Special Considerations

Hypothermia Considerations

If the victim is unresponsive with no breathing or no normal breathing, and suspected to be in hypothermia, healthcare providers would follow the normal steps for CPR and take a few extra steps.

  • Check for a pulse for no more than 10 seconds
  • If no pulse, begin CPR without delay
  • AED should be used as normal
  • Do not wait to check the victim’s temperature
  • Do not wait until the victim is rewarmed to start CPR
  • Wet clothes should be removed from the victim to prevent further heat loss
  • Shield the victim from wind or cold
  • Avoid rough movement and handle person gently
  • Passive warming, such as warm blankets and heat packs, can be used until active warming is available with advanced medical care

Drowning Considerations

Water does not need to be “pumped out” of the lungs or stomach of a drowning victim. The routine use of abdominal thrusts or other techniques to remove water from drowning victims is unnecessary, potentially dangerous, and not recommended.

Most victims do not get large amounts of water in their lungs, ie. aspirate water. This is because of the body’s natural defense of keeping water out of the lungs with a laryngospasm (breath holding). Even if water is aspirated, there is no need to clear the airway of aspirated water, because only a small amount of water is aspirated by the majority of drowning victims. Aspirated water is rapidly absorbed into the central circulation.

  • The number one priority is the rescuer’s safety. The rescuer must not put himself or herself in danger to rescue a drowning victim. Do not swim out to a drowning victim. Reach out with a long object, throw something that floats, but don’t go.
  • The first and most important treatment of the drowning victim is ventilation. Prompt initiation of rescue breathing increases the victim’s chance of survival. Victims with only respiratory arrest usually respond after a few artificial breaths are given.
  • For an unresponsive, non-breathing victim, immediate bystander CPR plus early activation of the EMS system is crucial
  • CPR normally begins with chest compressions in a C-A-B sequence. However, the guidelines recommend CPR for drowning victims should use the traditional A-B-C approach in view of the lack of oxygen, ie. hypoxic nature of the arrest.
  • To use the AED, the victim needs to be out of the water. However, it is only necessary to dry the chest area before applying the defibrillation pads and using the AED
  • Vomiting is common in drowning victims. If vomiting occurs, turn the victim to the side and remove the vomit using your finger. Continue care after airway is cleared.