b'DrowningChapterConcurrent hypothermia There is no evidence that drowning in colder water has an increased survival rate compared with warmer water, however there have been many reported cases of patients surviving rescue from icy waters, even after prolonged resuscitation efforts. Hypothermia is more likely due to prolonged immersion and ongoing cooling during resuscitation at the scene.In-water resuscitationRemove the patient from the water as soon as possible and only begin in water rescue breathing if immediate removal from the water is delayed or impossible. Rescue breathing in deep water requires an appropriately trained rescuer and floatation aid such as a rescue board, tube or buoyancy vest. In water, chest compressions are ineffective and should not be attempted.Use of the AED If available, the AED should be attached and the prompts followed as soon as possible. Dry the patients chest before applying electrode pads.Compression-only CPR The primary cause of cardiac arrest in drowning is inadequate breathing. Compression-only CPR circulates oxygen-poor blood and fails to address the patients need for immediate ventilation. It is not recommended and should only be used temporarily if the rescuer is unable or unwilling to perform rescue breathing before the arrival of a barrier device, resuscitation face mask or bag-valve-mask device.212 Medical Emergencies'