What is secondary drowning and how can it be prevented?

Dr. Frank LoVecchio is an emergency medicine physician on staff at Banner – University Medical Center Phoenix. His office can be reached at (602) 253-3334.  

Question: I’ve heard a number of stories about secondary drowning in the news lately. Can you please explain what secondary downing is and how it can be prevented?

Answer: When most people think of drowning, they likely don’t think of it happening out of the water. However, in rare instances, this can happen.

Secondary drowning or dry drowning occurs when an individual inhales water due to a near drowning or struggle in the water. A person who experiences a drowning “close call” can be out of the water and walking around as if all is normal before signs of dry drowning become apparent.

With secondary drowning, the inhaled water results in a buildup of fluid in the lungs, a condition called pulmonary edema. Symptoms often occur within 4 hours of the event (but may not become apparent for 24-48 hours after being in the water) and can include difficulty breathing, coughing, chest pain, lethargy, and changes in mood or behavior, according to the American College of Emergency Physicians. If untreated, pulmonary edema can be fatal. 

Recent news reports of secondary drowning deaths of children have increased attention on the topic. Drowning is a major cause of accidental death among persons under the age of 45 years and a leading cause in children under five years of age, particularly in states where pools or beaches are more accessible, such as Arizona, California, and Florida. Studies suggest that secondary drowning may be responsible for roughly 10-15% of all drownings.

Children or adults who demonstrate these symptoms need to be brought to the emergency department where we will take a thorough history, conduct a physical exam, and do the necessary blood and radiology testing. Treatment often includes oxygen, with some patients requiring a respirator.

Prevention is the best way to avoid concerns of drowning and secondary 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. Effective prevention also includes teaching proper water safety and knowing CPR. 

For more information on the prevention and treatment of secondary drowning, talk with your health care provider.