The "upside-down water control" method after a child drowns may worsen oxygen deprivation.
With the end of the rainy season, the scorching summer sun is beginning to test the endurance of citizens, and cool water bodies have become a popular spot for many children to escape the heat. However, due to lack of supervision and other reasons, drowning has become a major hidden danger causing accidental deaths among children during the summer break. Yet, there are still misconceptions among many parents about the correct first aid methods for drowning. Recently, a 4-year-old boy in Hunan accidentally fainted and drowned while taking a bath in the family bathroom. His parents quickly took the "upside-down water control" measure, but it still resulted in severe brain damage, sparking heated discussions online. So, what is the correct way to provide first aid after a child drowns? Reporters consulted professionals to get answers.
Online poll: 21.42% of netizens recommend the "upside-down method"
Yesterday, News Morning Post and Dashen Network jointly launched an online survey on children's summer safety. By 6 p.m., it had attracted thousands of participants.
24.72% of netizens believe that the biggest safety hazard for children during the summer is injuries from playing and falling; 17.73% of netizens think drowning is the biggest hazard, ranking second; falls from heights, animal scratches, food safety, and others are also concerns regarding children's safety hazards. In the vote on "what are the symptoms after a child drowns," 13.38% of netizens believed that "waving hands frantically and shouting for help" is a typical symptom, second only to "unable to wave or shout for help" (19.98%).
"What are the correct first aid methods after a child drowns?" Faced with this question, the most chosen answer was: "After a child drowns, call out loudly to the child. If there is no response, immediately lay the child flat and start chest compressions immediately," chosen by 22.79% of netizens. However, the online "upside-down water control method" is also regarded as a golden rule by many, with 21.42% of netizens believing it is the correct first aid method.
Using the "upside-down method" for first aid may worsen oxygen deprivation
Reporters found that many people online recommend using the "upside-down water control method" when rescuing a drowning person—i.e., after pulling the drowning person ashore, pressing their abdomen, then hanging them upside down (legs up, head down) over the rescuer’s shoulders to "drain the water." However, Ren Hong, attending physician in the pediatric critical care department at Shanghai Children’s Medical Center, does not recommend this approach. "In fact, very little water enters the lungs during drowning—most of it stays in the stomach. Turning the person upside down to drain the water can actually force the water into the trachea or lungs, worsening oxygen deprivation."
Ren Hong explained the correct method for draining water: place the drowning person in a head-low, buttocks-high position, quickly lift their waist so their back is upward and head is downward, and quickly drain water from the lungs, trachea, and stomach. Alternatively, place their abdomen on the rescuer’s bent knees, letting the head hang down, then press their back flat to drain water from the trachea and throat. A small wooden stool, large stone, or inverted iron pot can be used as a support. During this process, rescuers must act swiftly—avoid spending too much time draining water at the expense of other life-saving measures. The goal is to drain water from the mouth, throat, and trachea. If little water is expelled, immediately begin artificial respiration, chest compressions, and other emergency procedures.
Therefore, Ren Hong advises that if the drowning person has no heartbeat or breathing, begin CPR immediately without draining water. If the drowning person still has spontaneous breathing and a heartbeat, water drainage can be performed.
"Silent drowning" cannot be generalized
Summer is the peak season for child drowning. Based on years of clinical experience, Ren Hong summarized some areas where children are prone to drowning. Ponds and rivers in urban-rural fringe areas are the most common sites for drowning incidents. At home, when bathing or washing a baby’s face—even in shallow water—a baby who falls, especially face-down, with their nose and mouth submerged in water, can drown or even die without adult help. Even wearing life vests doesn’t guarantee safety; a life device may leak or the child may face breathing problems if the parent steps away temporarily.
A few days ago, a 5-year-old boy was hospitalized due to drowning. When asked by Ren Hong about the time and cause of the incident, his parents were clueless. It turned out the boy fell into a pond near a factory while playing with friends and was rescued by a passerby. His parents only learned about it after neighbors told them. "In most cases, the reason for child drowning is lack of adult supervision." Children aged 2–7 are the most frequent victims of drowning. At this stage, children can walk but lack safety awareness, which can easily lead to tragedy.
In addition, regarding the online claim that "most child drownings happen quietly, standing in water," Ren Hong said it cannot be generalized. She explained that drowning is divided into dry drowning and wet drowning. The former is caused by laryngospasm leading to suffocation, with little or no water entering the respiratory tract and alveoli. Due to panic, fear, or sudden cold, the larynx spasms, completely blocking the airway and causing suffocation and death. When the larynx spasms, the heart may reflexively stop, or it may stop due to cardiac hypoxia from suffocation. Data shows that 10%–40% of all drowning deaths may be dry drowning. Wet drowning occurs when the drowning person instinctively holds their breath to prevent water from entering the respiratory tract, but due to hypoxia, they cannot hold their breath and are forced to take deep breaths, allowing large amounts of water to enter the respiratory tract and alveoli, blocking gas exchange, causing systemic hypoxia and carbon dioxide retention, and rapidly absorbing water from the respiratory tract into the bloodstream.
Because the composition of the water involved in drowning varies, the resulting conditions also differ. "Drowning has different manifestations. What is called a blank, silent state is likely due to suffocation," Ren Hong said. When a child first falls into water, they will instinctively struggle. If there is no response, it could be due to brain hypoxia. "As a general rule, if you see a child playing in non-standard water bodies, pay attention—especially if their movements seem unnatural or they remain motionless for a long time."
Eight steps to correctly perform CPR
"Whether draining water or performing CPR, there are standard procedures. Even those without medical backgrounds can learn them easily. Parents should pay attention and be prepared for emergencies."
Ren Hong briefly introduced the CPR procedure—
First, call out and gently tap the child to check for consciousness.
Second, shout for help and request assistance. If a second rescuer is present, immediately call 120 for emergency services.
Third, observe whether the child’s chest is rising and falling (i.e., whether there is spontaneous breathing).
Fourth, feel the central artery pulse (carotid, femoral, or brachial artery) for 5–7 seconds to determine whether there is a heartbeat.
Fifth, if the child has lost consciousness, has no spontaneous breathing, and has no detectable pulse, immediately begin 30 high-quality chest compressions.
Sixth, after 30 chest compressions, give two rescue breaths. Therefore, for single-person CPR, the ratio of chest compressions to rescue breaths is 30:2. If two people are performing CPR,
the ratio is 15:2 (for children. For adults, it is always 30:2).
Seventh, repeat this cycle of CPR five times, then reassess for spontaneous breathing and heartbeat.
Eighth, if spontaneous breathing and heartbeat have not resumed, continue cardiopulmonary resuscitation (CPR); if breathing and heartbeat have resumed, place the person in the recovery position on their side.
During the CPR process, Ren Hong also reminded of several important points—
First, check whether the drowning child has any limb injuries, as well as spinal or cervical spine injuries, and ensure proper protection;
Second, for children who have a heartbeat but no breathing or only weak breathing, quickly clear the airway of foreign objects and immediately begin artificial respiration. For those whose heart rate and breathing are relatively stable, place them in the lateral recumbent position to prevent aspiration;
Finally, regardless of the circumstances of the drowning incident, the person should be promptly taken to the hospital for further examination and treatment.