After drowning, bystanders have about four minutes before brain damage starts. The actions taken in those minutes, getting them flat, opening the airway, giving five rescue breaths, then 30 chest compressions to two breaths, are what decide whether they survive.
What Drowning Looks Like: Signs, Symptoms, and Stages
On TV, drowning looks like loud splashing and shouting for help. The reality is the opposite: the person’s mouth bobs at the surface, their head tilts back, and they can’t call out because every breath goes to staying alive. Common signs of drowning include:
Head low in the water, mouth at water level
Eyes glassy, empty, or closed
Motionless in the water
Hyperventilating or gasping
Trying to swim but making no progress
Trying to roll onto their back
Drowning moves through several stages of drowning: the initial surprise, breath holding, water entering the airway, loss of consciousness, seizures from oxygen loss, and finally cardiac arrest. Once the airway is compromised, brain damage can begin within four to six minutes.
Rescuing a Drowning Person
Your first job is to keep yourself safe. Drowning victims panic, and a panicked grip can pull a rescuer under. Follow the order: reach, throw, row, go.
Reach. Lie flat on the pool deck or jetty and extend a pole, towel, branch, or your arm. Anchor yourself so you can’t be pulled in.
Throw. Toss anything that floats: a life ring, esky lid, kickboard, or even a sealed plastic bottle. A rope tied to a flotation device is ideal.
Row. If a boat, kayak, or paddleboard is available, use it. Stay in the craft and pull them in.
Go. Going into the water is the last resort, and only if you have rescue training. If you must go in, take a flotation device with you and approach from behind.
Once you have them out of the water, lay them on their back on a firm surface. Even if they’re conscious and coughing, treat the situation as serious.
Calling Triple Zero
Call 000 the moment you suspect a drowning incident. Every drowning case, including cases of drowning where the person seems okay, needs emergency medical assessment. Tell the operator:
Your exact location, including landmarks if you’re at a beach, river, or remote dam
What happened and how long they were underwater
The person’s approximate age and current condition (conscious, breathing, responsive)
Whether someone has already started CPR.
Stay on the line. The operator will guide you through life support if needed and dispatch paramedics. Send someone to flag down the ambulance.
Checking Consciousness and Breathing
With the person flat on their back, follow the DRSABCD action plan, the standard Australian first aid sequence.
D – Danger. Check the area for further hazards: deep water, slippery surfaces, electrical risk near pools.
R – Response. Tap their shoulders firmly and ask loudly, “Can you hear me? Open your eyes.” Squeeze their fingers if there’s no response.
S – Send for help. Call 000 if you haven’t already. Ask a bystander to fetch a defibrillator (AED).
A – Airway. Tilt their head back gently and lift their chin. Look inside their mouth. If you can see anything blocking their throat like vomit, use two fingers to sweep it clean. Never perform a blind sweep of potential blockages you can’t actually see.
B – Breathing. Watch for chest movement and listen for breath sounds for up to ten seconds. Drowning causes apnoea, so the absence of normal breathing means you start CPR immediately.
C – CPR. Begin chest compressions and rescue breaths.
D – Defibrillation. If the drowning has any connection to cardiac arrest, connect an AED and use it in between chest compressions and rescue breaths.
Resuscitation: The CPR Cycle
Drowning resuscitation follows the standard Australian Resuscitation Council Basic Life Support sequence: 30 chest compressions to two rescue breaths. Compression-only CPR is acceptable if you can’t give breaths, but breaths are strongly preferred where you can.
Step 1: 30 chest compressions. Place the heel of one hand in the centre of their chest, on the lower half of the breastbone. Place your other hand on top, fingers interlocked. Lock your elbows, position your shoulders directly above your hands, and push hard and fast: at least one third of the chest depth (about 5 cm in an adult) at a rate of 100 to 120 per minute.
Step 2: Two rescue breaths. Pinch their nose closed, seal your mouth over theirs, and give two slow breaths. Each breath should last about one second and make the chest rise visibly.
Step 3: Continue 30:2. Keep cycling 30 chest compressions to two rescue breaths until paramedics take over, the person starts breathing normally, or you become physically unable to continue.
For infant drowning and drowning in children, the technique is gentler: two fingers for compressions on infants, one or two hands for older kids, and softer puffs of air for breaths.
What to Do After They Start Breathing Again
Once they’re breathing on their own, place them in the recovery position: roll them onto their side with the top knee bent forward, arm supporting the head, mouth pointing slightly downward so any fluid can drain. Cover them with something to keep them warm, and stay with them until help arrives.
Life Saving Drowning Prevention and Water Safety Tips
The Royal Life Saving Australia’s national drowning research lists pool fencing, life jackets, supervision, swim education, alcohol restriction, CPR training, as common sense answers. These specifics take it a step further:
Toddlers can drown in 5 centimetres of water. Supervision means within arm’s reach, not visual range. A child standing in waist-deep shallow water can be drowning while you’re four metres away looking right at them.
Check your own pool gate. Even when the fence is compliant, gate failures cause drownings: the self-closing latch stops working, the gate gets propped open, or chairs and pot plants become climbing aids for toddlers. The fence must isolate the pool from the house, not just from the yard.
Inflatable toys are not safety devices. Lilos, pool noodles, and rings give non-swimmers the confidence to enter deep water, but they can drown if they slip off. An Australian Standard life jacket is the only flotation device with a safety rating, and life jackets prevent drowning by keeping the airway clear of water even if the wearer is unconscious.
Alcohol is a leading cause of adult drownings. The Royal Life Saving National Drowning Report identifies alcohol as a major factor in the risk of drowning, particularly when combined with cold water and an unexpected event like falling off a jetty or out of a boat. The blood alcohol level that compromises water-safety judgement is well below the driving limit.
Most fatal drowning in Australia happens in natural bodies of water. People who drown in natural bodies of water often weren’t planning to swim. Open water drowning in rivers, surf beaches, and dams accounts for most drowning fatalities, and freshwater drowning in farm dams is a specific risk in regional areas. Floodwater is heavier than it looks: 15 centimetres of moving water can sweep an adult off their feet, and 60 centimetres can float a vehicle.
Cold-water drowning happens above 20°C. The cold shock can happen in any water below body temperature, not just freezing water. 18°C ocean water in winter is enough to trigger an involuntary gasp that pulls water into the lungs.
CPR training expires. ANZCOR updates its guidelines periodically. A first aid certificate from a decade ago doesn’t reflect current practice. The drowning chain of survival depends on bystanders being current, not just trained at some point.
First Aid and CPR Training
Drowning is fast, quiet, and unforgiving, but it is also preventable, and survivable when bystanders know what to do. Most drowning deaths happen within minutes of submersion, and the actions taken in those minutes shape every outcome that follows. A few hours in a CPR course will give you the muscle memory to act calmly while others around you panic. You don’t need to be a paramedic to save a life. You need to know the steps, recognise the signs of drowning, and start CPR without hesitation.
FAQs
What is "Dry Drowning?"
Wet drowning describes water entering the lungs. Dry drowning refers to a laryngospasm, where the vocal cords clamp shut to keep water out, but the person still suffocates.
What is "Second Drowning"?
Secondary drowning, or delayed drowning, describes situations where someone seems fine after a water drowning event but develops breathing problems hours later.
Does an AED Work on a Drowning Victim?
Sometimes. Drowning can lead to cardiac arrest, which requires an AED. Dry the chest with a towel before placing the pads. Move the person away from puddles or wet ground if possible. The AED will analyse the heart rhythm and only deliver a shock if it’s needed.
