Drowning Outside of Water?

I recently read a FaceBook post about the dangers of “secondary drowning.”  As a pool owner, I not only found the information a real eye opener, but also worthy of sharing with my readers.

Johnny was splashing around in a neighborhood pool.  He wore flotation devises on his arms and was being supervised.  When he took in some water, Johnny coughed a little, but then seemed fine.  His mother said there was nothing out of the ordinary.  But, less than two hours later, the 10-year-old defecated in his pants twice and was complaining of being tired.  He bathed, dressed himself, and walked to his bed unaided.  Shortly after his nap, Johnny’s mom found her son unconscious and his face covered in a foam-like substance.  He had turned purplish-blue and his tongue was swollen.  She called 911.  Sadly, Johnny suffered from cardiac arrest on the way to the hospital; he was pronounced dead upon arrival. The cause of death – asphyxiation due to drowning; there was a lot of water found in the child’s lungs.

After some research, I found that Johnny’s story is not unique.  In 2008, another ten-year-old boy died in his bed an hour after swimming. A 60-year-old man fell off a friend’s boat into New York’s Long Island Sound, but was able pulled himself out.  Once he returned home, the man told his wife he felt ill.  She called 911 and he was transported to the hospital where he died, apparently of drowning. Earlier this month, a mother and her toddler were at a family pool party. The child played on the top step of the spa while his mother sat on the edge of the pool.  In mere seconds, the child was frantically trying to keep his head above water as his body was being whirled around by the jets in the whirlpool.  The child was pulled out by his mom; other that coughing and being upset, he seemed totally fine, even participating during the rest of the party.  Later that day, the child appeared extremely tired and had an unusual cough. To be on the safe side, his mom called the pediatrician who told her to go to the ER immediately.  A round of blood tests and x-rays showed the child’s lungs were aspirated; he was suffering from secondary drowning.  The mother’s instinct saved her son.  Later, she learned that her son was the third case of secondary drowning on the same hospital floor that day.

As one can see from these real-life stories, secondary drowning can be difficult to recognize.  A victim may breathe in a very small amount of fluid and believe s/he has successfully expelled it through coughing. In reality, the water may fill up some of the oxygen-rich pores of the lungs, reducing the lungs’ ability to oxygenate the blood as it passes through. The heart does not slow down appreciably during this process, so the victim can still walk and talk. In Johnny’s case, physicians said the child would only needed to inhale four ounces of water to drown, even less to injure his lung enough to become a victim of secondary drowning.

“Depending on what’s in the fluid it can have numerous effects on the lung,” said Stephen Epstein, a spokesman for the American College of Emergency Physicians and practicing physician at Boston’s Beth Israel Deaconess, Medical Center. “One of the things that keeps the breathing bubbles in your lungs – alveoli – open is a chemical called surfactant, which can get diluted when fluid enters the lungs.  What results when the surfactant is diluted and the lung is not working properly is that the body’s natural reactor kicks in and sends other fluids from your body to help – flooding your lungs with fluids.”  “Sometimes the body has a natural reaction that is not helpful,” said Epstein. “The fluid comes out of your blood stream and invades the lung, and then we have a lot of fluid inside the lung, leaving no room for the air. When this happens, the body may respond by pushing even more liquid into the lungs (this is called pulmonary edema).  Pulmonary edema can result in cardiac arrest as oxygen is prevented from getting into the blood stream and eventually stops the heart from beating.”

Secondary drowning can happen in a pool, in the ocean, and even in a bathtub, occurring between one and forty-eight hours of being pulled from the water.  By sharing these stories, I hope to educate parents on secondary drowning so everyone can reduce the risks.  Keep a constant eye on children near any bodies of water and know the warning signs of secondary drowning including:

• Coughing
• Vomiting or involuntary defecation immediately following swimming
• Sudden change in personality, such as agitation
• Labored or difficulty breathing or altered mental status.
• Extreme tiredness/lethargy
• Pain in the lungs or chest especially when taking a deep breath

Anyone who has been submerged and has aspirated should seek medical attention immediately.  As with the case earlier this month, a victim can survive a secondary drowning with fast medical attention.

Secondary drowning is something every parent needs to know about, so please share this information for the safety of all swimmers this summer.

Mark Bello has thirty-seven years experience as a trial lawyer and fifteen years as a leading expert in the lawsuit funding industry.  His company, Lawsuit Financial Corporation, provides necessities of life funding to plaintiffs involved in pending, personal injury, litigation. He is a Member, Justice Pac Member, and Sustaining Member of numerous state and national justice associations.