Chest Compressions Alone: Are They Sufficient for Drowning Victims Experiencing Cardiac Arrest?

For drowning victims experiencing cardiac arrest, performing chest compressions alone is generally not recommended. One of the most significant updates in the 2010 International Guidelines for Cardiopulmonary Resuscitation (CPR) was the change in the sequence from ABC to CBA. In this revised approach, C stands for chest compressions, B for rescue breathing, and A for opening the airway.

Why the CBA Sequence Matters

The shift to the CBA sequence was based on extensive research and real-world data. In most cases of out-of-hospital cardiac and respiratory arrest, the cause is often cardiac-related, and the body typically still contains a sufficient oxygen reserve. Some individuals may even gasp for air shortly before cardiac arrest, which can provide limited oxygenation. Therefore, immediate chest compressions are prioritized to maintain blood circulation.

Application in Drowning Scenarios

However, drowning presents a unique situation. Unlike typical cardiac arrests, drowning often leads to hypoxia—severe oxygen deprivation—before the heart stops. This distinction means that while chest compressions are crucial, they should ideally be combined with airway management and rescue breathing to restore oxygen levels effectively. Delaying ventilation may reduce the chances of a successful resuscitation outcome.

In summary, while chest compressions play a vital role in CPR, especially under the updated CBA protocol, they are not sufficient on their own for drowning victims. Combining compressions with proper breathing techniques significantly improves survival rates and aligns with best practices recommended by global CPR guidelines.