Drowning Emergency: What to Do in the First Minutes

In a drowning emergency, act in this order: shout for help and call 911, get the person out of the water without putting yourself in danger, and if they are not breathing, begin rescue breathing and CPR as you were trained and use an AED if one is nearby. Anyone who needed help in the water and has symptoms afterward should be checked by a medical professional.

This page explains each step and why it matters. It is not a substitute for a CPR course: we describe what to do, not how to do CPR, and we point you to hands-on training instead.

The chain of drowning survival

The American Red Cross says a person who is drowning has the greatest chance of survival when these steps are followed. This is its Chain of Drowning Survival (opens in a new tab):

1. Recognize the signs of someone in trouble and shout for help.
2. Rescue and remove the person from the water, without putting yourself in danger.
3. Ask someone to call emergency medical services (EMS). If you are alone, give 2 minutes of care, then call EMS.
4. Begin rescue breathing and CPR.
5. Use an AED if one is available, and hand over care to advanced life support when it arrives.

If a child is missing, the Red Cross says to check the water first, because seconds count.

Step 1: Call 911 and shout for help

Get help coming before anything else.

• If other people are nearby, one person calls 911 while others help. Ask a specific person so it actually happens.
• If a lifeguard is on duty, alert them right away.
• If you are alone with someone who has been pulled from the water and is not breathing, the Red Cross says to give 2 minutes of care first, then call. A CPR course will show you what that care is.

Our guide to calling 911 near water covers what to say when you don't have a street address.

Step 2: Get the person out, without going in

The Red Cross step is to rescue and remove the person without putting yourself in danger. For bystanders, that means reaching or throwing from the edge.

• Reach with a pole, rope, towel or branch, or throw something that floats. See reach or throw, don't go.
• Leave in-water rescue to people trained for it. The 2024 American Heart Association and American Academy of Pediatrics guidance says resuscitation may begin with in-water rescue breathing only when safely provided by rescuers trained in the technique (opens in a new tab), and continues with chest compressions once the person is out of the water.

Step 3: If they are not breathing, start CPR as trained

Drowning is different from a sudden heart attack. It starts with the lungs.

• Breathing comes first. The CDC defines drowning as breathing problems from being under or in water (opens in a new tab). The AHA and AAP say resuscitation after drowning must focus on restoring breathing as much as it does circulation (opens in a new tab).
• Learn CPR with rescue breaths. Water Safety USA recommends learning CPR with both chest compressions and rescue breaths (opens in a new tab), plus first aid.
• Use an AED if there is one. The Red Cross chain ends with using an AED (automated external defibrillator) if available and handing over to advanced care.
• Keep going until help takes over. Follow the 911 dispatcher's instructions and your training.

Step 4: If they are breathing, stay with them

A person who was in trouble in the water can get worse over the next few hours, so don't leave them alone.

• Watch their breathing and behavior. The Red Cross says people with only mild symptoms that clear quickly, like the coughing you get when water "goes down the wrong pipe," can be observed by an attentive caretaker (opens in a new tab). They will usually get better or worse within 2 to 3 hours.
• Get medical care for stronger symptoms. The Red Cross says people who have excessive or prolonged coughing, fast or hard breathing, aren't breathing normally or aren't acting right should seek medical care.
• Watch for new symptoms. If the person develops coughing, breathing trouble, sleepiness or confusion, the Red Cross says they should seek medical attention. Call 911 if it is an emergency.
• If they were in cold water, the National Weather Service lists these steps (credited to the Red Cross): call 911, move the person somewhere warm, monitor breathing and give CPR if needed, and rewarm slowly, core first (opens in a new tab). See hypothermia after cold water.

Step 5: Everyone who had trouble should be checked

Water Safety USA lists the symptoms that mean a person should be evaluated by medical professionals (opens in a new tab) after a drowning episode:

• coughing that doesn't stop;
• any loss of consciousness, even briefly;
• needing rescue breathing or other breathing support;
• needing CPR;
• chest pain or shortness of breath that continues despite rest;
• confusion, unusual tiredness, or not acting or behaving normally.

Drowning injuries can be serious even when a person survives. The CDC says outcomes after a nonfatal drowning range from no injury to brain damage or permanent disability (opens in a new tab). For children treated in emergency rooms for pool or spa drowning injuries, the CPSC found that 42% were admitted or transferred (opens in a new tab) to another hospital (2023-2025), compared with 4% for all product-related injuries in that age group.

42%

Worried about "dry drowning"? Those terms aren't medical diagnoses. See what parents need to know about symptoms after swimming.

After the emergency

A drowning emergency is frightening for everyone who sees it, including children. Once everyone is safe and checked:

• Talk about what happened, simply and calmly. Our guide on helping a child after a scary moment in the water has ideas from a children's hospital.
• Look at what would help next time: a fence, a Water Watcher, a life jacket, swim lessons, or a written plan for your pool or event. See how to write a water emergency action plan.

What you can do today

• Book a CPR and first aid class that includes rescue breaths.
• Save your address and nearest cross streets in your phone, and post them near your pool.
• Fill in the emergency action plan below for your home pool, camp or event.
• Check where the nearest AED is at your pool, gym, school or place of worship.
• Read the National Drowning Prevention Alliance's layers of protection (opens in a new tab): emergency preparation is one of five.