Today’s topic is water safety & secondary drowning – sometimes called Delayed Drowning. In short, it’s a condition in which a person who has survived near-drowning then goes on to ‘drown’ on dry land or in their bed at a later time. It’s something we talk about when we discuss water safety in the Child Care and Standard First Aid courses, but it’s not very well-known – so here goes….

What causes secondary drowning?

Water or fluid build-up in the lungs, which prevents oxygen getting to the blood (and so eventually there’s not enough getting to heart, lungs & brain). Imagine a person who nearly drowns: They get rescued and seem to recover. During the near-drowning, they manage to breathe in say 30 mLs (2 table spoons full) of water. It’s a bit irritating and they cough a lot, but eventually seem to recover. The water collects in the very bottom of their lungs and isn’t much trouble. That night they lay down and go to sleep. While sleeping, the water spreads. Because the person is now on their back the water can cover up to half of their lung surface. It prevents oxygen exchange and they slowly stop breathing and die. Take a look at the picture and see what we mean!
Lungs show water levels during secondary drowning
Water in the lungs could have been breathed in while they were having the near-drowning episode. It could also be caused by minor irritation of the lung from eg: sand in the water. If a person happened to inhale a small amount of dirty water, the constant irritation can cause fluid build up (just like constant irritation on, say, your feet can cause a blister).

How to prevent secondary drowning

Um… basic water safety and avoiding near-drowning events. Really you can’t prevent secondary drowning – you have to be aware that it’s possible and be on the watch for it. Obviously good water safety will help – along with learning to swim, staying within your depth, etc. Anyone who has been involved in a near-drowning situation should be watched closely for the next 72 hrs. Near drowning is where they’ve struggled and needed rescue, it doesn’t mean your kid ducked under water and came up spluttering!

Signs & Symptoms of secondary drowning

  • Irritation or pain in the throat or chest
  • Coughing after taking a deep breath
  • Persistent coughing or wheezing
  • Shortness of breath or difficulty breathing
  • Unusual fatigue
  • Dizziness/altered level of consciousness
  • Vomiting or diarrhea

Treatments for secondary drowning

Prevention (water safety!) but if it happens, call 9-1-1, EMS, get to hospital. Be aware of the potential need to do CPR.

Secondary Drowning in the News

Yes, it really happens. The biggest issue is that people aren’t aware of it. Here are a couple of articles we found:
(10 year old) Boy dies of ‘secondary drowning’ while napping after swim
A 60-year-old man fell into New York’s Long Island Sound, pulled himself out — and then died several hours later


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