This alternation is repeated until vital signs are re-established, the rescuers are unable to continue, or advanced life support is available.For babies (very small sized infants), the procedure is slightly modified. In each sequence of rescue breaths (the 5 initial breaths, and the further series of 2 breaths), the rescuers mouth covers the babys mouth and nose simultaneously (because a babys face is too small). Besides, the intercalated series of 30 chest compressions are applied by pressing with only two fingers (due to the body of the babies is more fragile) on the chest bone (approximately on the lower part). Attempts to actively expel water from the airway by abdominal thrusts, Heimlich maneuver or positioning head downwards should be avoided as there is no obstruction by solids, and they delay the start of ventilation and increase the risk of vomiting, with a significantly increased risk of death, as the aspiration of stomach contents is a common complication of resuscitation efforts.Treatment for hypothermia may also be necessary. However, in those who are unconscious, it is recommended their temperature not be increased above 34 degrees C. Because of the diving reflex, people submerged in cold water and apparently drowned may revive after a relatively long period of immersion. Rescuers retrieving a child from water significantly below body temperature should attempt resuscitation even after protracted immersion.
This cardiac arrest stops the flow of blood and thus stops the transport of oxygen to the brain. Cardiac arrest used to be the traditional point of death, but at this point, there is still a chance of recovery. The brain cannot survive long without oxygen, and the continued lack of oxygen in the blood, combined with the cardiac arrest, will lead to the deterioration of brain cells, causing first brain damage and eventually brain death from which recovery is generally considered impossible. The brain will die after approximately six minutes without oxygen at normal body temperature, but hypothermia of the central nervous system may prolong this.The extent of central nervous system injury to a large extent determines the survival and long term consequences of drowning, In the case of children, most survivors are found within 2 minutes of immersion, and most fatalities are found after 10 minutes or more. Water aspiration
If water enters the airways of a conscious person, the person will try to cough up the water or swallow it, often inhaling more water involuntarily. When water enters the larynx or trachea, both conscious and unconscious people experience laryngospasm, in which the vocal cords constrict, sealing the airway. This prevents water from entering the lungs. Because of this laryngospasm, in the initial phase of drowning, water generally enters the stomach, and very little water enters the lungs. Though laryngospasm prevents water from entering the lungs, it also interferes with breathing.