The danger of secondary drowning

If your child has a near-drowning incident, it is important to bring him or her to the doctor for a follow up

Picture this: you are lounging by the pool with your 3-year-old daughter. You receive a phone call, and you look away for a second. When you look back, your child is splashing in the pool, clearly in distress, and sinking.

You quickly rescue your child and, after lots of coughing, she settles down and seems to have fully recovered. You don’t think anymore of it, and why would you? If your child is breathing, walking and talking, she must be fine, right?

Not necessarily. Although not very common, there is a chance very serious complications could arise after a near-drowning incident, and even death. This is generally referred to as secondary drowning (although not a term used by the medical profession, it is how it is cited in the media).

According to Simon Roughley, a National Lifeguard instructor in Montreal, secondary drowning is death by pulmonary oedema. This means that water infiltrates the lungs, making it difficult for the lungs to properly oxygenate blood.

“Not every near-drowning victim aspirates water, so it would be a lot more common in near-drowning situations where the person has taken in lots of water,” he said. 

According to Tiffany Lafleur, a certified lifeguard, secondary drowning is something she was taught as part of her training. “If a near-drowning incident occurs, we tell the parents about the risks and symptoms,” she said.

Symptoms that could manifest include difficulty breathing and some flu-like symptoms, such as chest pain, fever, persistent coughing, and fatigue. These symptoms may take up to 72 hours before setting in, according to Parachute Canada, a national organization dedicated to preventing injuries.

Although there are no statistics about the number of secondary drownings in Quebec, in 2011, there were 83 water-related deaths in the province — the second highest in the country after Ontario.

According to Debbie Friedman, the director of trauma at the Montreal Children’s Hospital and director of the Canadian Hospitals Injury Reporting and Prevention Program, regardless of skill or age, no one is “drown proof.”

“Every year, when we get to the summer, we see preventable tragedies,” Friedman said.

She added that there is no one way of preventing drowning incidents. The solution is multi-faceted. Whether swimming in a lake or a pool, many steps can be taken to reduce the risks of water-related incidents. Children should be given swimming lessons at an early age, have a designated supervisor (whose eyes never leave the pool), and never swim alone. When on a boat, safety vests should be worn and properly secured. “Younger children are always curious, and do not understand the risks water poses,” she said.

When it comes to private pools, a gate measuring at least 1.2 metres high with an automatic lock should surround the pool, and there should be no access directly from the porch to the pool. A law was passed in Quebec stating that a gate had to be installed on all pools built after 2010. It does not oblige homeowners to install gates on pools build before 2010, making these a hazard. 

Friedman, who is also an assistant professor in the Department of Paediatrics at the McGill Faculty of Medicine, says she recommends that adults take first-aid lessons to know what to do in the case of an emergency.

According to the Lifesaving Society, an organization dedicated to preventing drowning and water-related injuries, every near-drowning incident should involve medical follow-up in order to reduce the chance of serious complications.