With all the things we have to worry about, now a new and real concern has exploded in just about all media outlets this summer---secondary drowning. Often secondary drowning is mentioned along with dry drowning but many physicians who study drowning don’t believe drowning can occur if water never enters the lungs. If water does not enter the lungs, there is no drowning according to the medical panel at the International Lifesaving Society.
But secondary drowning does and can happen, although it is an extremely rare occurrence. Some physicians speculate that secondary drowning can make up as few as 1 percent to 2 percent of all drownings, but I doubt the number is even that high.
Keeping it simple, secondary drowning occurs well after the child leaves the swimming pool under their own power and is caused by water being aspirated and trapped in the lungs that inactivates or removes the surfactant that allows the lungs to oxygenate the blood. Most often children expel the water naturally by simply coughing, but sometimes this aspirated water makes its way all the way into the lungs and causes respiratory distress. This is why rough-housing and repetitive plunging under the surface of the water is not recommended. Likewise, overly aggressive toddler and baby swim lessons taught by overzealous instructors where dunking leads to the aspiration of water are likewise not a good idea.
The child that experiences this unique and unusual medical malady can die within one to 24 hours from the time the child left the swimming pool. But again, this is extremely rare and unusual. So what do we do about secondary drowning? Like many other concerns and issues, awareness is the key. However, I’m not convinced this is something that service techs and retailers need to lecture parents and pool owners extensively about.
When asked about secondary drowning, pool professionals should alert parents that if their child swallows water and their behavior changes later in the day, the child should be taken to the hospital immediately for observation. Signs and symptoms may be difficult to detect in young children but may include a change in personality, extreme fatigue, lack of awareness, coughing, trouble breathing chest pain, etc. It is important to remember that the child afflicted by secondary drowning doesn’t need to be rescued or resuscitated first.
One way pool professionals can help parents is by talking to customers about discouraging rough play and plunging into the water repeatedly because it might cause the child to aspirate sufficient water in the lungs to create problems, as well as slipping beneath the surface.
My greatest fear in this regard is after a child dies unexpectedly and that child has been in the water within 24 hours, experts and lay persons alike may jump to the conclusion that secondary drowning killed the child. With all the recent attention it has received, secondary drowning may begin to mask a myriad of underlying medical maladies like seizure disorders, Hypotrophic Cardio Myopathy (HCM), Long Q-T Syndrome, RyR2 and others that lead to sudden death without necessarily leaving a trace.
Although it does exist and we need to know the signs, symptoms and treatments for secondary drowning, in my professional opinion, parents, pool owners and pool professionals have more important things to worry about and should not dwell or fear secondary drowning. If the media keeps hyping this drowning ghost, parents may actually fear bringing their kids to the swimming pool and enrolling them in swim lessons.
But you can make a difference. The prevention for primary and secondary drowning is simple and affordable: If parents would buckle up their children in swimming pools the way they buckle them up in seat belts and car seats in cars, we would quickly reduce the drowning rate by 50 percent. Buckle them up in a U.S. Coast Guard-approved life jackets only and those children won’t drown, and they will less likely aspirate water. Life jackets are the least expensive and most effective drowning prevention tool our industry has. So tell your customers to get rid of the noodles, water wings, and other floating toys and place their children in USCG life jackets until they learn how to swim. Swim lessons early and often are of course highly recommended. If we change the culture in America to have non-swimmers wear life jackets in ALL bodies of water rather than just the open water, we would not have to worry so much about secondary or any other type of drowning