So the person should be taken out of the water as soon as possible. Rescuers should avoid endangering themselves unnecessarily and, when possible, should assist from a safe position (such as a boat or the shore). This assistance usually consists in throwing with precision a flotation instrument (as a hoop-shaped lifebuoy). In other cases, the manner to help could be by holding out an object (as a rope or pole, even the own arm. etc.) towards the person, but, doing this, the rescuer's body should be laying down, well secured to the ground, to avoid falling to the water too. In a direct swimming rescue, the initial grasp is important and must be well managed by the rescuer. If something goes wrong, it could happen that an anxious drowning person clings to the rescuer to stand out of the water, submerging the rescuer in the process. To avoid this, it is recommended that the rescuer approaches to the panicking person with a buoyant object, or offering one hand, or even from behind and bending the person's arm against the back to restrict movement. Anyway, if the person pushes the rescuer towards below the water, the rescuer can usually escape diving downwards (because people who are unable to swim tend to move up, searching the water surface). After escaping in that manner, it is possible to come back and try a new approach to the drowning person. When the rescuer accomplishes a successful approach, the negatively buoyant objects (used in diving, such the weight belt) should be removed. Next, the priority is to transport the person to the water's edge using a tow maneuver. The rescuer usually approaches to the drowning person from behind, and then the person's body is turned face up, and grasped with a secure grip. There are many grips that can be used, but it is common that they grasp the person around the jaw area. The person's mouth and nose must be kept above the water surface. If the person is cooperative, the towing may be in a similar fashion held at the armpits. Unconscious people may be pulled in another similar fashion held at the chin and cheeks, and ensuring that the mouth and nose are well kept above the water. Special care has to be taken for people with suspected spinal injuries, they can require a more specific grip, and a back board (spinal board) may be needed for their rescue. In unconscious people, an in-water resuscitation could increase the chances of survival by a factor of about three, but this procedure require both medical and swimming skills, and only the breaths of the rescue ventilation are practicable in the water.