Drowning First Aid: How to Rescue Safely, Give CPR and What to Do After a Water Emergency

Quick answer: if someone is in trouble in the water, shout for help, call 911 and try to reach or throw something that floats instead of going in yourself. Once the person is out, check for breathing. If they are not breathing normally, start CPR right away and follow the dispatcher’s instructions, giving rescue breaths if you are trained. Keep the person warm, stay until help arrives and make sure anyone who needed rescue, coughs a lot or struggles to breathe afterward gets checked by a medical professional, even if they seem to recover.

Drowning is often quiet. It does not look like the dramatic splashing and shouting seen in movies, and it can happen in seconds, in a bathtub, a backyard pool, a lake or a flooded street. Because apartment complexes, community pools, parks and nearby beaches bring families close to water, knowing the basics is part of being prepared. This guide is part of our emergency first aid guide and explains how to respond safely. It cannot replace hands-on training, so consider taking a certified CPR and water safety course.

Sources: American Red Cross water safety and first aid guidance; American Heart Association (AHA) CPR and emergency cardiovascular care guidelines on drowning resuscitation; Centers for Disease Control and Prevention (CDC) drowning prevention facts; American Academy of Pediatrics (AAP) drowning prevention recommendations. This article is general information and does not replace training or professional medical care. In an emergency, call 911 or your local emergency number.

Why Drowning Is Easy to Miss

Drowning happens when a person’s airway is covered by water and they cannot breathe. The CDC notes that drowning is a leading cause of unintentional injury death in the United States, and it is especially a risk for young children. People who are drowning often cannot call for help, because their bodies focus on getting air.

Common signs include:

• Head low in the water, with the mouth at water level
• Head tilted back with the mouth open
• Eyes glassy or closed, or unable to focus
• Hair over the forehead or eyes
• Vertical body position with little leg movement
• Gasping or hyperventilating
• Arms moving to the sides, pressing down on the water, rather than waving
• Trying to roll onto the back without making progress

A child who has gone quiet in the water needs attention immediately. If you are not sure, ask, “Are you okay?” A person who cannot answer is in trouble.

Step 1: Get Help and Stay Safe

Your safety comes first. Drowning people can panic and pull rescuers under, so do not jump in unless you are trained and equipped.

1. Shout for help so that others nearby can assist.
2. Call 911 or ask someone else to call. Put the phone on speaker so you can follow the dispatcher’s directions.
3. Reach or throw, but do not go. This is a standard water safety message: reach with a pole, branch or towel, or throw a life ring, cooler, empty jug or anything that floats.
4. Stay low and brace yourself on the shore or pool deck when reaching, so you do not get pulled in.
5. Send someone for equipment such as a life jacket, rope or pool hook.

If a lifeguard is on duty, alert them immediately and let them take over.

Step 2: Get the Person Out Carefully

Once you reach the person, pull them to safety. Support the head and neck if you suspect a diving or fall injury, but do not delay breathing help if the person is not breathing.

• Lay them on their back on a firm surface.
• Remove wet clothing only if it does not slow down CPR.
• Avoid pressing on the stomach to push out water, which can cause vomiting and choking and wastes time.

Step 3: Check Breathing

Tap the person and shout their name. Check for normal breathing for no more than 10 seconds, looking at the chest for movement. Gasping is not normal breathing.

• If the person is breathing normally, turn them onto their side in the recovery position, keep them warm and stay with them until help arrives.
• If the person is not breathing or only gasping, start CPR.

Step 4: Start CPR

Drowning is different from many cardiac arrests because the main problem is a lack of oxygen. For this reason, breaths are especially important. The AHA guidelines advise that, for people who have drowned, rescuers who are trained should give rescue breaths along with compressions. If you are untrained, or unwilling to give breaths, hands-only CPR is better than nothing, and the dispatcher can guide you. Our guide to hands-only CPR and AED basics shows the compression technique.

For adults and children

1. Open the airway by tilting the head back and lifting the chin.
2. Give two rescue breaths, each lasting about one second, enough to make the chest rise.
3. Begin chest compressions at the center of the chest, pressing hard and fast. For adults, the typical rate is 100 to 120 compressions per minute and a depth of about 2 inches (5 cm).
4. Continue cycles of 30 compressions and 2 breaths if you are trained to give breaths.
5. Use an AED as soon as one is available. Dry the chest first, because water can interfere with the pads, and follow the voice prompts.
6. Do not stop until the person starts breathing, trained help takes over or you are too exhausted to continue.

For infants

Use two fingers on the center of the chest, pressing about 1.5 inches (4 cm), and give gentle puffs of air covering both the nose and mouth. Call 911 first if someone else is with you, and follow the dispatcher’s guidance. A hands-on infant CPR class gives you practice with the right touch and technique.

Step 5: Keep the Person Warm

People pulled from water can become cold quickly, even in warm weather, which can complicate recovery.

• Replace wet clothes with dry ones or wrap the person in towels or blankets once CPR is not needed.
• Cover the head.
• Move indoors or out of the wind if you can do so safely.

Cold water emergencies carry added risks. Our article on hypothermia and frostbite explains the warning signs.

What About Vomiting?

Vomiting is common during and after resuscitation. If it happens, turn the person onto their side, clear the mouth and then resume CPR. Do not stop CPR to try to drain water from the lungs.

