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Protect Your Family From Secondary Drowning

By DuPage Medical Group Pediatrics

Swimming, pools, beaches and children all go together in the summertime. Sunscreen is not the only thing you need to remain diligent about while enjoying a cool-down in the water. After birth defects, the leading cause of death in children ages 1-4 is drowning. While this can happen in a shallow bathtub, summertime is when the danger is highest. Surprisingly, drowning deaths can occur up to 24 hours after a child takes water into their lungs. This is referred to as “dry drowning” or “secondary drowning” but is actually two separate conditions which show similar symptoms. Fortunately, these conditions occur only rarely after submersion injuries and are completely avoidable if you familiarize yourself with the following tips.

First, it is important to understand the different types of drowning.

Dry Drowning (also called delayed drowning): No water in the lungs, similar to a “panic sensation” that causes a spasm of the larynx leading to asphyxiation (oxygen deprivation), and causes the vocal cord to spasm and no longer allow air in the lungs.

Secondary Drowning: Post-water injury where water, food or vomit gets into the lungs and causes labored breathing, fluid build-up in the lungs and eventual asphyxiation (oxygen deprivation). Also can be chemical pneumonitis (pool chemicals cause asphyxiation, which prevents adequate oxygen exchange and causes inflamed lungs to produce fluid). The body’s own fluids actually cause the victim to “drown.”

Prevention- Your First Line of Defense
First, be aware that drowning can happen anywhere (and in as little as 30 seconds) even in a few inches of water. You can avoid most incidents by thinking ahead and using safety tactics. Beyond the bathtub and swimming pool, know that ponds, toilets, backyard puddles and even large water bowls for dogs can present a drowning danger for small children. Think ahead:

  • Be realistic about your child’s swimming ability. Do what you can to talk to them about self-safety and understanding when water is too deep for their ability.
  • Make sure your child has taken swimming lessons. Swimming instructors are trained to teach “self-safety” checks for children of all ages. For example, when water is deep enough to reach their chin this is a warning sign to move to more shallow water. Running on a deck could cause a slip and fall into a deeper body of water than a child can manage.
  • If you have your own pool, install an alarm and a fence with a lock. Most drowning incidents occur in backyard pools, according to the CDC.
  • If you are visiting someplace with a pool, ensure the locks and alarms are functioning.
  • Don’t ever leave toys on the pool deck that might entice a child to try to gain access to a place where they could accidentally fall in the pool.
  • Have small children wear life jackets. Air-filled water wings or foam flotation toys are not reliable safety devices.
  • Don’t swim in public beaches or pools without a lifeguard present. They are trained for water rescue and resuscitation if a submersion injury occurs. That being said, it is not the lifeguard’s job to watch your children. Taking your eyes off a child for even a few seconds could be too long.
  • Along with reliable safety devices, be in the pool with your child, within arm’s reach, at all times.
  • Brush up on your CPR facts. Your local hospital may offer a low-cost class for parents and child-care providers.
  • Make sure the pool you use has adequate drain and filter coverage to ensure a child cannot get stuck in the equipment.
  • If your child has asthma, their lungs may be more susceptible to post submersion conditions.
  • Check ahead before swimming at city beach fronts. The rip currents can be too strong for small children or even adults during high wind conditions.

Education- Your Second Line of Defense
Take heart in knowing that both secondary and dry drowning are rare. If your child has a submersion injury where their lungs fill with water, the danger of secondary drowning can be eliminated if you follow the precautions below.

Symptoms of Dry or Secondary Drowning:
Close monitoring for the first 24 hours after an accident are crucial. After rescuing the child from water, call 911 right away. If the child is alert, able to talk and otherwise appears to behave normally, you can take them for evaluation in an immediate care setting rather than calling 911.

Dry and secondary drowning share the same warning signs. All are related to lack of oxygen to the brain. If your child has experienced a water accident, watch for the following symptoms for the first 24 hours after the submersion. If you notice any of the symptoms below, you should not allow your child to fall asleep or be alone for any amount of time. You need to seek medical attention immediately. After 24 hours have passed you can follow up with your child’s primary care physician for lingering symptoms.

  • Difficulty breathing
  • Mental status changes
  • Extreme fatigue, lethargy
  • Chest pain
  • Discolored lips or pale skin
  • Glassy eyes
  • Labored breathing (flared nostrils, rapid breathing)
  • Crankiness
  • Forgetfulness
  • Vomiting/nausea
  • Uncontrollable coughing

Secondary drowning occurs very rarely. It can be avoided all together by practicing diligent safety strategies when near water and by knowing when to seek medical evaluation after a submersion injury. Missing the warning signs is usually the reason deaths occur. Educate yourself on the facts to keep your family safe.


Topics and Subtopics: General Health

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Family Medicine Pediatrics
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