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The events that result in drowning can be divided into the following sequence: (i) struggle to keep the airway clear of the water, (ii) initial submersion and breath-holding, (iii) aspiration of water, (iv) unconsciousness, (v) cardio-respiratory arrest and (vi) death – inability to revive.

The first and most important treatment of the drowning victim is the immediate provision of ventilation. Prompt initiation of rescue breathing increases the victim’s chance of survival. Rescue breathing is usually performed when the unresponsive victim is in shallow water or out of the water.

The Heimlich maneuver expels aspirated water, vomitus, debris, and other foreign matter. In treating near-drowning victims, place the victim in the supine position with head turned to the side and perform the Heimlich maneuver to evacuate water from the lungs, unless you know water is not in the respiratory tract.