By a Wilderness Survival & High-Altitude Rescue Specialist with 20+ Years of Field Experience
Introduction: Seconds Matter, Skills Save
In remote wilderness — from glacier-fed rivers to jungle creeks — drowning is a silent killer. No screams. No flailing. Just stillness.
I’ve pulled bodies from alpine lakes and jungle rivers — some I revived, some I didn’t. What made the difference? Immediate, decisive, skilled action.
In this guide, you’ll learn how to perform field CPR and rescue breathing specifically for drowning victims, when you’re far from hospitals and time is your enemy.
1. Understanding Drowning: It’s Not What You Think
Drowning often doesn’t look dramatic. Victims lose consciousness silently after struggling for less than 30 seconds.
Key facts:
- Drowning ≠ Inhalation of large water volumes. Often it’s just a few gulps that block airflow.
- Brain damage begins in 4–6 minutes without oxygen.
- Cold water may extend survival time — hypothermia slows metabolism, which is why rescue attempts should NEVER be abandoned quickly.
2. First Actions: Safety First
⛑ Step 1: Ensure Scene Safety
- Never become the second victim.
- Reach, throw, row, then go (enter water only as a last resort).
🌬️ Step 2: Get Victim to Air
- Remove from water face up, supporting neck and spine if trauma suspected.
- Call for help or activate your wilderness emergency protocol (radio, satellite device, flare).
3. Initial Assessment (Within 10 Seconds)
Check Airway, Breathing, Circulation (ABC):
| Step | What to Check | What to Do |
|---|---|---|
| A | Is airway open? Water, debris, tongue blockage? | Clear airway: head tilt–chin lift, or jaw thrust if spinal trauma suspected |
| B | Is the person breathing? Watch chest, feel breath | If not breathing → start rescue breathing |
| C | Is there a pulse? (Check carotid for 10 sec) | No pulse → start full CPR |
4. Performing Rescue Breathing (If Pulse Present but No Breathing)
This is common in drowning victims: heart still beats, but no breathing.
🌬️ Rescue Breathing for Adults:
- Position: Victim on back, open airway
- Pinch nose, give 1 breath every 5–6 seconds
- Each breath should last ~1 second and make the chest rise
- Recheck pulse every 2 minutes
- Continue until breathing returns or help arrives
5. Performing Full CPR (If No Pulse & No Breathing)
🔁 CPR Ratio for Adults: 30:2
- 30 chest compressions:
- Place heel of one hand over center of chest, other hand on top
- Compress 5–6 cm deep, 100–120 bpm (think: Stayin’ Alive rhythm)
- 2 rescue breaths after every 30 compressions
- Use head tilt–chin lift unless spinal trauma suspected
📍Field Tips:
- If alone, perform CPR for 2 minutes before going for help, unless a radio/sat device is available.
- If two rescuers: one compresses, one breathes — rotate every 2 mins to avoid fatigue.
6. Special Considerations in Wilderness Scenarios
🌡️ Cold Water Immersion
- Victims in cold water (below 21°C / 70°F) may survive up to 30 minutes submerged.
- Do not stop CPR too soon — many have been revived even after extended submersion.
🧊 Hypothermia Complication
- Cold, stiff, and unresponsive ≠ dead.
- “They’re not dead until they’re warm and dead.” Continue rewarming & CPR.
⚠️ Vomiting During Rescue
- Roll victim to side to clear airway
- Resume CPR immediately after
7. Improvising in the Wild
When gear is limited, adapt:
| Need | Improvised Option |
|---|---|
| Barrier for rescue breaths | Ziplock bag with hole, jacket sleeve |
| Spine board | Backpack, foam mat, trekking poles |
| Chest compressions on uneven ground | Dig out soft soil or use clothing pads under chest |
8. Aftercare Post-Resuscitation
Even if revived, never assume “it’s over.”
- Monitor vitals continuously
- Keep victim warm and calm
- Evacuate ASAP — dry drowning (fluid in lungs) or cardiac complications can develop hours later
- Encourage slow sips of warm water only if fully conscious
9. Training & Preparation: Be Rescue-Ready
Every mountain team member should train in Wilderness First Responder (WFR) or Wilderness First Aid (WFA).
Carry a CPR mask, rescue breathing sheet, pulse oximeter, and a basic water rescue throw rope in every kit.
Conclusion: Courage Without Skills Is a Gamble
When someone’s life depends on your hands, skills beat strength.
Learn CPR. Practice rescue breathing. Be calm in chaos. Because out there — you are the first responder.
💬 Real Talk from the Field:
“On a jungle trek in Laos, a porter slipped into a swollen river. We pulled him out, not breathing, blue lips. I started compressions while my teammate did mouth-to-mouth. After 3 minutes — he gasped. That gasp wasn’t just breath. It was life coming back.”
— 22-year expedition veteran, 5000m+ rescues, multiple field saves
