The American Canoe Association’s (ACA) Safety and Rescue Committee’s (“the Committee”) membership includes recipients of the Higgins and Langley Award (the highest international award given in swiftwater rescue), pioneers in the development of swiftwater rescue, authors of the standard texts on the subject, and innovators who are developing leading-edge advancements in swiftwater rescue. This statement was endorsed by the committee and created by leading wilderness medicine physician leaders and educators with a passion for water sports.
Drowning is experiencing respiratory impairment from immersion or submersion in a liquid medium as defined by the World Health Organization (WHO).
Accepted drowning terminology includes drowning without morbidity (persistent symptoms) or mortality (death), drowning with morbidity (persistent symptoms), and drowning with mortality (death). Modifying terms such as "near" drowning, "dry" drowning, and "delayed" drowning should no longer be used.
Drowning is the leading cause of death in water sports. Drowning is a respiratory (breathing) problem, and therefore, oxygenation (rescue breath or bag valve mask) for drowning victims should be prioritized.
Many organizations are now teaching hands-only CPR, which is of great benefit for adult patients with a cardiac event leading to cardiac arrest. However, cardiac arrest in drowning patients is typically due to a respiratory issue. Therefore, paddlers should be encouraged to learn rescue breathing (mouth-to-mouth) in addition to compressions when taking a CPR course. Compression-only CPR is preferable to no CPR. However, early rescue breaths carry a survival benefit in drowning victims.
Paddlers should consider carrying a barrier device for rescue breaths in their life jackets. Rescue breaths should be provided as soon as feasible and, with proper training, can be provided in the water upon first contact in certain situations. Often, there is significant foam in the mouth during rescue breaths; it is best not to spend time clearing the foam and instead deliver rescue breaths through the foam.
Training is important as rescuers on site with proper training can improve outcomes by performing rapid patient contact, rescue breaths, rescue from the water, and CPR.
Note: participants are encouraged to reference the ACA River Safety & Rescue Terminology Handbook for further information and education.
© American Canoe Association
Date of last revision: 4/22/2025
This curriculum is managed by the ACA Safety & Rescue Committee. To connect with the leadership of this committee, please view the SEIC Committee rosters on the ACA website.