[CanisLupusArctos]

In EMT class 13 years ago, and in every refresher I've gone to since, they have taught the following about rescuing a person in the water:

A person who feels he/she is in danger of drowning (whether they are or not) is very desperate, and therefore very dangerous to approach. He/she will not think twice about pushing the rescuer under and using the rescuer as a flotation cushion. The victim may be a total saint under normal conditions, but dire situations can bring out some very unpredictable and dangerous behavior in us all.

Therefore, when you're faced with a person thrashing about in the water, remember this order:

Reach - Throw - Row - Go.

First try to reach for the person while secured to dry land or a stable boat. You can use a pole or paddle to extend your reach.

If that doesn't work, try a throwable device, preferably with a rope attached so you can haul them in. In many cases this will be the first thing you do anyway, since victims are seldom within reach.

If that doesn't work, use a boat to go get them ("Row".) This step assumes that the rescuer is on land. "Row" may be the first thing you do if you're already on the water. Upon arriving near the victim you would go through steps 1 & 2 (reach-throw) ONLY IF your craft is stable enough to support someone hanging off the side. If you're in a canoe or a small rowboat, the desperate victim may well capsize it while trying to get in (against your wishes.) If you're not in a sturdy craft, DON'T get too close to the victim. Skip step 1 and just "throw." Then you can tow them to safety - just don't let the desperate person get near your unstable craft.

Finally, if all else fails, and only if all else fails, GO. This means swim. Only do this if you know how to rescue a person from the water and if you're fully prepared to prevent the victim from pushing you under.

Here is something that stunned us all when we learned it in EMT class, but it makes sense:

It is actually OK to wait for the victim to go unconscious IF

1) the victim is hysterical - obviously desperate AND

2) Swimming to the victim is your only rescue option AND

3) You are not prepared or are physically unable to subdue and restrain the victim while simultaneously rescuing him/her.

In such a case, it is a matter of scene safety - the first priority in any rescue scene. If the scene is not safe, an unprepared rescuer is more likely to make the scene worse by becoming an additional victim.

When you have to rescue by swimming, waiting for the hysterical person in water to go unconscious is the only way to ensure scene safety. The unconscious person may then be pulled to safety without endangering the swimmer who's doing the pulling.

Once ashore/aboard, go through the rescue breathing routine - open the airway and check for breathing, and provide it if there is none. The victim may need to be treated for choking (belly thrusts) and sometimes they start breathing spontanously after the water is cleared from the airway. Other times, rescue breathing is what's needed to re-stimulate spontaneous breath. Get the ambulance rolling your way if it's not already.

In both cases, the previously-unconscious victim should get to a hospital to get checked out - even if he/she feels fine. There may be water in the lungs that could lead to infection, and other complications from the near-drowning may become problems later if they're not treated early.

That brings up a final point - Everyone should learn CPR. Even kids can learn it and they have saved lives with it.