Req 6b — Overdose, Drowning & Electrical Shock

These are among the most dangerous causes of unconsciousness. Each one can be fatal without rapid intervention. Knowing what to do — and what not to do — in these situations could be the difference between life and death.

Drug Overdose and Alcohol Poisoning

An overdose occurs when a person takes more of a substance than their body can safely process. This can happen with prescription medications, over-the-counter drugs, illegal drugs, or alcohol.

Alcohol poisoning is a specific type of overdose caused by drinking a dangerous amount of alcohol in a short period. It is a leading cause of death among young people.

Signs and symptoms: Confusion or unresponsiveness, slow or irregular breathing (fewer than 8 breaths per minute), blue or pale skin, vomiting (especially while unconscious), seizures, low body temperature, inability to be woken up.

First aid:

1. Call 911 immediately. Do not wait to “see if they get better.”
2. Check breathing. If the person is not breathing, begin CPR.
3. Place them in the recovery position if they are breathing but unconscious — this prevents choking on vomit.
4. Stay with them. Monitor breathing continuously.
5. If you suspect an opioid overdose (heroin, fentanyl, prescription painkillers) and naloxone (Narcan) is available, administer it as a nasal spray. Naloxone temporarily reverses opioid effects and is available without a prescription in most states.
6. Do not give them coffee, cold showers, or try to “walk it off.” These do not reverse an overdose and waste precious time.

Prevention: Never misuse prescription medications. Avoid alcohol and drugs entirely — they are illegal for minors and dangerous at any age. If you see someone in danger, call for help. Good Samaritan laws in many states protect people who call 911 for an overdose from prosecution.

Underwater Hypoxic Blackout

Underwater hypoxic blackout (also called shallow water blackout) happens when a swimmer loses consciousness underwater due to low oxygen levels in the blood. It is most often caused by hyperventilating before diving — taking several fast, deep breaths to “load up” on air. This does not actually increase oxygen — it just lowers carbon dioxide, which is the signal that tells your brain to breathe. The swimmer feels fine, dives under, and blacks out without warning.

Signs: A swimmer who suddenly stops moving underwater. An unconscious person at the bottom of a pool. A swimmer who surfaces unconscious or limp.

First aid:

1. Get the person out of the water immediately. If you are trained in water rescue, follow safe rescue techniques. If not, use a reaching or throwing assist — do not swim to the victim unless you are a trained lifeguard.
2. Call 911.
3. Check breathing and pulse. Begin CPR immediately if needed.
4. Do not give up. Drowning victims — especially in cold water — have survived after extended submersion. Continue CPR until EMS arrives.

Prevention: Never hyperventilate before swimming underwater. Swim with a buddy who watches you from the surface. Never swim alone. Follow the BSA Safe Swim Defense guidelines.

Cold Water Shock and Drowning

Cold water shock is the body’s involuntary response to sudden immersion in cold water (below 70°F / 21°C). Within the first minute, the body gasps, hyperventilates, and the heart rate spikes. This can cause a person to inhale water and drown even if they are a strong swimmer.

If a person survives the initial shock, cold water rapidly saps strength and coordination. Within 10–15 minutes, the muscles may become so weak that the person cannot swim or hold onto a rescue device.

Drowning is death by suffocation in water. It is the leading cause of unintentional death for children ages 1–4 and a top cause for all ages.

Signs of a drowning person: Head low in the water with mouth at water level. Head tilted back with mouth open. Glassy, unfocused eyes. Vertical body position, not using legs. Trying to swim but making no forward progress. Attempting to roll over on the back. Silence — drowning is almost always silent.

First aid:

1. Do not jump in unless you are trained in water rescue. More than half of people who die trying to rescue a drowning person are untrained bystanders.
2. Reach, throw, row, go — in that order. Extend a pole or branch. Throw a flotation device. Use a boat. Enter the water only as a last resort with proper training.
3. Call 911.
4. Once the person is out of the water, check breathing and begin CPR if needed.
5. Treat for hypothermia. Remove wet clothing. Wrap in blankets. Warm gradually.

Prevention: Always wear a PFD when boating or paddling. Never swim alone. Follow BSA Safe Swim Defense and Safety Afloat policies. Learn to swim well. Know the water temperature before entering.

Lightning Strike and Electric Shock

A lightning strike delivers up to 300 million volts in a fraction of a second. Lightning can cause cardiac arrest, severe burns, nerve damage, and brain injury. Electric shock from power lines, outlets, or equipment can cause similar injuries.

Signs and symptoms: Loss of consciousness, cardiac arrest (no pulse), burns (entry and exit points), confusion, muscle pain, numbness, difficulty breathing, seizures.

First aid:

1. Ensure the scene is safe. For lightning: if there is still a storm, move the victim and yourself to a safe structure or vehicle if you can do so quickly. For electrical shock: make sure the power source is off before touching the victim.
2. Call 911 immediately.
3. Check for breathing and a pulse. Lightning can stop the heart. Begin CPR immediately if there is no pulse — lightning victims have a high survival rate with prompt CPR.
4. Treat burns at entry and exit points.
5. Treat for shock — lay the person down, elevate legs, keep warm.
6. Check for spinal injuries — the force of a lightning strike or fall from electrical contact can cause fractures.

Prevention: Follow the 30/30 rule — if the time between a lightning flash and thunder is 30 seconds or less, go inside. Wait 30 minutes after the last thunder before going back outside. Avoid open fields, hilltops, tall isolated trees, and bodies of water during storms. Stay away from downed power lines.