Intended for healthcare professionals

Practice ABC of Resuscitation, 6th Edition


BMJ 2014; 348 doi: (Published 16 April 2014) Cite this as: BMJ 2014;348:bmj.g1734 This article is from The BMJ's archive and was originally published in 2015.
  1. Anthony J. Handley
  1. Colchester Hospital University NHS Foundation Trust Colchester, UK

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  • Drowning is a common cause of accidental injury and death, particularly in the young

  • If attempting an aquatic rescue take care not to place yourself at risk of getting into difficulty and drowning

  • Death due to drowning arises primarily as a consequence of hypoxia

  • Initial treatments should prioritise airway and breathing interventions


Worldwide, there are approximately 450,000 deaths each year from drowning. Most occur in low- and middle-income countries, but in 2006 there were 312 accidental deaths from drowning in the UK and 3582 in the USA, an annual incidence of 0.56 and 1.2 per 100,000 population respectively. Drowning is the leading cause of accidental death in Europe in young males. It occurs most commonly during the warmer summer months (Figure 1). Contrary to popular perception, nearly half of drowning cases occur in inland waterways. Drowning in a swimming pool is relatively rare (Figure 2).

Figure 1 

Seasonal variability for drowning.

Figure 2 

Location of drowning events.


Many definitions and sub-definitions of drowning exist which have resulted in confusion and inability to compare studies on management and outcome. To try and simplify matters, an advisory statement from the International Liaison Committee on Resuscitation (ILCOR) was published in 2003 under the title Recommended Guidelines for Uniform Reporting of Data From Drowning. The “Utstein Style”. In it, drowning was defined as a process rather than an event: Drowning is a process resulting in primary respiratory impairment from submersion/immersion in a liquid medium. Implicit in this definition is that a liquid/air interface is present at the entrance …

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