recorded when a drowned person was successfully resuscitated after 20-30 minutes of being in the water, while the water could be relatively warm, both fresh and salty, and the lungs were filled with water.

It is advisable to swim up to a drowning person from behind. After that, it is necessary to turn it over on its back so that its face is on the surface of the water and quickly transport it to the shore. It should be remembered that a drowning person has developed the so-called "self-preservation instinct" and he can cling to his rescuer and pull him to the bottom. If this happens, then in no case should you panic. You need to take a deep breath and dive into the depths. The drowning man will lose his footing and open his arms.

First aid is to remove the victim from the water. Then it is necessary to determine the pulse and the type of drowning. Wet drowning is characterized by a bluish appearance of the face and skin.

With wet drowning, it is necessary to remove water from the victim's respiratory tract. To do this, he is placed on a bent knee and patted on the back. Then, in the absence of a pulse, immediately begin chest compressions and artificial respiration.

In the case of dry or syncopal drowning, resuscitation should be started immediately.

If a person managed to be pulled out of the water very quickly and he did not have time to lose consciousness, then you still need to call ambulance, as even in this case there is a risk of complications.

Attention! Each victim must be shown to the doctor, even in case of excellent health after resuscitation! There is a risk of pulmonary edema and other serious consequences (for example, repeated cardiac arrest). Only in one week will it be possible to say with certainty that his life is out of danger!

The proverb “The salvation of the drowning is the work of the drowning themselves” is not without meaning. In a critical situation, the most important thing is not to get confused. When you get into the water, you need to soberly assess the situation, calm down and swim to the shore. If after a while severe fatigue appears - relax, lie on your back and, breathing calmly, rest. When you get into a whirlpool, you need to dive and try to swim to the side at a depth (the speed of the current at depth is always less). If you can see that a big wave is coming towards you, it is highly advisable to dive in order to avoid being hit.

Notes

Rules for transporting a drowning person:

It is desirable to transport a drowning person to the shore or a watercraft by the efforts of two people using rescue equipment (life buoy or any object with good buoyancy).
If a drowning person is actively moving in the water, rescuers should be careful, as the victim can reflexively harm those who come to the rescue.
A drowning person is grabbed by the armpits from behind, turned face up and in this position is transported to the shore.
If the victim grabbed the rescuer and interferes with movement, it is necessary to take in air and dive under the water. A drowning man, having lost his support, will loosen his grip.
The sooner you manage to deliver the victim to the shore, the higher the chances of salvation.

Signs of drowning

signs initial stage drowning:

victims retain consciousness, but are not always able to adequately respond to what is happening;
excited, can break out, run away, refuse medical care, then there may be a phase of inhibition, apathy, lethargy up to a violation of consciousness;
in the first minutes, breathing and heartbeat are quickened, then they slow down;
chills are observed;
the stomach is swollen, vomiting of water and gastric contents often develops, coughing;
bluish skin.

Signs of drowning gradually disappear, but residual effects may persist for several days: weakness, apathy, headaches.

Agony stage:

the victim is unconscious;
breathing and heartbeat are weak, arrhythmic;
cyanotic skin, cold;
pink foam may be released from the respiratory tract.

The stage of initial drowning and agony are significantly expressed only with true drowning, but the efficiency of resuscitation in this case is higher. With other types of drowning, clinical death develops very quickly.

Stage of clinical death:

there is no consciousness, breathing and heartbeat;
the pupil does not react to light;
no gag reflex.

Why is drowning dangerous?

As a result of drowning, severe pathological changes develop in the body. In the stage of agony and clinical death, the chances of saving the victim are very small. However, there are cases of the return to life of the drowned after tens of minutes spent in the water. They play a big role here individual characteristics person, circumstances of the accident and water temperature.

Even after a successful rescue, the victim must be urgently taken to medical institution, as the effects of drowning may appear after some time.

First aid for drowning

As soon as the victim was on the shore or on board the watercraft, proceed to provide assistance. Regardless of the severity of the victim's condition, an ambulance must be called.
If you managed to get a person out of the water in consciousness, first aid is to most effectively remove water from the respiratory tract and stomach, calm and warm the victim. To do this, the rescuer helps the person roll over on his stomach, bends him over his thigh, taps on his back, helping to clear his throat. A person is freed from wet clothes, wiped dry, wrapped up. They give him a warm drink and send him to the hospital as soon as possible.
If the drowning person is unconscious, do not waste time determining the stage and type of drowning, calculating the time spent under water. The effectiveness of rescue measures largely depends on the speed of your actions. First aid in this case is provided according to a single algorithm:

Quickly turn the person on their stomach, face down, with your own hip or knee under the stomach. With your free hand, try to open the victim's mouth and press your fingers on the root of the tongue. So with one action you achieve three effects at once:

promote the release of the respiratory tract from water, sand and other foreign objects;
stimulate the respiratory center;
evaluate the condition of the survivor.

In the first case, a large amount of water is poured out of the mouth, a gag reflex occurs, coughing and respiratory movements, the person regains consciousness.
In the second case, no water comes from the respiratory tract, there is no gag reflex. Without wasting a second, turn the victim on his back and start artificial respiration.
If there is no heartbeat, alternate artificial respiration with chest compressions.
Signs of revival will be pinking of the skin, the appearance of a cough reflex, attempts to breathe independently, pulse and movements.

What can't be done?

Start resuscitation without making sure that there is no water in the airways. If the lungs are filled with water, artificial respiration will be ineffective.
Wasting time trying to bring you to your senses with loud shouts, punches in the face, and so on.
Keep the victim warm with alcohol.
Leave the rescued unattended after regaining consciousness. The state of a person after drowning is very unstable. It is necessary to constantly monitor the pulse and breathing.
Neglect medical assistance and supervision even with a successful rescue and satisfactory well-being of the victim.

Nota Bene!

You should never lose hope for salvation, even if a person spent in the water long time and shows no signs of life. By properly performing heart massage and artificial respiration, you maintain the vitality of the central nervous system and other organs of the victim. There are cases of successful rescue of people who were under water for up to 30-40 minutes. Especially high is the probability of salvation in cold water, which provides a slowdown in metabolism, a kind of preservation of the body.

Created from:

Vertkin A. L., Bagnenko S. F. Guide to emergency medical care. - M.: GEOTAR-Media, 2007.
Kostrub A. A. medical reference book tourist. - M.: Profizdat, 1990. 2nd edition, revised and supplemented.
Guide to Primary Health Care. - M.: GEOTAR-Media, 2006.
Handbook of the paramedic / ed. prof. A. N. Shabanova. - M.: Medicine, 1976.
Schwartz L. S. Reference book of emergency and emergency care physician. - Saratov, 1968.

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