You respond to a river resort where a young male was found floating face-down in the water. After entering the water and reaching the patient, you should:

• A. move him as a unit to a supine position
• B. leave him in the prone position until on shore
• C. perform chest compressions in the water and then bring him up headfirst
• D. shake him vigorously to assess responsiveness

Answer: (A)

The main idea is to get the patient into a stable, airway-ready position quickly while protecting the spine if injury is possible. When you reach a patient who’s face-down in the water, the safest, most effective step is to move him as a single unit into a supine position. This keeps the body aligned and minimizes additional movement that could worsen a spinal injury, and it places the patient in the standard position for assessing breathing and starting CPR if needed.

Shaking him to assess responsiveness isn’t reliable and can cause harm, and performing chest compressions in the water is impractical and dangerous due to water resistance and the ability to deliver effective compressions. Leaving him prone delays airway assessment and rescue efforts. Moving him as a unit to a supine position sets up rapid assessment of airway, breathing, and circulation and allows appropriate resuscitation to begin as soon as possible.