What to Do After a Rescue

Why medical care matters

Anyone who needed rescue, received rescue breaths or CPR, or has symptoms such as persistent coughing, trouble breathing, chest pain, vomiting, unusual sleepiness or confusion should be evaluated by a medical professional. Water in the lungs can cause breathing problems that develop over hours. Doctors sometimes use terms such as delayed respiratory symptoms to describe these. The older terms “dry drowning” and “secondary drowning” are no longer favored by medical groups, but the message stays the same: do not wait to see if it gets better if breathing is difficult.

Watch for warning signs

For several hours after a water scare, watch for:

• Coughing that will not stop
• Fast or labored breathing
• Chest pain
• Extreme tiredness or unusual behavior
• Vomiting
• Blue or gray color around lips

If any of these appear, call 911 or go to the emergency room.

Special Situations

Bathtubs and buckets

Young children can drown in just a few inches of water. Never leave a child alone in the bath, even for a moment, and empty tubs, buckets and wading pools after use. Keep bathroom doors closed and use toilet locks if your child is curious.

Apartment and community pools

Check that the pool has a fence and a self-latching gate, and that lifeguards or posted rules are followed. Learn where the safety equipment and the nearest phone are. Keep watch actively and put the phone away.

Open water

Lakes, rivers and oceans can have currents, cold water and uneven bottoms. Swim in designated areas, use life jackets for children and weak swimmers and never swim alone. If you are caught in a rip current, the usual advice is to swim parallel to the shore until you are out of the current, then angle back toward land.

Floods

Moving floodwater can sweep away people and vehicles in seconds. Never walk or drive through it. Our guide to flood safety explains how to prepare.

Ice

If someone falls through ice, call 911, and use a rope, ladder or long pole to reach them from a safe position. Do not walk onto the ice yourself.

Suspected spinal injury

A neck or back injury is more likely after diving into shallow water or a fall. If you suspect it, keep the head, neck and back in line as much as possible when moving the person. If they are not breathing, however, getting oxygen to the brain takes priority over concerns about the spine.

How to Place Someone in the Recovery Position

When the person is breathing normally but is not fully alert, the recovery position helps keep the airway open and lets fluid drain from the mouth.

1. Kneel beside the person, who should be lying on their back.
2. Place the arm nearest you at a right angle to their body, with the palm up.
3. Bring the far arm across the chest and hold the back of that hand against the cheek nearest you.
4. Bend the far knee up, with the foot flat on the ground.
5. Gently roll the person toward you, so that they end up on their side with the top knee supporting the body.
6. Tilt the head back slightly to keep the airway open and check breathing regularly until help arrives.

Should the person stop breathing, or should you feel unsure, roll them onto their back and begin CPR.

Water Safety by Age

• Infants and toddlers: stay within arm’s reach at all times near any water, including bathtubs, pet bowls and buckets. Drowning is silent, so a quick phone check is not safe.
• Preschoolers: introduce water play with close adult supervision, and teach them never to go near a pool or pond without a grown-up.
• School-age children: enroll them in swim lessons, teach rules about running, diving and swimming alone and keep an eye on them even when lifeguards are present.
• Teenagers: talk about the risks of dares, swimming after drinking or in unfamiliar water and the need to wear a life jacket on boats.
• Adults: know your own limits, take a CPR course and swim with a partner.

Prevention Tips

• Supervise actively: assign an adult “water watcher” with no distractions.
• Teach swimming: the AAP recommends swim lessons for most children starting at age 1 and older, depending on readiness, with continued supervision.
• Use life jackets: choose Coast Guard approved jackets for boating and open water.
• Install barriers: fences, gates and pool covers help protect young children.
• Learn CPR: a certified course builds skills and confidence.
• Avoid alcohol around water: it can affect judgment and coordination.
• Know your limits: be honest about your own and your children’s swimming ability.

Gear to Keep Handy

• A life ring or a floating cushion near the pool area, if you are in charge of one
• A reaching pole or a rope with a float
• A phone in a waterproof bag
• A towel and blanket
• A simple first aid kit for scrapes and bumps. Our guide to a first aid kit for a small apartment lists the basics.
• A card with emergency numbers and your address, which helps a babysitter or guest

Practice Makes You Faster

Plan a short family discussion about water safety. Practice the rule of reaching or throwing, rehearse calling 911 and giving an address and take a CPR class. Learning together makes it easier to act in a real emergency.

Frequently Asked Questions

What should I do first if someone is drowning?

Call 911, shout for help and reach or throw a floating object to the person. Do not jump in unless you are trained, because panicked swimmers can pull rescuers under.

Do I start with breaths or compressions for a drowning victim?

Trained rescuers should give rescue breaths along with compressions because drowning causes oxygen loss. If you are untrained, hands-only CPR is still helpful, and the 911 dispatcher can guide you.

Should I push on the stomach to get water out?

No. Pressing on the stomach can cause vomiting and delay CPR. Focus on breathing and compressions.

Does someone who seems fine after a rescue need a doctor?

Yes, if they needed rescue or have coughing, trouble breathing, chest pain, vomiting or unusual sleepiness. Breathing problems can develop after the incident.

How little water can a child drown in?

A child can drown in a few inches of water. Never leave young children alone near a bathtub, bucket or pool.