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Cardiac Arrest at a Swimming Pool
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Cardiac arrest at a swimming pool arrives in two forms that look the same at the end and need slightly different thinking at the start: a primary cardiac event in someone on the deck or in the water, and a hypoxic arrest caused by drowning.
Cardiac Arrest at a Swimming Pool: The Sequence
- Get them out. Compressions cannot be delivered in water. Everything else waits on extrication, and a suspected spinal injury means backboard extrication rather than a lift.
- Confirm no breathing and no pulse, taking no more than about 10 seconds.
- Start compressions at 100 to 120 per minute, at least 2 inches deep, full recoil.
- Dry the chest and apply the AED without stopping compressions. One rescuer dries and applies, another compresses.
- Ventilate early. If this is a drowning, oxygen is the deficit, so ventilations are not an afterthought.
- Swap compressors every two minutes.
- Hand over with a clear account: time of collapse, time CPR started, shocks delivered, and whether the casualty was submerged and for how long.
Drowning versus a cardiac event
A primary cardiac arrest is more likely to be a shockable rhythm and responds well to early defibrillation. A drowning arrest is usually not shockable at first, because the problem is oxygen rather than electrical. The practical difference is emphasis, not sequence: apply the AED either way, and do not let ventilations slide either way.
The submersion time matters to the hospital
Record how long the casualty was under, and the water temperature if known. Cold water submersion changes the clinical picture substantially and the receiving team will ask. A guess written down at the time is worth more than a reconstruction afterwards.
Managing the scene
Someone clears the water, someone meets the ambulance and holds doors and gates open, and someone stays with distressed family. A cardiac arrest at a swimming pool is a whole-facility response, which is what the emergency action plan is for.
Cardiac arrest at a swimming pool: frequently asked questions
What is the sequence for cardiac arrest at a swimming pool?
Extricate first because compressions cannot be given in water, confirm no breathing and no pulse in about 10 seconds, begin compressions, dry the chest and apply the AED without pausing compressions, ventilate early, and swap compressors every two minutes.
How is a drowning arrest different from a cardiac one?
A drowning arrest is hypoxic and usually not shockable at first, so ventilations carry more weight. A primary cardiac arrest is more often shockable and responds well to early defibrillation. The AED is applied in both cases.
What information should be handed over?
Time of collapse, time CPR started, shocks delivered, and how long the casualty was submerged with the water temperature if known. Cold water submersion changes the clinical picture significantly.
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