COVID-19: recommendations for resuscitation in case of drowning

The COVID-19 pandemic has posed several challenges for safety and aquatic rescue organizations, especially regarding the procedures to be adopted during their teams work, when it is not possible to maintain a safe distance following a drowning.

In order to assist organizations working in the field, an international task force, coordinated by the researcher Catarina Queiroga from the Instituto de Saúde Pública da Universidade do Porto (ISPUP) prepared a position statement with recommendations for resuscitation after drowning, based on the scientific information available on COVID-19 to date.

The document, made public on June 4th, presents international guidelines, validated by more than 50 experts from many parts of the world. These guidelines served as a basis for the Portuguese recommendations directed at rescuers for the 2020 Summer Bathing Season, which started on June 6th in Portugal.

As the ISPUP researcher explains, “the decision to proceed to resuscitation after drowning is not easy, in the context of the COVID-19 pandemic. Contact with drowned people poses an increased risk to the rescuer’s safety, especially if the resuscitation procedures adopted before the pandemic are maintained. Therefore, several questions have emerged. Should we continue to administer mouth-to-mouth ventilations to drowning victims, whose level of infectivity is unknown? What personal protective equipment should be used by safety and water rescue professionals during resuscitation? It was to clarify these and other doubts that we created this task force to be able to present an official international position with a set of recommendations”.

The international work, coordinated by Catarina Queiroga, presents recommendations for organizations in the COVID-19 era, specifically on the prevention of drowning, infection risk mitigation among professionals, use of personal protective equipment, resuscitation of drowned persons, education and training programs, professional training, and ethical issues and responsibilities of organizations.

Recommendations to follow

Regarding infection risk mitigation, for example, the document advises that mouth-to-mouth ventilations should not be carried out by professionals if no type of barrier is present. Also, resuscitation or other activities that involve direct contact between people should not be performed if the rescuers belong to a high-risk group for developing severe COVID-19 disease. It is also suggested that aquatic safety and rescue organizations require their workers to be among the first groups to receive the vaccine, when it becomes available.

Regarding personal protective equipment, it is important that rescuers wear gloves, a face mask and eye protection, as well as being able to conduct proper hand-hygiene following each intervention or personal contact. “It is essential that organizations ensure the supply of all required equipment, and that they teach professionals how to use it and how to dispose of it correctly”, stresses Catarina Queiroga.

Among several other topics covered in the position statement, an algorithm for cardiorespiratory resuscitation is presented, which indicates all the steps needed to carry out the procedure in the safest way possible, both for the drowned victim and the rescuer.

Tips coincide with the start of the summer bathing season

The recommendations now released coincide with the beginning of the summer bathing season in Portugal, and can assist Lifeguards Associations, beach concessionaires and City Councils, who must follow the national standards already published, says the ISPUP researcher.

The document states that not all organizations will be able to adopt the recommendations presented and that these may be adapted to the reality of each country. The researchers say that these suggestions may be updated in the future, according to the evolution of knowledge about the new coronavirus.

The position statement is entitled Resuscitation of the drowned person in the era of COVID-19 disease: A common ground for recommendations, identification of research needs and a global call to action and is the result of a joint initiative by the three world organizations that host and guide aquatic rescue professionals: the International Life Saving Federation, the International Maritime Rescue Federation and the International Drowning Researchers ’Alliance. The document is available HERE.

Image: Leonardo Manino

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