Delayed drowning, also known as secondary drowning, dry drowning, or near-drowning, refers to respiratory distress that develops hours to days after a person experiences a suffocation event while in water. This article will provide an overview of delayed drowning, including what it looks like, symptoms, causes, risk factors, diagnosis, treatment, and prevention. While delayed drowning is rare, it’s important for parents and caregivers to understand the signs and take proper precautions to prevent tragedy.
What is delayed drowning?
Delayed drowning occurs when water gets into the lungs and causes damage or swelling that impedes breathing hours or even days later. It can happen to both children and adults. When a person’s airway goes underwater, even briefly, it can cause spasms in the airway or fluid buildup in the lungs. This interrupts normal breathing and oxygen flow. While the person may seem fine immediately after being rescued from the water, respiratory symptoms can appear gradually over the next few hours or days as fluid continues to accumulate or swelling worsens. This leads to hypoxia (lack of oxygen) that can turn fatal if not treated quickly.
What are the symptoms of delayed drowning?
The signs and symptoms of delayed drowning may include:
- Coughing or trouble breathing
- Sleepiness, confusion, or other changes in behavior
- Vomiting or green-tinged phlegm/mucus
- Chest pain
- Irritability or lack of appetite (in children)
- Blue lips, nails, or skin (cyanosis)
- Decreased energy or lethargy
- Wheezing
Symptoms can appear anywhere from 1-72 hours after the water incident. In some cases, the person may initially seem totally fine before respiratory distress sets in. That’s why it’s essential to monitor children carefully for at least 24 hours after any water submersion event. Seek immediate medical help if you notice any signs of breathing difficulty, oxygen deprivation, or behavioral changes.
What causes delayed drowning?
There are a few mechanisms that can lead to delayed drowning:
- Fluid buildup in the lungs – Even small amounts of water inhaled into the lungs can cause swelling, inflammation, and fluid accumulation over time, making breathing increasingly difficult.
- Disruption of surfactant – Surfactant lines the inside of the lungs and helps facilitate oxygen exchange. When it’s washed away or damaged by water, lung function can be impaired.
- Laryngospasm – The vocal cords or throat can spasm when water enters, closing off the airway. This can cause oxygen deprivation before the airway reopens.
- Aspiration – Stomach contents like vomit can be aspirated into the lungs when a person is submerged, causing pneumonia.
- Unconsciousness – Temporary loss of consciousness under water can allow fluid to enter the airway and lungs.
These effects may not be immediately apparent but can worsen over time, leading to delayed respiratory distress or failure. Prompt medical treatment is key to preventing death from delayed drowning.
Who is most at risk for delayed drowning?
While delayed drowning is rare, certain groups may be more vulnerable, including:
- Young children – kids under 5 are most susceptible as their airways are smaller and easily constricted. Lack of swimming skills also increases risk.
- Anyone who aspirates water – inhaling even a small amount of water into the lungs significantly increases risk.
- Near-drowning victims – those who required rescue may have aspirated more fluid and suffered oxygen deprivation.
- People with underlying conditions – chronic lung disease, heart disease, and seizures disorders can increase susceptibility.
- Alcohol drinkers – intoxication increases drowning risk and impairs airway protective reflexes if water is inhaled.
Adults can also experience delayed drowning, so seek prompt attention if you inhaled any water and have breathing difficulties later.
How is delayed drowning diagnosed?
A doctor will make a diagnosis of delayed drowning based on:
- Medical history – determine if recent near-drowning event, even if person initially seemed fine.
- Physical exam – check for symptoms like trouble breathing, abnormal lung sounds, or low oxygen levels.
- Chest X-ray – may show fluid accumulation or other lung abnormalities.
- CT scan – provides detailed images of the lungs to assess for damage.
- Blood tests – evaluate oxygen and carbon dioxide levels.
- Pulse oximetry – monitors oxygen saturation levels in the bloodstream.
Rapid diagnosis is critical so treatment can be started promptly before respiratory failure occurs. Always seek medical help immediately if you or your child experiences any delayed drowning symptoms after a water incident.
How is delayed drowning treated?
Treatment focuses on stabilizing breathing and oxygen levels and reducing any fluid buildup in the lungs. This may involve:
- Oxygen therapy – delivering oxygen through a mask or tube to help normalize oxygen saturation levels.
- Breathing treatments – using inhaled medications to open airways and improve breathing.
- Chest physiotherapy – techniques to help clear mucus plugs and fluid from the lungs.
- Suctioning – removing excess fluid from the airway and lungs.
- Medications – steroids, diuretics, or antibiotics if needed to reduce swelling, fluid, or pneumonia.
- Hospitalization – severely affected patients may need to be hospitalized for close monitoring and intensive care.
- Mechanical ventilation – using a breathing machine if the person cannot breathe adequately on their own.
In severe cases, delayed drowning can lead to acute respiratory distress syndrome, seizures, coma, or death if not treated urgently. However, with prompt medical care, outcomes can be good.
How can delayed drowning be prevented?
Some key drowning prevention tips include:
- Supervise children closely whenever in or near water – designate a responsible adult water watcher.
- Learn CPR and refresh skills regularly.
- Install four-sided pool fencing and alarms on doors/windows leading to water areas.
- Ensure kids wear U.S. Coast Guard-approved life jackets when boating, rafting, etc.
- Avoid alcohol use during swimming or water activities.
- Learn water safety and enroll children in swim lessons.
- Empty small pools like kiddie pools immediately after use.
- Monitor anyone who was submerged or swallowed water for signs of breathing difficulty.
Following proper safety precautions around water can help prevent drowning incidents. Recognizing delayed drowning symptoms quickly and getting prompt medical care also improves outcomes. With awareness and vigilance, delayed drowning deaths can potentially be avoided.
Conclusion
Delayed drowning results when water is inhaled, causing respiratory impairment that worsens over time. While relatively uncommon, delayed drowning can be fatal if not treated urgently with oxygen therapy and other interventions. Key warning signs include breathing problems, lethargy, and cyanosis in the hours following water submersion. At-risk groups like young kids should be closely supervised around water and monitored after incidents. Swift action and medical treatment are imperative at the first signs of delayed drowning. With proper precautions, knowledge of the hazards, and early intervention, delayed drowning can often be prevented.