Drowning and near-drowning

How to manage drowning and near-drowning casualties, prioritising rescue breaths, CPR and post-incident monitoring.

What is drowning?

Drowning occurs when a person experiences respiratory impairment from submersion or immersion in liquid, leading to hypoxia, loss of consciousness and cardiac arrest if not reversed. Near-drowning refers to survival after such an incident, but complications like lung injury, infection and secondary drowning can still occur.

First aid priorities are safe rescue, opening the airway, giving effective rescue breaths and chest compressions as needed, and ensuring all casualties who have inhaled water receive medical assessment even if they seem to recover fully at the scene. Cooling and hypothermia are common in water-related incidents and must also be addressed.

Drowning is a leading cause of accidental death worldwide, and in the UK many incidents occur in open water, baths and pools, often involving alcohol, children or people with underlying conditions.

Who needs this skill?

Any environment with water - pools, spas, rivers, lakes, coastal areas and baths - needs staff and bystanders who understand drowning first aid and the importance of safe self-preservation.

Health & Social Care

In health and social care, risks include baths and showers for people with seizures, dementia or mobility problems; staff should follow water-safety policies, never leave high-risk individuals unsupervised and be prepared to rescue and resuscitate in confined wet spaces.

Licensed venues & nightlife

In nightlife and licensed venues, intoxicated patrons near rivers, canals or hotel pools are at significant risk; door and bar staff should be trained to recognise and respond to water incidents, coordinate emergency services and avoid unsafe rescues that put staff at risk.

Schools

Schools using swimming pools, water sports or sites near open water must plan for immersion incidents and ensure staff supervising water activities have appropriate lifesaving and resuscitation skills.

Workplaces

In workplaces, risks range from construction near water and docks to leisure centres and hotel pools; employers must provide lifeguards or trained staff where appropriate and ensure first aiders are confident with water-related CPR and hypothermia management.

How to manage drowning

These steps explain how to respond to drowning and near-drowning, focusing on safe rescue, rescue breaths, CPR and monitoring.

1

Ensure your own safety and call for help

Before attempting a rescue, assess hazards such as currents, depth, cold and access; use reach or throw techniques if possible rather than entering the water yourself, and call 999 early, requesting appropriate water rescue services.

Entering the water should be a last resort; a rescuer in trouble creates a second casualty and complicates response.

2

Remove the casualty from the water when safe and open the airway

Once it is safe, remove or support the casualty in a position where you can open the airway with head tilt-chin lift or jaw thrust as appropriate, and quickly assess breathing.

If the casualty is not breathing normally, start rescue breaths and chest compressions immediately according to drowning guidelines.

3

Prioritise rescue breaths and effective CPR

In drowning-related cardiac arrest, rescue breaths are particularly important because the primary problem is hypoxia; give 5 initial rescue breaths followed by cycles of 30 compressions and 2 breaths.

Continue CPR until the casualty starts breathing normally, you are exhausted or handed over to emergency services.

4

Manage hypothermia and monitor breathing

After ROSC or in responsive casualties who have inhaled water, remove wet clothing if possible, dry and insulate them and monitor breathing and level of consciousness closely.

Even if they seem well, advise or arrange urgent medical assessment because lung injury and deterioration can occur hours after the event.

5

Document and debrief

Record the circumstances, timings, water conditions and resuscitation attempts carefully, as these details support clinical decisions and any later investigations.

Offer support and debriefing to rescuers and witnesses, as drowning incidents are often traumatic.

This guide is a learning reference only. It does not replace attended, assessed first aid training.

Qualifying courses

These courses include drowning management as part of CPR and environmental emergencies, with specialist water-rescue training available separately. Choose the course that matches your role, sector, and the level of clinical practice required.

Qualsafe Level 3 Award in First Aid at Work (RQF)

3 days

3 years

Learn More

Qualsafe Level 3 Award in Emergency First Aid at Work (RQF)

1 day

3 years

Learn More

Qualsafe Level 3 Award in Paediatric First Aid (RQF)

EYFS recognised paediatric first aid

2 days

3 years

Qualsafe Level 2 Award in Activity First Aid (RQF)

Relevant for water-based and outdoor activities

2 days

3 years

Learn More

Common questions

Practical answers for employers, venue managers, and healthcare teams about drowning training.

Can't find your answer? Contact us.

a large body of water sitting next to a lush green field

B

Should I try to get water out of the casualty’s lungs before starting CPR?

No; you should not waste time trying to expel water from the airway or lungs by hanging the casualty upside down or using abdominal thrusts. Focus on opening the airway and starting rescue breaths and compressions.

B

Can someone drown in very shallow water?

Yes; people can drown in baths, puddles or shallow pools if they are unable to move or protect their airway, for example due to seizures, intoxication or loss of consciousness. Any face-down immersion requires urgent attention.

B

What is secondary drowning and should I worry about it?

Secondary drowning refers to delayed respiratory problems after inhaling water; while uncommon, it reinforces the need for medical assessment after any significant drowning or near-drowning. Watch for cough, breathlessness or chest pain in the hours after the incident.

B

Is CPR different for children in drowning?

Core principles are similar but with age-appropriate compression and ventilation techniques and a stronger emphasis on rescue breaths; paediatric life support training covers these details. In first aid, follow your paediatric CPR training and call 999 early.

B

How can organisations reduce drowning risk?

Measures include supervised swimming, barriers and signage around water, alcohol and drug policies, staff water-safety training and clear emergency action plans, especially in venues near open water or with pools.