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Secondary Drowning – How Real is the Risk?

As families are packing up their beach bags and jump into pools, oceans, rivers and lakes this summer, many parents are concerned about a swimming risk that’s gotten a lot of recent media attention. It’s called secondary drowning (also known as dry drowning).

Here at the WakeMed Children’s Emergency Department, we have seen an influx of patients and parents concerned for dry drowning. Although rare – secondary drowning accounts for only 1-2% of all drownings – it’s important to know the facts and to remind children, parents and families to swim safe.

What is Secondary Drowning?

Secondary drowning is a rare lung injury that can happen when a person is submerged under water, and he or she inhales water along with salt, dirt and/or chlorine directly into the lungs.

A child (or adult) can breathe in a small amount of water to experience secondary drowning, but it’s important to understand that it’s much more than just choking on water.

Children – especially those who are learning how to swim – suck in and choke on water all the time and are just fine. This is typically nothing to worry about,” explains Dr. Jakubowicz. If someone has a near-drowning experience and seems fine after being pulled to safety, make sure to monitor them closely.


Symptoms of Secondary Drowning

The symptoms of secondary drowning may not show up immediately, but typically show up within six to 24 hours. That’s why if someone has a near drowning incident and seems fine after being pulled to safety, make sure to monitor them closely for the following signs:

  • Coughing
  • Wheezing
  • Fever
  • Weakness
  • Confusion

Long-Term Effects

With prompt treatment, secondary drowning usually doesn’t leave long-term effects, although a serious lung infection or brain damage could ultimately result if the person is not treated quickly. Chemical pneumonitis – inflammation of the lungs due to harmful chemicals – 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 an adult who does not know how to swim. Children most likely to drown are those with a parent who is afraid of the water. If a parent can overcome fear and get swim lessons for their child, they will break the cycle of fear and reduce the risk of drowning for generations to come. Here is some advice from Dr. J:

#1 – Learn how to swim.

Swimming is a vital life skill, and swimming lessons are the best way to prevent drowning. A person’s chance of drowning decreases by 80 percent when they’ve had swim lessons.

According to the American Academy of Pediatrics, children ages 1 to 4 who take swim lessons may be less likely to drown. Adults who do not know how to swim should take lessons as soon as possible.

#2 – 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.

Utilize the “touch rule” by always being within arm’s reach when young children are in the water.

#3 – Avoid distractions.

Drowning often occurs silently.

#4 – Always swim in a safe environment.

If a pool is not crystal clear and you cannot see the bottom, don’t swim in it.

#5 – Never leave children unattended.

Secondary drowning can also occur after a child is briefly submerged in a bathtub or extremely shallow waters (such as a baby pool or in shallow ocean pools/waves). Never leave a baby or toddler unattended in these areas – even for a moment.


About Andy Jakubowicz, MD

Dr. Andy Jakubowicz (aka: “Dr. J.”) is an emergency physician and assistant director of WakeMed Children’s Emergency Department.