Across the WCDP 2025, the medical sessions demonstrated meaningful progress toward a more unified, evidence-based, and globally applicable approach to drowning resuscitation. For the first time, we are seeing the fruits of more than a decade of sustained effort reflected in the acceptance of drowning resuscitation and spinal injury management into international guidelines. This represents an essential step toward closing the lay public and professional training gap between sudden cardiac arrest models and the unique physiology of drowning. Both the AHA and ERC now explicitly reference ILCOR’s terminology by naming “cardiac arrest following drowning” as a distinct clinical condition. This alignment strengthens the scientific foundation and facilitates clearer global communication and research.
A consistent theme across all resuscitation presentations was simplicity in-training, execution, and system design. This message is particularly relevant in low- and middle-income countries (LMICs), where complexity often becomes a barrier to implementation. Sessions highlighted the value of low-cost manikins, locally made training tools, and the importance of identifying gaps in community preparation. The Train-the-Trainer model emerged as a practical and scalable way to strengthen capacity while respecting local realities. Several presentations reinforced that guidelines designed for high-income environments cannot simply be transplanted into resource-limited settings. Adaptation is necessary, not only in equipment expectations, but also in cultural, ethical, and logistical considerations.
The revised UTSTEIN Style for drowning and aquatic incidents is a critical advancement in simplifying drowning data collection and ensuring more uniform data sharing and comparison. Emerging researchers are working to strengthen study design and data reporting in drowning publications. There was some small focus on often overlooked niche areas such as breath hold diving, blackout, and disaster affected communities. These small areas will continue to grow in importance over the coming years.
Another strong theme this year was the integration of Lifeguards and EMS within coordinated response systems. Presentations discussed structured activation pathways, patient care transitions, and a greater emphasis on situational awareness, role clarity, and communication during resuscitations. Strengthening these interfaces is essential for improving survival outcomes, especially in environments where emergency medical services operate with limited resources.
For high-income settings, technology was another emerging focus. From real-time feedback devices to improved airway adjuncts and simulation tools, we are beginning to see how technological innovations can be applied to CPR and drowning management in ways that hold promise for the future. Yet, even as these tools advance, the message remains clear: technology should support, not replace, strong foundational training and locally appropriate systems.
Importantly, community engagement remains at the core of prevention and response. Studies in rural communities with cultural barriers demonstrate that drowning interventions must be co-designed with the people they aim to serve. The success of any resuscitation or prevention strategy depends on community trust, participation, and contextual adaptation.
Though previously thought to be outside the clinical scope of drowning management, it is notable that this WCDP featured nearly as many presentations on the mental health of rescuers as on resuscitation itself. Recognizing the psychological impact of drowning incidents on the rescuers, survivors, families, and community is critical to strengthening a holistic approach to prevention, rescue, and treatment. Supporting the physical AND mental wellbeing of rescuers of all ages remains a key element in rescuer safety and sustainability in any lifesaving system, regardless of income level. Multisectoral engagement from key stakeholders across the drowning timeline and chain of survival will play a pivotal role in the coming years as we continue to learn the breadth and depth of these issues.
It is also worth noting the exponential progress made in this field the last 25 years. The idea of having a dedicated drowning research center or multiple doctoral programs for drowning prevention and lifeguarding was unheard of at the onset of the millennium. The global medical and research network has grown from a handful of physicians and professors to an impressive and extensive collection of everyone from medical students, undergraduates, lifeguards, lifesavers, doctors young and old, and everyone in between. To paraphrase something overheard in the hallway this year – We have a younger generation of practitioners, doctors, and researchers who only know hope and potential in the field of drowning prevention. Standing on the shoulders of the first few visionaries of the modern drowning era, they are poised to carry us into the future and beyond.
In summary, the medical contributions at WCDP 2025 reinforced that improving drowning outcomes worldwide requires a balance between scientific rigor, contextual adaptation, and human centered implementation. By aligning international guidelines with the realities of low-resource settings, strengthening the lifeguard–EMS interface, adopting the revised UTSTEIN Style, leveraging appropriate technology, and empowering local trainers and communities, we move closer to a truly global and equitable drowning response framework.
Mg.Leonardo A. Manino
Jefe Guardavidas Costanera Rosario EEM
SIES 107 Departamento Capacitación
Municipalidad de Rosario
ARGENTINA
ILS Americas Secretary General
ILS Medical Committee Chairman
International Liaison EPSA AC ARG
Chairman Comité de Reanimación SAMPRE ARG
Personal Académico UAI Medicina Rosario
Justin Sempsrott, MD
International Drowning Researchers’ Alliance
Lifeguards Without Borders