c. It is very important to begin artificial ventilation immediately. The longer a
person goes without oxygen, the greater the chance of permanent neurological
damage. Artificial ventilation can be done before the person is removed from the water.
The rescuer can hold on to the side of a board or a dock and perform artificial ventilation
at the same time. If full cardiopulmonary resuscitation (CPR) is needed, begin CPR as
soon as the patient is stabilized on a long board.
AFTER REMOVING THE VICTIM FROM THE WATER
a. Determine whether the person has a pulse. If there is no pulse, initiate CPR.
NOTE: Be sure to continue artificial ventilation or CPR until the victim has either revived or
been pronounced dead by a physician. If there is no doctor at the scene,
continue resuscitation efforts until the patient has been transported to an emergency
b. Begin endotracheal intubation. This permits pressure ventilation and protects
the airway from aspiration during the vomiting that is almost inevitable in resuscitation
from near drowning.
c. Administer supplemental oxygen under positive pressure or in the highest
d. Suction as needed.
e. After an endotracheal tube is in place, you may insert a nasogastric tube to
decompress the stomach.
f. If there is no pulse, begin advanced life support measures similar to those
measures for cases of cardiopulmonary arrest.
Establish an IV lifeline.
Administer bicarbonate and epinephrine.
Monitor the heart.
Perform electric conversion of ventricular fibrillation.
Often near drowning victims develop extreme metabolic acidosis. Whether or
not the victim suffers cardiac arrest, he may need more bicarbonate than is
usually given a cardiac arrest victim.