Near Drowning

Near drowning or "dry drowning" refers to a lung injury that usually occurs after submersion in water, though it can occur in other conditions. The symptoms of near drowning begin minutes to many hours after submersion in water. These symptoms can also develop from other problems not involving water, such as a choking episode or strangulation injury. After a near drowning, severe reflex spasms occur in the voice box and can seal off the airway. This temporary block of the airway causes injury to the lungs. The damaged lung tissue leaks fluid and can cause an abnormal, dangerous buildup of fluid in the lungs (pulmonary edema). For this reason, medical personnel should examine all victims of a near drowning to ensure that delayed reactions do not develop.

The end result is the same whether or not water was involved. The lungs do not work properly. This reduces the amount of oxygen delivered to the blood and can lead to heart and brain damage or even death. In cases where little or no water enters the lungs, the whole process may occur over a longer period of time. Be aware of near drowning and its warning signs. It requires immediate and specialized care by trained medical professionals.

CAUSES

  • Submersion in water or fluid.

  • Damage to the lungs.

SYMPTOMS

Symptoms of near drowning are due to the lungs not working properly and reduced oxygen delivery to the heart and the brain. These symptoms can develop within minutes or up to 24 hours after the incident. The symptoms are:

  • Difficult breathing that gets worse.

  • Extreme tiredness that gets worse.

  • Confusion.

  • Cough or wheezing.

  • Chest pain.

  • Blue or pale skin.

DIAGNOSIS

A caregiver may suspect near drowning based on the history of the event, patient symptoms, and a physical exam. Tests may be ordered which could include:

  • Pulse oximetry. A small sensor is placed on the fingertip to measure oxygen in the blood.

  • Blood tests, including one that measures the acid-base balance in the blood.

  • Chest X-rays.

TREATMENT

Successful treatment for any near drowning victim depends on a swift response and a quick diagnosis by trained medical professionals. This is an emergency and needs to be treated in an emergency room. The treatment consists of supplying oxygen to the lungs, heart, and brain.

A patient with only minor problems may be sent home after 6 to 8 hours of observation. In more severe cases, it is critical to correct problems with salts in the blood (electrolytes). It is also critical to correct problems with the balance of acid and base in the blood. Most patients with near drowning require hospitalization for close observation. Some patients need to be hospitalized in an intensive care unit (ICU).

PREVENTION

  • Children should wear personal flotation devices when they are around water. Watch children, especially toddlers, at all times when they are around water. This includes a bathtub or bucket full of water.

  • All pools should be fenced and locked when not in use. These fences should be at least 4 to 5 ft (120 to 150 cm) tall. Pools not in use may be made safer with correctly fitted and maintained pool covers and alarms. Windows with access to the pool area should remain closed and locked. Parents who own pools or who take their children to pools are encouraged to learn CPR. Children should be taught to swim, but even then, they still need to be supervised.

  • Personal flotation devices should be used when on a boat or in the water. Boaters should be taught to anticipate wind, waves, and water temperature. Protective suits and other insulating clothing should be used in cold weather.

  • All children should be taught to check the water carefully for depth. They should also check for objects in the water before diving in.

  • Children should be made aware of their swimming limitations and taught not to play dangerously in pools or on decks surrounding pools.

  • Alcohol and other recreational drugs must be avoided when swimming.

  • People with underlying medical illnesses should swim under the watchful eye of an adult. These illnesses include seizure disorders, diabetes, coronary artery disease, severe arthritis, and problems of neuromuscular function.

  • Do not swim alone.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You think someone may be having symptoms of near drowning after being in the water within the past 24 hours.

  • There is a continuous cough, shortness of breath, or chest pain.

  • There is unusual tiredness or unusual behavior.

  • The skin becomes pale or bluish in color and does not improve.

Even if symptoms are mild, anyone who may have had a submersion problem within 24 hours of the onset of symptoms should be examined in a hospital emergency department.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.