A GP’s advice – planning for the unexpected

In our practice we have unfortunately seen too many near drownings or accidental deaths due to drowning. These are always very horrifying experiences and some prevention and knowledge/training can make the difference between life and death.

75% of pool drowning victims are between 1 to 3 years old and, at the time, the child is usually being supervised by one or both parents. 75% of the victims have been missing from sight for less than 5 minutes (for example, when answering a phone call).

CPR instructions – renew your confidence about helping in a drowning event.

Often if some basic CPR can be initiated within 5 minutes of a drowning, the outcome for the victim is significantly better as far as brain function and survival goes. Below is a combination of my CPR guidelines which is drawn from ATLS courses and CPR courses. Hopefully these can help spark the correct action in those horrifying first few minutes. I will always advocate the best is to attend a basic Life Support Class for CPR.

CPR Steps Procedure

Always remember H,H,H,1,2,3,a,b,c

H= shout “hello”, is the victim actually drowning or just face down in the water floating?

H= shout for help, always better to have more hands helping during the incident. If two people are present, one person phones Emergency Services.

H= hazards, make sure there are no hazards before pulling victim from water e.g. electrical cables.

STEP 1: Pull the victim out of the water.

STEP 2: Rescue breaths in 5 second intervals. While you are pulling the victim to land, provide a rescue breath every 5 seconds to the victim.

STEP 3: Lay victim on their back and begin CPR.

If at all possible, get two CPR savvy people involved. This is called “Two-Rescuer CPR”. Rescuer #1 will do the 2 rescue breaths and Rescuer #2 will do compressions… after 2 rounds of CPR, the rescuers switch. It makes CPR less interrupted, the rescuers less fatigued and higher success rates of CPR.

A (Airway)=FIRST! Look for gross blockage (marbles etc…) that can be pulled out or cleared from the victim mouth and/or throat.

B (Breaths)=Give two rescue breaths that last about a second each. (Watch to see the chest rise. If it does not, it means there is airway restriction or blockage. Do a finger sweep if you see blockage. Re-adjust the head so that the chin is pointing upward (for an adult), slightly upward for a child and parallel to the chest for a baby. Try rescue breaths again to see if the chest rises. If not, start chest compressions to try to force the blockage out. Keep checking to see if you can clear the blockage.)

C (Circulation/Compressions) With one hand flat, grasp your dominant hand over the top (palm down). And lace fingers.

Place grasped hands between victim’s nipples. * Begin compressions. 1 ½ – 2 inches deep for an adult, 1- 1 1/2 inches deep for a child and 1/2 – 1 inch deep for an infant.

At a rate of 100 compressions per minute. (So you want them to be less than a second apart.) After 30 compressions, stop and give 2 rescue breaths. Give rescue breaths by pinching the nose and sealing the victim’s entire mouth with yours. (For a baby, cover the baby’s nose AND mouth with your mouth).

* Resume compressions. 30 compressions, 2 rescue breaths. Continue CPR until one of the following happens:

1) A qualified person takes over CPR,

2) The scene becomes unsafe

3) You are too exhausted to continue, or

4) The victim shows obvious signs of life.

IMPORTANT:. I suggest attending a CPR course and getting certified. I have only given basic instruction on CPR so that even if you have been MEANING to go get certified in CPR, here is how to save a life in those horrifying few minutes.

Don’t forget your H,H,H,1,2,3, ABC’s ! Hello, Help, Hazard, 1,2,3, Airway (blockage?/ head tilt), Breathing (Rescue breaths), Circulation (Compressions)–in that order!

By Dr Dion O’Cuinneagain, General Practitioner and former athlete (Irish and Western Province Rugby)

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