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The Dangers of Secondary Drowning

For adults and children who cannot swim, extreme caution must be used when enjoying time in a pool, lake, river or ocean. Drowning is one thing, but if someone has a near-drowning experience and seems fine after being pulled to safety, are there any implications later on? Although rare, secondary drowning could be a concern.

What is Secondary Drowning?
Secondary drowning is a lung injury that happens when a person is submerged under water and he or she aspirates a large volume of water along with salt, dirt and/or chlorine directly into the raw lungs. The risk is that the lungs’ lining, surfactant, can be washed away, creating health issues. Tell-tale symptoms, such as coughing, wheezing, fever and a change in mental state (i.e. confusion), will typically show up within six to 24 hours. A serious lung infection or brain damage could ultimately result if the person is not treated quickly.

However, a person must breathe in a significant amount of water to experience secondary drowning (more than just choking on water). Children, especially those who are learning how to swim, suck in and choke on water all the time.  This is typically nothing to worry about. In fact, secondary drowning is far less common in those who are neurologically intact. For example, if someone suffers a seizure under water, they are at a much greater risk of suffering from the condition. 

Long-Term Effects
With prompt treatment, there are usually no long term effects. Chemical pneumonitis could result but improves in a week or so. There have been rare cases of permanent lung injury resulting from a secondary drowning episode, but again, this is rare.

Prevention is always critical near the water, especially when it comes to a child or adult who does not know how to swim. Here is some advice:

  • Learn how to swim!  Swimming is a vital life skill.  A person’s chance of drowning decreases by 80 percent when they’ve had swim lessons. According to the American Academy of Pediatrics, 4 is a good age to start giving children swim lessons. Adults who do not know how to swim should take lessons as soon as possible. Contact the YMCA for adult swim lesson options and potential discounts.
  • Don’t depend on the lifeguard to watch your children in the water. Ensure you are always supervising your child directly, and look for signs of struggle or exhaustion as a signal to take a break.
  • Always swim in a safe environment. If a pool is not crystal clear and you cannot see the bottom, don’t swim in it.

Dr. Snyder was also featured in a WRAL news story on the prevention of drowning: Swimming Lessons Key in Drowning Prevention.

Graham Snyder, MD, is an emergency physician with Wake Emergency Physicians, PA, and medical director of the WakeMed Center for Innovative Learning. Learn more about the emergency services at WakeMed.