This article is not a substitute for certified CPR training. If you own a pool, host swimmers, or have children, take an in-person CPR course from the American Red Cross or American Heart Association. The course is around $90, lasts a few hours, and includes hands-on manikin practice that no article can substitute for. Certifications expire every two years; keep yours current.
That said: if an emergency happens today, before you’ve taken that course, this is the protocol. Print it, post it near your pool, and walk through it once with anyone who supervises swimmers.
The first 60 seconds
If you find a swimmer unconscious in or out of the pool, the actions in the first minute matter more than anything that happens later.
- Get them out of the water. You cannot do effective CPR on a victim in the water. Drag them by the armpits onto a flat surface — deck, lawn, any solid ground.
- Yell for help. Tell a specific person to call 911. “You — call 911 now.” If you’re alone, call 911 yourself on speakerphone before starting CPR. Modern dispatchers will coach you through compressions.
- Check for response. Tap their shoulder firmly, shout “Are you okay?” If they don’t respond, begin CPR.
- Check for breathing. Look at their chest for 10 seconds. Normal breathing means regular rise and fall. Gasping (“agonal breathing”) is not normal breathing — treat it as no breathing.
If they’re not responsive and not breathing normally, start CPR immediately. Do not stop to look for a pulse. Lay rescuers should not check for a pulse; the time it takes is time the brain doesn’t have.
Drowning is different from cardiac arrest
For most adult cardiac arrests, CPR guidelines emphasize chest compressions, sometimes without rescue breaths (compression-only CPR).
Drowning is different. A drowning victim’s primary problem is lack of oxygen, not heart failure. Rescue breaths matter more for drowning than for almost any other emergency. The current Red Cross and AHA guidelines for drowning emergencies recommend traditional CPR with rescue breaths, not compression-only.
If you’re not trained in rescue breaths, do compression-only CPR — it’s still much better than nothing. If you are trained, use the 30:2 protocol below.
Adult and child (over 1 year) CPR protocol
Position the victim:
- Lay them flat on their back on a firm surface.
- Tilt their head back gently and lift their chin to open the airway. Don’t probe the throat — there’s almost never a foreign object causing the problem in drowning.
Give 2 rescue breaths first (this is specific to drowning):
- Pinch the nose closed.
- Make a complete seal over their mouth with yours.
- Blow steadily for about 1 second, watching their chest rise.
- Take a breath yourself. Repeat once.
If the chest doesn’t rise on the first breath, reposition the head and try again. If it still doesn’t rise, move to chest compressions.
Begin chest compressions (30 compressions):
- Heel of one hand in the center of the chest, at the line between the nipples (sternum). Other hand on top, fingers interlocked.
- Arms straight, shoulders directly over the hands.
- Push hard and fast: at least 2 inches deep for adults, about 2 inches for children. Rate of 100–120 per minute. The Bee Gees’ “Stayin’ Alive” is the famous reference; “Baby Shark” works too.
- Let the chest fully rise between compressions. Incomplete recoil reduces blood flow.
Continue 30 compressions, then 2 breaths, then 30 compressions, then 2 breaths. Do not stop. Switch with another rescuer every 2 minutes if you can — quality drops fast.
Continue until:
- Paramedics arrive and take over
- The victim shows signs of life (movement, normal breathing, coughing)
- An AED is available and ready to use
- You are physically too exhausted to continue (rare, but real after 10+ minutes)
Infant (under 1 year) CPR protocol
The technique changes for infants.
Position:
- Flat on their back on a firm surface.
- Tilt the head back gently — but only slightly. Over-tilting closes the infant airway.
Rescue breaths:
- Cover both the infant’s mouth and nose with yours.
- Give 2 gentle puffs — just enough to make the chest rise. Adult-volume breaths can damage infant lungs.
Compressions:
- Use 2 fingers placed just below an imaginary line between the nipples.
- Compress about 1.5 inches deep, at 100–120 per minute.
- 30 compressions, 2 breaths, repeat.
If you’re alone and need to call 911, do 2 minutes of CPR first, then call. For infants, getting CPR started immediately is more important than the initial 911 call.
Using an AED
AEDs (automated external defibrillators) are increasingly common at public pools, schools, and gyms. If one is available:
- Turn it on. Modern AEDs talk you through the steps.
- Apply the pads where the diagrams show — adult pads on adults, pediatric pads or pediatric setting on children under 8 (if not available, adult pads are still appropriate).
- Stand clear when prompted; press the shock button if directed.
- Resume CPR immediately after the shock or after the device says “no shock advised.”
AEDs are designed for untrained users. Don’t hesitate to use one — they will not deliver a shock the victim doesn’t need.
After breathing returns
If the victim resumes breathing on their own:
- Roll them onto their side (the recovery position) — left side if possible. This helps clear water and vomit from the airway.
- Stay with them. Drowning victims can deteriorate hours later from delayed pulmonary edema. Even an awake, talking patient must go to the hospital.
- Continue monitoring breathing until paramedics arrive.
What about water in the lungs?
You may have heard about chest compressions or back blows to force water out. Don’t do this. The current guidance from the Red Cross and AHA is clear: do not delay CPR to attempt to remove water from the lungs. The amount of water actually inhaled in most drownings is small; rescue breaths and compressions will move it as a side effect. Time spent trying to drain water is time not spent providing oxygen.
The only exception: if the victim is clearly choking on a visible object that’s blocked their airway, the choking protocol (back blows, abdominal thrusts) applies. Drowning alone is not a choking emergency.
What about pre-existing injuries?
If the drowning was associated with a diving accident — head-first into shallow water, head impact at the bottom — assume a spinal injury until paramedics tell you otherwise.
- Pull them out keeping the head, neck, and back in a straight line if possible.
- Don’t tilt the head back to open the airway. Use the jaw-thrust maneuver: place fingers behind the angle of the jaw and gently lift the jaw forward without moving the neck.
- Continue CPR as needed. Brain damage from oxygen deprivation is a more immediate threat than spinal damage from gentle handling.
What to do now
If you’ve read this article and feel a vague intention to take a CPR class “someday,” intercept yourself.
- Go to redcross.org or heart.org right now.
- Find an in-person Adult and Pediatric CPR/AED course within driving distance of you.
- Sign up for the nearest available date.
The skill is muscle memory. You cannot acquire it from an article. You can acquire it in three hours and have it for two years.
Print this for your pool
Tape this page (or your own short summary) inside the cover of your pool’s first aid kit. The protocol takes 30 seconds to read in calm conditions and 3 minutes to apply correctly in an emergency. Knowing where to find the steps under stress is part of the layered defense system that keeps families safe.
For the full safety system this protocol fits into, see the family pool safety plan.