title: In-water resuscitation: a pilot evaluation.
abstract: BACKGROUND
  The first and most important treatment for the apnoeic drowning victim is the rapid alleviation of hypoxia by artificial ventilation. Recent studies have suggested that commencing resuscitative efforts with the victim still in the water may be beneficial. The aim of this pilot study was to evaluate the feasibility and efficacy of in-water unsupported rescue breathing.
  
  
  METHODS
  Three lifeguards were taught how to perform in-water unsupported rescue breathing. Ventilation volume, inflation duration were recorded from a modified Laerdal resuscitation manikin. The rescue duration was recorded and compared to a rescue undertaken without in-water resuscitation.
  
  
  RESULTS
  The three lifeguards performed between seven and nine ventilations during each simulated rescue. This gave average inflation volumes for each lifeguard of 711 ml (S.D. 166), 750 ml (S.D. 108), 629 ml (S.D. 182) and average inflation duration of 0.8s (S.D. 0.3), 0.9s (S.D. 0.2) and 0.6s (S.D. 0.1). The rescue duration was increased from an average time of 1 min 10 s to 1 min 24 s by performing in-water resuscitation.
  
  
  CONCLUSIONS
  This study has demonstrated the feasibility and potential efficacy of in-water unsupported rescue breathing with a victim in deep water. Furthermore, the technique was not associated with an undue prolongation of the rescue duration over a 50 m rescue. In circumstances where the trained lifeguard finds themselves with an apnoeic victim in the water, with no buoyant rescue aid available, they may consider the application of in-water, unsupported rescue breathing, especially if recovery to dry land is likely to be delayed. The effectiveness of this technique, however, remains to be proven in the open water environment.
authors.affiliation: Division of Medical Sciences, University of Birmingham, Birmingham, UK. gavin.perkins@virgin.net
authors.forename: Gavin D
authors.initials: GD
authors.lastname: Perkins
mesh_terms: D001049:Apnea / Q000209:etiology / Q000628:therapy*; D005240:Feasibility Studies; D006801:Humans; D008348:Manikins; D015701:Near Drowning / Q000150:complications / Q000628:therapy*; D010865:Pilot Projects; D012121:Respiration, Artificial / Q000379:methods*; D016896:Treatment Outcome