Children at Special Risk: Secondary drowning: A gradual process of asphyxiation

If water gets into the lungs during a swimming accident, the body’s oxygen supply is disrupted. Red blood cells absorb less oxygen, so cells in the body can no longer get enough nourishment and die as a result. The man is drowning. Those affected usually die in the water or shortly thereafter in hospital.

However, in an estimated one to two percent of all fatal swimming accidents, it takes 24 hours or longer for the person to develop drowning symptoms and die. This phenomenon is called secondary drowning. There are no official statistics on this, only estimates.

But what is certain is that a few milliliters of inhaled and remaining water in the lungs is enough to cause secondary suffocation. Pollution in the water can cause inflammation, edema or severe pneumonia some time after a swimming accident. Insufficient oxygen is supplied to the body for a long time – a gradual process of asphyxiation.

A strong urge to cough immediately after a swimming accident is the first indication that water has been inhaled. However, the treacherous thing about secondary choking is that the cough can subside temporarily. A false sense of security arises. After 24 hours, clear symptoms appear, which if left untreated can lead to death:

• Strong, persistent cough, sometimes with wheezing breath sounds
• high body temperature or fever
• Diarrhea and vomiting
• fatigue and exhaustion
• chest pain
• Rapid breathing to the point of shortness of breath
• Bluish discoloration of the lips

Adults and children are exposed to swimming accidents. However, drowning is the second leading cause of accidental death in children after traffic accidents. The obvious reason: they can’t swim most of the time, or they just swim poorly. For this reason, children should never be left unattended near water.

If a child has just dived underwater and has drowned, you don’t need to call an emergency right away. If he calms down quickly and there are no other symptoms, the child should only be kept under observation for the next 24 hours. During the night, it is recommended to occasionally check for regular breathing. In the case of secondary choking, symptoms usually come on gradually – only then a doctor’s visit is necessary. On the other hand, if the child complains of shortness of breath or has already bruised lips, parents should go directly to a hospital’s emergency department.

The term dry drowning often causes confusion. Here, too, people are drowning out of the water. The most affected are children who inhale water as they enter the water. The body reacts reflexively and closes the vocal cords in the larynx, preventing water from entering the lungs. This can lead to a laryngeal spasm that does not go away on its own. As a result of this body’s own protective mechanism, the child cannot breathe and suffocates.

For young children up to the age of five, the smallest amounts of water are sufficient to drown them immediately or secondarily. For this reason bathing children should never be left unattended, ideally even within reach. Even swimming aids are not an alternative, but at most an additional measure.

Attention is needed not only in the pool, sea or lake. Children up to the age of three can drown in water as deep as five centimeters – paddling pools, garden ponds and puddles are therefore just as dangerous as swimming pools. For this reason, children’s pools should be locked when not in use. When boating, children should always wear a suitable life jacket.

An early, fun introduction to the water is recommended. This can start with a course for babies a few months old. Age four is considered a good start for learning to swim.