News Release

Bystanders who intervene can reduce the risks of a drowning child’s death or severe disability by 80%: study abstract

A drowning victim was more likely to recover when submerged under water for less than 5 minutes and when rescued by a bystander

Reports and Proceedings

American Academy of Pediatrics

A drowning victim was more likely to recover when submerged under water for less than 5 minutes and when rescued by a bystander, according to research presented at the 2021 American Academy of Pediatrics National Conference & Exhibition

ITASCA, IL – Regardless if CPR was performed, a rescuing bystander reduced the odds of severe disability or death in pediatric drowning victims by 80%,” according to a study abstract presented at the AAP 2021 virtual National Conference & Exhibition.

The retrospective study in Harris County, Texas, “Bystander Resuscitation in Pediatric Drowning,” examined EMS, hospital and fatality data from 2010-2012 in 264 pediatric drowning victims.

Drowning is a leading cause of unintentional injury death in children ages 1 through 14 years old.

“Bystanders play a critical role in preventing poor outcomes in childhood drowning by instituting safe, early and effective rescue and resuscitation of pediatric drowning victims,” said abstract author Rohit P. Shenoi, MD, pediatrics professor at Baylor College of Medicine and Attending Physician, Emergency Center, Texas Children’s Hospital.  “Early rescue can lead to good outcomes in victims of drowning.”

Children who were submerged under water less than five minutes were significantly less likely to experience severe disability or death, according to the research.

Researchers also found that, regardless of whether cardiopulmonary resuscitation (CPR) was performed, a child’s odds of not suffering an unfavorable outcome were 80% higher when a bystander intervened. Many bystanders rescue drowning victims by virtue of their proximity to the victim, according to the research. They tend to interrupt the drowning process at the respiratory arrest stage before full cardiopulmonary arrest has occurred.

“Bystander” was defined as a parent, relative, babysitter, lifeguard, friend or other person who was present at the site.

The study included all pediatric drowning victims - those who sustained respiratory arrest and those who sustained cardiac arrest. Most were between ages 1 and 4, and most drowning incidents occurred at a swimming pool.

“The drowning chain of survival is key to reducing drowning deaths and injury,” Dr. Shenoi said.  “The steps of the chain are to prevent drowning, recognize distress, provide flotation, remove from water, and provide care and CPR as needed.”

Co-author Colleen Driscoll, a 4th year medical student at Baylor College of Medicine, will present the study abstract at 11:15 am CT Sunday, Oct. 10, 2021.

Please note only the abstract is being presented at the meeting. In some cases, the researcher may have more data available to share with media or may be preparing a longer article for submission to a journal. 

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit


Program Name:

Abstract Title: Bystander Resuscitation in Pediatric Drowning

Rohit Shenoi

Houston, TX, United States

Sunday, October 10, 2021: 11:15 AM –

Drowning is a leading cause of unintentional injury death in children 1-14 years. Favorable outcomes in drowning victims occur with brief submersion duration, early cardio-pulmonary resuscitation (CPR) and shorter EMS response times. The aim of this study was to determine the effect of bystander rescue and resuscitation on pediatric drowning victim outcomes.

This was a cross-sectional study of pediatric drowning victims, aged 0-18 years, in a metropolitan area from 2010 to 2012. Submersion, prehospital, and victim data were obtained from hospital, Emergency Medical Services, and child fatality records. Unfavorable outcome was defined as death or severe impairment at hospital discharge and favorable outcome was a return to baseline status or mild impairment. Logistic regression determined factors associated with unfavorable outcome after controlling for demographics and submersion location and duration. We studied the association between the presence of a rescuing bystander and unfavorable outcome stratified by whether the victim received or did not receive bystander CPR

There were 264 pediatric submersion victims aged 0-18 years in Harris County, Texas between 2010-2012. The median age was 3.2 years (IQR:1.8, 4.9). Most of the victims were males (60%) and belonged to under-represented minorities (64%). Most drownings occurred in swimming pools (78%). There were 38 victims (16%) with unfavorable outcomes at hospital discharge. Unfavorable outcome was associated with submersion duration > 5 minutes (p<0.001). A rescuing bystander (irrespective whether CPR was performed) reduced the odds for an unfavorable outcome by 80% [aOR = 0.2(95% CI 0.07–0.6); p=0.004] when compared to non-bystanders after adjustment. Bystander CPR reduced the odds of an unfavorable outcome [aOR = 0.22 (95% CI 0.05–1.1); p=0.07] but the results were not significant.

Bystander rescue is associated with favorable outcomes in pediatric victims of drowning. We observed a trend towards bystander CPR reducing the likelihood of unfavorable outcomes but the results were not significant.

For release:  12:01 a.m. ET, Friday, October 8, 2021

AAP contact: Lisa Black, 630-626-6084,

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