What is the initial EMS approach at the scene of a drowning victim?

• A. Immediate water rescue without scene safety
• B. Scene safety, PPE, assess ABCs, ensure airway/breathing, administer high-flow O2, prepare for rapid transport
• C. Wait for help
• D. Focus on bystander CPR only

Answer: (B)

In a drowning scene, the first priority is to protect everyone involved while beginning life-saving care. Start with scene safety and don appropriate PPE so you and the patient aren’t exposed to additional hazards. Then move quickly to the primary survey focused on airway, breathing, and circulation. If the person isn’t breathing or is only gasping, provide ventilation and be prepared to initiate CPR as indicated. Securing and maintaining an open airway, along with delivering effective breaths, is crucial because the main threat from drowning is hypoxia. Administer high-flow oxygen to correct low oxygen levels and support breathing, and get the patient en route to definitive care as rapidly as possible. This approach combines hazard prevention, rapid assessment, and immediate treatment, which is essential for improving outcomes after drowning. Waiting for help or focusing only on bystander CPR ignores the need to restore and maintain oxygen delivery and to transport promptly, making them less appropriate in the initial EMS response.