1. Ch. 26-Water Emergencies 1

2. 2

3. Vocabulary
Near-drowning- Survival, at least temporarily, of near suffocation due to submersion
Drowning- Death from suffocation due to submersion
“Wet” drowning- Drowning in which water enters the lungs
“Dry” drowning- Drowning in which little or no water enters the lungs
Secondary drowning- Death from aspiration pneumonia following resuscitation after a water accident
Active drowning- Drowning in which the victim is struggling in the water and is still breathing
Passive drowning- Drowning in which the victim is not breathing and is face-down in the water
Mammalian diving reflex- A reflex that prevents death after submersion in cold water 3

4. Ensuring Your Own Safety
You know how to swim
You have been trained in water-rescue techniques
You are not injured
You are sure you can comfortably handle the victim considering your and the victim’s height and weight
You are wearing a personal flotation device
You are accompanied by other rescuers
Make sure you have firm, solid footing and cannot slip into the water
Keep your body low, and lean backward as you pull the victim to reduce your risk of being pulled into the water.
Hold out an object for the victim to grab; the best thing to use is a rope
Once the victim has grabbed the object, pull the victim to shore 4

5. If the victim is conscious but too far away to reach:
You can try a throwing assist by throwing something that will help the victim stay afloat or reach the shore. A number of throwing devices can be used:
Ring buoy – a floatable ring made of buoyant material attached to a lightweight tow line or rope
Heaving line – a floatable, buoyant line that is usually kept coiled; the line or rope should be a bright, easily visible color (such as yellow or white)
Throw bag – a nylon bag that contains 50 to 75 feet of coiled floating line; this is a commercial device commonly found on boats, and contains a foam disk to preserve its shape and keep it from sinking
Heaving jug – a homemade device made of a gallon-sized plastic container filled with a half-inch of sand or water and tied to a floating line 5

6. Take these steps in a throwing assist:
Make sure you have firm, solid footing and that you cannot slip into the water. Assume a stride position in which the leg opposite your throwing arm is positioned forward, a stance that will help you keep your balance. Keep your feet apart and your knees bent.
Step on the end of the floatable line with your forward foot. Make sure you do not step on the coiled part of the line with your other foot.
Shout at the victim to get his or her attention, explain that you are going to throw an object, and instruct the victim to grab the object.
Aiming slightly beyond where the victim is in the water, bend your knees and throw the object using a swinging underhand motion; keep a good length of coiled rope or line in your other hand.
If the object doesn’t reach the victim, rapidly pull the line back and repeat the throw, aiming beyond where the victim is in the water. Don’t try to recoil the rope or line before you throw it a second time.
Once the victim has grabbed the object, rope or line, keep your knees bent and lean back – away from the water – as you slowly and steadily pull the victim to safety. 6

7. If you are not specially trained in water rescue:
Do not remove the victim from the water.
Keep the victim afloat on his or her back.
Always support the head and neck level with the back.
Maintain the airway and support ventilation in the water.
Wait for help. 7

8. PROGRESS CHECK
1. ____________is death from suffocation due to submersion.
(Near-drowning/Drowning/Asphyxia)
2. Victims submerged in ____________ water have the poorest prognosis. (cold/warm/deep)
3. “Dry” drowning occurs when a severe spasm of the___________ cuts off respiration, but water does not enter the lungs. (trachea/bronchioles/larynx)
4. The ____________ reflex helps victims submerged in cold water survive longer. (mammalian/Freudian/subdiaphragmatic)
5. Never go in the water unless you can swim and have been trained, and are ____________. (in good health/prepared to perform rescue breathing/ wearing a flotation device) 8

9. 26.2 First Aid Care for Near-Drowning
1. Remove the victim from the water as quickly and safely as you can.
2. If you do not suspect spinal injury, place the victim on the left side so that water, vomitus, and secretions can drain from the upper airway.
3. Assess for breathing and pulse.
4. If there is no breathing, establish an airway as rapidly as you can and begin ventilations.
5. If there is no pulse, begin chest compressions and perform CPR. Continue resuscitation until emergency personnel arrive. 9

10. PROGRESS CHECK
1. If you suspect spinal injury, stabilize the neck and spine ____________ you remove the victim from the water.
(before/after/while)
2. If you suspect spinal injury, apply a cervical collar and secure the victim to a ____________. (buoyant device/stable object/spine board)
3. ____________ can cause resistance to ventilations.
(Spasms/Swelling of the airway/Water in the airway)
4. Near-drowning victims should always be taken to the hospital; 15 percent of all drowning deaths are due to ____________. (aspiration/laryngeal spasm/secondary complications) 10

11. Diving in Shallow Water Deep-Water Diving Air Embolism
26.3 Diving Emergencies
Diving in Shallow Water
Deep-Water Diving
Air Embolism
Decompression Sickness
Barotrauma 11

12. Air Embolism & Decompression Sickness
First Aid Care
1. If there is no sign of neck or spine injury, position the victim on the left side; slant the entire body 15 degrees with the head down to force air or gas bubbles to stay in the abdomen.
2. Provide basic life support; administer ventilations and initiate CPR if needed. Life support is critical in these cases because oxygen reduces the size of nitrogen bubbles and improves circulation.
3. Monitor the victim continuously until emergency personnel arrive. The victim needs to be taken to a recompression chamber for treatment. 12

13. Vocabulary
Air embolism- A diving injury in which air bubbles enter the bloodstream
Decompression sickness- A diving injury in which gases (usually nitrogen) enter the bloodstream
Barotrauma- A diving emergency in which body cavities are subjected to extreme pressure 13

14. PROGRESS CHECK
1. Always assume that someone who dived in shallow water has sustained ____________.
(respiratory injury/abdominal injury/spinal injury)
2. A major complication of deep-water diving emergencies is ____________. (coma/head injury/spine injury) 14