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Learn the Facts of Drowning

7-3-14

By Michelle Sartor Lang
Senior Multimedia Web Producer

With Hurricane Arthur expected to cause rip currents along the Jersey Shore for the July 4 holiday weekend, many are worried about the possibility of drowning. Experts advise anyone caught in a rip current to swim parallel to the shore to avoid being swept out to sea.

Dangerous rip currents aren’t the only conditions to look out for, however. Dr. Sanjay Mehta, division chief of the CentraState Medical Center Pediatric Emergency Department, explained that drowning can take place from any body of water, even a bathtub for small children.

“According to the WHO, the World Health Organization, drowning is a primary respiratory impairment from an immersion or submersion in a liquid medium,” he said.

Many people have the impression that drowning victims are very visible, flailing their arms, screaming and jumping around in the water. Mehta attributes that to TV shows and movies that portray those types of scenarios. In reality, drownings are much more subtle. “Patients, particularly children, will just maybe bob their heads up and down for a couple seconds and in most situations will just sink underwater,” he explained.

There are two categories of drowning — fatal and non-fatal. But even when a drowning victim is resuscitated, there’s still a chance they could experience delayed symptoms. There are several names that have been used for this, according to Mehta, including secondary drowning or delayed drowning.

“It’s an entity that occurs later or after the fact of the initial insult,” Mehta explained. “For example, one would perhaps find a child who may have either swallowed water or been temporarily submerged for a couple seconds. They may have been rescued in a timely fashion. The child may seem like they’re OK and quote unquote out of the woods. And then several hours later, the child may start to have symptoms. That can actually be what we describe as delayed drowning.”

Symptoms of delayed drowning include coughing, difficulty breathing, wheezing, lethargy and blueness or whiteness around the face, Mehta said. While some research has found symptoms can occur up to 72 hours after the event, Mehta said most of the time symptoms appear within eight hours of the initial incident.

When a person has swallowed water, Mehta said it causes the lungs and even the back of the throat — the larynx — to become spastic. This causes the person to cough out the water, and often they seem back to normal. “But several hours later, what’s actually happening is in a small percentage of patients — not all patients by any means — the body starts to have a systemic reaction. When this happens, essentially the blood vessels that supply the lungs start to become what’s called leaky because of the systemic response,” he explained. “And water kind of floods the lungs causing someone to essentially drown within their own fluids.”

According to Mehta, only a very small amount of water is needed in the initial incident to create a situation where secondary or delayed drowning can occur. “The literature sites anywhere from only one to two milliliters of water per kilogram. In a 3-year-old, for example, less than an ounce of water for the initial insult could actually potentially cause such severe problems,” he said.

While secondary or delayed drowning can be fatal, Mehta said it doesn’t occur very often. He also said seeking medical attention at the sign of symptoms is the best way to prevent further injury or death.

Mehta said in an immediate drowning situation, CPR should be administered and 911 called right away. “After a true drowning event if they were unconscious or couldn’t breathe, even if they were resuscitated and they seem OK, 911 should still be called, and they should still be evaluated in the hospital,” he said.

According to the New Jersey Department of Health, there were 719 drowning/submersion deaths in the state from 2000 to 2010. During that 11-year timeframe, the average number of drowning/submersion deaths per year was 65.36. In 2010, the most recent year with data available, 71 people died because of drowning/submersion.

Practicing pool and water safety can help prevent injury and death. Mehta said the American Academy of Pediatrics recommends that pools are completely enclosed by a fence on all four sides that is at least four feet high and pools have gates that self latch. He also said parents should avoid using swimmies and floaties for their children; life vests are the safest. Parents should have their children at arm’s length while they’re in a pool, even a kiddie pool. And while swimming lessons are important, Mehta said parents shouldn’t have a false sense of security and become complacent with their children who do know how to swim.

Another tip Mehta gave is assigning an adult as a designated supervisor for a pool party with children. If it’s feasible, he also recommends hiring a lifeguard for a pool party, especially if alcohol is going to be involved.

Learning CPR is very important for all caregivers, according to Mehta. CentraState offers classes, as do many local hospitals. “It’s a little time, it’s a little sacrifice that can truly save a life,” Mehta said.