The Australian Resuscitation Council (ARC) has guidelines and flow charts specific to basic life support and the management of a drowned victim. We recommend that these be used for all teaching to the lay public and for all pool signage resuscitation charts that are to be read and used as training and public incident management prompts. As the nationally recognized peak body in resuscitation, made up of representatives of many national resuscitation and aquatic rescue organizations, we would recommend for Australia wide consistency of training and practice.
The ARC believes that the most effective way to encourage bystander resuscitation in the event of any cardiac arrest either due to drowning or another precipitant, is to have simple resuscitation steps that are standard, and interchangeable regardless of the cause, and regardless of the age of the victim.
In drowning, the ARC believes that resuscitation by a member of the lay public should be performed in accordance with the Basic Life Support guidelines as published on its website. This is in line with the practice supported by resuscitation councils around the world, including the European Resuscitation Council and American Heart Association. It is also the recommendation of the International Life Saving Federation.
In a drowning resuscitation, it is important that the victim receives rescue breaths, not just chest compression resuscitation. There is no evidence to support nor refute the order of commencing the resuscitation. As such, to keep the learning simplified, and aid memory retention by a lay provider who would be an infrequent performer of resuscitation, the ARC recommends starting drowning resuscitation with the chest compressions, as in any other resuscitation, followed by the rescue breaths.
In the most recent revision of the ARC guideline Management of a Drowned Victim, the assessment of the victim’s airway and assessment of breathing is done with the victim lying face up. This brought Australia into line with other international aquatic rescue organizations and the International Life Saving Federation. Only if the airway is found to need immediate clearing, is the victim rolled onto the side. Assessing the victim is a face up position aids visualization of the airway and assessment of breathing. It also means that resuscitation can commence earlier in a victim with a clear airway as unnecessary rolling onto the side and back is avoided.
The Queensland Government’s Department of Housing and Public Works has a requirement, documented in chapter 8 of the Building Act, that all pools display a CPR sign that must show how to perform CPR as per a flow sequence on the following weblink: http://www.hpw.qld.gov.au/construction/BuildingPlumbing/PoolSafety/Pages/RequirementsCPRwarningSigns.aspx (accessed 22/09/2016).
The 7 step resuscitation sequence displayed on this web link and mandated in Queensland is not compliant with the Australian Resuscitation Council guidelines, firstly because it recommends rolling and assessing all victims onto their side, regardless of the need for airway clearance, and secondly because the Queensland requirement is to display pool signage that starts resuscitation with rescue breathing rather than chest compressions.
As well as believing that the Queensland mandate for a different resuscitation of a drowned victim will confuse the lay provider and possibly lead to a reluctance to start any resuscitation, The Australian Resuscitation Council believes that having one state in Australia promoting and enforcing resuscitation that is different from everywhere else in the country causes difficulties in teaching and resource production for many of the national rescue and resuscitation training organizations.
The Australian Resuscitation Council continues to work with the Queensland Government and Queensland resuscitation organizations to standardize guidelines across the country.
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