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How to Spot the Top Warning Signs of Secondary Drowning

You probably think of drowning as something that happens when you’re submerged in water. That’s true in most cases of drowning. But there’s another type of drowning, called secondary drowning, that can occur after a drowning close call.

Melissa Luxton, a trauma prevention specialist at Banner – University Medical Center Phoenix, explained that secondary drowning is a complication of drowning. “It happens when water gets into the lungs, irritates the lungs’ lining and causes fluid to build up in a condition called pulmonary edema,” she said. “A person who experiences a drowning close call can be out of the water and walking around normally before signs of secondary drowning become apparent.”

Studies suggest that secondary drowning may be responsible for roughly 10 to 15% of all drownings.

Secondary drowning symptoms

This condition doesn’t develop right away. Symptoms of secondary drowning may begin within four hours after being in the water. But they may not be apparent for 24 to 48 hours. According to the American College of Emergency Physicians, with secondary drowning in adults or children, you may notice:

  • Difficulty breathing
  • Coughing
  • Chest pain
  • Lethargy
  • Changes in mood or behavior

You don’t have to take in a lot of water for secondary drowning to occur. “People think ingesting more water makes it more dangerous, but that isn’t necessarily true,” Luxton said. 

Secondary drowning is relatively rare. Most people will get into a bit of trouble in the pool or get knocked over by a wave and jump right back up. “The problem is, if secondary drowning goes unrecognized, it can be deadly. That’s why it’s so important to be vigilant,” she said.

Secondary drowning is not the same as drowning or dry drowning

Drowning happens when you can’t breathe properly because you’re submerged in liquid, usually water. It doesn’t always lead to death. If you survive drowning, you could have side effects ranging from no lasting injuries to brain damage.

With dry drowning, water doesn’t reach your lungs. You breathe in water, and your vocal cords spasm and close up so you can’t breathe. Drowning and dry drowning happen right away, whereas the secondary drowning timeline can have symptoms developing a day or two after being submerged in water. 

How secondary drowning is diagnosed

A health care professional can recognize or check for common signs and symptoms:

“The most important thing is to seek medical attention for any significant incidents in the water,” Luxton said.

How secondary drowning is treated

You need to get the person to the emergency room if you suspect secondary drowning. It’s crucial to seek medical care since secondary drowning can be fatal. Depending on how severe it is, it can be treated with oxygen, antibiotics or diuretics, which can help eliminate fluid in the lungs. In more severe cases, you could need a breathing machine for mechanical ventilation. 

How to prevent secondary drowning

You can prevent secondary drowning with the same precautions you take for drowning. Keep a close eye on inexperienced swimmers and children in the water, and teach swimmers to blow water out, know their limits and not panic in the water. 

Luxton shares these additional water safety tips:

  • Make sure at least one adult oversees children in the water.
  • Start children in swimming lessons at a young age.
  • Keep rescue equipment, like rescue tubes and safety hooks, as well as a telephone and emergency numbers by the pool.
  • Fence in pools and secure them with a self-closing and self-latching gate.
  • Don’t rely on water wings, floaties or air-filled toys as lifesaving devices—use life jackets.
  • Never leave a child alone in a bathtub.
  • Close and lock toilet seat lids.
  • Store buckets and containers upside down so they can’t collect water.
  • Learn CPR (cardiopulmonary resuscitation).
  • Don’t let your children play around canals.
  • Wear a life jacket when boating, near open bodies of water or participating in water sports.
  • Don’t dive into unfamiliar water—jump in feet first the first time.
  • Always swim with a buddy and never swim impaired.

The bottom line

Secondary drowning is a dangerous complication of a drowning close call that can develop 24 to 48 hours later. It’s crucial to watch for signs of secondary drowning, such as trouble breathing, coughing or chest pain and to seek help if these symptoms develop after a struggle in the water. To learn more about preventing drowning and secondary drowning, reach out to a health care professional at Banner Health.

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