• Submersion in water regardless of depth
  • Possible trauma to C-spine
  • Possible history of trauma (i.e., diving board)
  • Duration of immersion
  • Temperature of water or possibility of hypothermia


Significant Findings:


  • Unresponsive
  • Mental status changes
  • Decreased/absent vital signs
  • Vomiting
  • Coughing
  • Apnea
  • Stridor
  • Wheezing
  • Rales




  • Trauma
  • Pre-existing medical problem
  • Pressure injury (i.e., diving)
  • Barotrauma
  • Decompression sickness
  • Post-immersion syndrome
  • Hypothermia




  • 12-Lead EKG
  • Obtain BGL
  • Initiate IV


Respiratory distress, wheezing, rales?


  • Yes


    • Consider CPAP (EMT/Medic)



  • No


Hypothermia ≤ 95⁰F (35⁰C)?


  • Yes



  • No


    • See appropriate protocol based on symptoms


    • Notify receiving facility or contact Medical Control




  • Drownings have a high index of suspicion for possible spinal injuries.
  • When water temperature is less than 70⁰F (21⁰C) there is no time limit; resuscitate all.  These patients have an increased chance of survival.
  • Some patients may develop delayed respiratory distress.
  • All victims should be transported for evaluation due to potential for worsening over the next several hours.
  • Drowning is a leading cause of death among would-be rescuers.
  • Allow appropriately trained and certified rescuers to remove victims from areas of danger.
  • With pressure injuries (decompression/barotrauma), consider transport to a hyperbaric chamber located at Greenville Memorial.
  • Consider hypothermia in all drownings.

Drowning and Submersion