According to the World Health Organization, drowning is the third leading cause of death from unintentional injury worldwide, accounting for 7% of all injury-related deaths.* WHO estimates that there are ≈236,000 deaths due to drowning worldwide each year. Significant efforts have focused on creating systems to prevent drowning, but an average of 4,000 fatal and 8,000 nonfatal drownings still occur annually in the United States—likely an underestimate.

On November 12th, the American Heart Association® published the 2024 American Heart Association and American Academy of Pediatrics Focused Update on Special Circumstances: Resuscitation Following Drowning This joint update details latest guidelines for resuscitation after drowning.

This focused update incorporates systematic reviews from 2021 to 2023 performed by the International Liaison Committee on Resuscitation (ILCOR) related to the resuscitation of drowning. These clinical guidelines are the product of a committee of experts representing the AHA and the American Academy of Pediatrics. The writing group reviewed the ILCOR systematic reviews, including updated literature searches, prior guidelines related to resuscitation from cardiac arrest following drowning, and other drowning-related publications from the AHA and the American Academy of Pediatrics.

Below, find the 10 take-home messages from the recommendations as it relates to resuscitation of cardiac arrest following drowning in adults and children.

10 Take-Home Messages

1. The Drowning Chain of Survival¹ focuses on the prevention of drowning, early recognition of a drowning individual, and considerations for safe rescue and resuscitation.

2. Our current recommendations support standard basic life support and advanced life support as the cornerstones of resuscitation.
3. In drowning resuscitation, airway management and ventilation are of particular importance because of the continuum from respiratory arrest to cardiac arrest following drowning.
4. Providing in-water rescue breathing, if the rescuer is appropriately trained and it is safe to do so, may prevent the progression to cardiac arrest following drowning.
5. Cardiac arrest following drowning is generally the result of severe hypoxemia; therefore, oxygen administration is recommended when available.
6. Trained rescuers should provide rescue breaths as part of cardiopulmonary resuscitation in cardiac arrest following drowning and may initiate with breathing (airway, breathing, chest compressions) or with compressions (chest compressions, airway, breathing).
7. The use of an automated external defibrillator may be lifesaving in cardiac arrests following drowning that present with shockable rhythms, which are a minority.
8. Public-access defibrillation programs may yield important benefits when instituted in aquatic environments and large public areas where cardiac arrest may be more likely even when not the result of drowning.
9. There is no preferred mode of delivering ventilation (with or without equipment) for trained rescuers in the prehospital setting.
10. Knowledge gaps in drowning prevention and resuscitation require future research, especially in resource-limited regions.

Read the entire research article published in the AHA’s Circulation, here.