TREATMENT
Pulling the Victim out of the Water: Where swimming to a drowning victim in the water is beyond your swimming capability, the Coast Guard recommends a technique called "throw, row, or tow."

1. From a float, shoreside dock, or moored boat, attach a long rope to a buoyant object such as a life jacket, life preserver, or a large empty plastic bottle that is securely closed and throw it to the floundering swimmer and then pull her to shore.

2. If it is not possible to throw something to the swimmer and a rowboat or other boat is available, row out to the victim as quickly as possible.

3. Give the person an extra oar, rope, or life preserver to hold on to, and tow him or her to shore. Don't try to haul the person into the boat; this may cause it to capsize and you'll both be in the water.

SPECIAL CIRCUMSTANCES
1. If there is a chance the near-drowning victim has a neck or back injury (e.g., from a diving, water-skiing, or boating accident), special care in maintaining neck and back alignment will be needed in getting him to shore. If possible, float the victim onto a board and then pull to shore. If the victim is breathing and a spinal injury is suspected, keep him in the water floating on his back until a board or other support can be brought to you.

2. If the victim has fallen through ice into the water, do not walk on the ice to rescue him. Instead, have the victim, if conscious, try to rest on the edge of the ice, rather than trying to climb out, which may only result in breaking more ice. Throw a rope from shore, or use a long board or stick and try to pull the victim out and across the ice on his belly, to distribute the weight as evenly as possible. If the victim is unconscious, tie the rope around your waist, secure the other end, and slide out on the ice on your belly. If other rescuers are present, form a human chain, with everyone lying down, to reach the victim.

3. If breathing has stopped, begin mouth-to-mouth respiration. This can be done even while the victim is still in the water by giving 4 quick breaths and then a breath every 5 seconds while you are pulling the victim to shore.

AFTER THE RESCUE
1. Once the victim is out of the water, determine if there is a pulse. If not, begin CPR at once and continue until help arrives. Do not attempt to drain water from the lungs. If a back injury is suspected, do not transport the victim except to remove him from the water, and then use a board if possible.

2. Even if the victim is revived, observe carefully for possible complications, such as cardiac arrest, call 911 for immediate medical assistance. Water in the lungs decreases their ability to function; the body's salt and fluid balance also may be upset, leading to further complications that may not be immediately apparent. Hospital personnel should be informed as to whether the drowning took place in fresh or salt water; these circumstances may influence the type of medical aftercare.