Top Things to Know: 2024 AHA and American Academy of Pediatrics Focused Update on Special Circumstances: Resuscitation Following Drowning
Published: November 12, 2024
Prepared by Melissa Mahgoub, PhD, Science and Health Advisor
- The Drowning Chain of Survival focuses on the prevention of drowning, early recognition of a drowning individual, and considerations for safe rescue and resuscitation.
- Our current recommendations support standard basic life support (BLS) and advanced life support (ALS) as the cornerstones of resuscitation.
- In drowning resuscitation, airway management and ventilation are of particular importance because of the continuum from respiratory arrest to cardiac arrest following drowning.
- Providing in-water rescue breathing, if the rescuer is appropriately trained and it’s safe to do so, may prevent the progression to cardiac arrest following drowning.
- Cardiac arrest following drowning is generally the result of severe hypoxemia; therefore, oxygen administration is recommended when available.
- Trained rescuers should provide rescue breaths as part of cardiopulmonary resuscitation (CPR) in cardiac arrest following drowning and may initiate with breathing (airway, breathing, chest compressions) or with compressions (chest compressions, airway, breathing).
- The use of an automated external defibrillator (AED) may be lifesaving in cardiac arrests following drowning that present with shockable rhythms, which are a minority.
- Public-access defibrillation (PAD) programs may yield important benefits when instituted in aquatic environments and large public areas where cardiac arrest may be more likely even when not the result of drowning.
- There is no preferred mode of delivering ventilation (with or without equipment) for trained rescuers in the prehospital setting.
- Knowledge gaps in drowning prevention and resuscitation require future research, especially in resource-limited regions.
Citation
Dezfulian C, McCallin TE, Bierens J, Dunne CL, Idris AH, Kiragu A, Mahgoub M, Shenoi RP, Szpilman D, Terry M, Tijssen JA, Tobin JM, Topjian AA; on behalf of the American Heart Association and the American Academy of Pediatrics. 2024 American Heart Association and American Academy of Pediatrics focused update on specialcircumstances: resuscitation following drowning: an update to the American Heart Association Guidelines forCardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. Published online November 12, 2024. doi: 10.1161/CIR.0000000000001274