Medical care
People with a near-drowning experience who have normal oxygen levels and no respiratory symptoms should be observed in a hospital environment for a period of time to ensure there are no delayed complications. The target of ventilation is to achieve 92% to 96% arterial saturation and adequate chest rise. Positive end-expiratory pressure will generally improve oxygenation. Drug administration via peripheral veins is preferred over endotracheal administration. Hypotension remaining after oxygenation may be treated by rapid crystalloid infusion. Cardiac arrest in drowning usually presents as asystole or pulseless electrical activity. Ventricular fibrillation is more likely to be associated with complications of pre-existing coronary artery disease, severe hypothermia, or the use of epinephrine or norepinephrine.While surfactant may be used, no high-quality evidence exist that looks at this practice. Extracorporeal membrane oxygenation may be used in those who cannot be oxygenated otherwise. Steroids are not recommended. Prognosis
People who have drowned who arrive at a hospital with spontaneous circulation and breathing usually recover with good outcomes. Early provision of basic and advanced life support improve the probability of a positive outcome.A longer duration of submersion is associated with a lower probability of survival and a higher probability of permanent neurological damage.Contaminants in the water can cause bronchospasm and impaired gas exchange and can cause secondary infection with delayed severe respiratory compromise.Low water temperature can cause ventricular fibrillation, but hypothermia during immersion can also slow the metabolism, allowing longer hypoxia before severe damage occurs. Hypothermia that reduces brain temperature significantly can improve the outcome.
The rescuer must bring the victim to the surface by grabbing either (or both) of the victims arms and swimming upward, which may entice the victim to travel in the same direction, thus making the task easier, especially in the case of an unconscious victim. Should the victim be located in deeper waters (or simply complicates matters too much) the rescuer should dive, take the victim from behind, and ascend vertically to the water surface holding the victim. After a successful contact with the victim, any ballast (such as weight belt) should be discarded. Finally, the victim must be taken out of the water, which is achieved by a towing maneuver. This is commonly done placing the victim body in a face-up horizontal position, passing one hand under the victims armpit to then grab the jaw with it, and towing by swimming backwards. The victims mouth and nose must be kept above the water surface. If the person is cooperative, the towing may be done in a similar fashion with the hands going under the victims armpits. Other styles of towing are possible, but all of them keeping the victims mouth and nose above the water. Unconscious people may be pulled in an easier way: pulling on a wrist or on the shirt while they are in a face-up horizontal position.