• Roberto Barcala-Furelos, Daniel Graham, Cristian Abelairas-Gómez, and Antonio Rodríguez-Núñez.
• REMOSS research group, Faculty of Education and Sports Sciences, Universidade de Vigo, Pontevedra, Spain; CLINURSID Research Group, Psychiatry, Radiology, Public Health, Nursing and Medicine Department, Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Santiago de Compostela's Health Research Institute (IDIS), Santiago de Compostela, Spain; IDRA, International Drowning Researchers' Alliance, Kuna, ID, USA. Electronic address: roberto.barcala@uvigo.es.
• Am J Emerg Med. 2021 Jun 1; 44: 38-44.

ObjectiveMany victims of drowning fatalities are lay-people attempting to rescue another. This review aims to identify the safest techniques and equipment (improved or purpose made) for an untrained bystander to use when attempting a water rescue.MethodA sample of 249 papers were included after the bibliographic search, in which 19 were finally selected following PRISMA methodology and 3 peer review proceeding presented at international conferences. A total of 22 documents were added to qualitative synthesis.ResultsGeographical location, economic level, physical fitness, or experience may vary the profile of the lay-rescuers and how to safely perform a water rescue. Four lay-rescuers profiles were identified: 1) Children rescuing children in low- and middle-income countries (LMICs), 2) Adults rescuing adults or children, 3) Lay-people with some experience and rescue training, 4) Lay-people with cultural or professional motivations. Three types of techniques used by those lay-rescuers profiles: a) non-contact techniques for rescues from land: throw and reach, b) non-contact techniques for rescue using a flotation device and, c) contact techniques for rescue into the water: swim and tow with or without fins.ConclusionThe expert recommendation of the safest technique for a lay-rescuer is to attempt rescue using a pole, rope, or flotation equipment without entering the water. However, despite the recommendations of non-contact rescues from land, there is a global tendency to attempt contact rescues in the water, despite a lack of evidence on which technique, procedure or equipment contributes to a safer rescue. Training strategies for lay-people should be considered.Copyright © 2021 Elsevier Inc. All rights reserved.

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