The chances are you’ve heard of ‘secondary drowning’ (sometimes also called ‘dry drowning’) through the grapevine or through social media and admittedly, the idea that your child can drown while out of the water is absolutely terrifying, and is a situation that can make many parents feel helpless.
What’s more, hot afternoons, weekends and school holidays in sunny Singapore often mean swimming in the condo pool or local club is a fun way for the kiddie’s to get outdoors, exercise and burn off all that energy, so it’s even more important to know how to keep them out of harm’s way. To help us with the facts, we spoke to Dr Nicole Reidy from International Medical Clinic to find out what we need to know to keep our kids as safe as possible both in and out of the water.
Thanks for speaking to us Dr. Reidy. Please explain to us exactly what secondary drowning is and how it happens.
Secondary drowning (sometimes known as delayed drowning) occurs when a small amount of water enters the lungs after an episode of being submerged under water. The child may be coughing and spluttering immediately after an incident, but then seem fine afterwards. The inhaled water interferes with the lungs ability to oxygenate the blood and causes increasing difficulty with breathing, which can occur up to 24 hours later. If it’s not recognised and treated early, then unfortunately it can result in death. Thankfully though, secondary drowning is a very rare occurrence, only accounting for 1 to 2 percent of all drowning cases.
What actually causes the process?
When the water enters the lungs it can wash away surfactant, a chemical which is essential for the transfer of oxygen and carbon dioxide. This causes the alveoli of the lungs to become damaged and fluid to leak inside, called pulmonary oedema. As a result it becomes increasingly difficult to breathe and there is a lack of oxygen getting to the brain, called hypoxia.
What do we need to look out for?
Any child who has been rescued by an adult from the water and has come up struggling for breath, coughing or vomiting should have a medical evaluation as soon as possible. There are four key symptoms to watch out for in the first 24 hours which are:
1. Difficulty breathing, coughing, chest pain or vomiting.
2. Extreme tiredness – this can be a sign that the brain is not getting enough oxygen.
3. Behavioural changes – children in the early stages of secondary drowning may seem more irritable or become argumentative – this is caused by a lack of oxygen to the brain.
4. Physical symptoms can also show, like blue lips or pale skin.
If you notice any of these changes in your child after they have inhaled water then take them to the emergency department to be checked out immediately; time is a critical factor in successful treatment. Their oxygen levels will be monitored, they will have lung examinations and may be referred for further testing such as a chest x-ray. Treatment is supportive with children being given oxygen and ventilation in extreme cases.
How can it all be prevented?
Although awareness is very important, the key message is to practice water safety to prevent it from happening in the first place.
The best way to monitor your children around the pool is to get into the water with them. You should be within an arms’ reach of your children at all times. Children under 4 should not be left alone – even for a minute – around water. Babies and young children can drown in as little as 1 inch of water so vigilance is essential at all times.
At parties, we suggest allocating one adult to have sole responsibility of watching each child. When lots of people are around, there may be assumptions that someone else is watching, and so this is a high risk time for drowning. Drowning is silent and often occurs when the child is being supervised but there is a momentary loss of attention. Also, it’s advisable not to be drinking alcohol when supervising your children around the pool because of the same reason – maintaining attention span.
It also helps to make sure your children are aware of water safety from an early age, and also educate yourself and become formally trained in CPR. Finally, make sure all the family are aware of the condition so they know the importance of telling you if there is an incident – no matter how small it may seem – in the bathroom or at the pool.
To reach out for more information, contact the International Medical Clinic.