By Kayla Chapman, APRN-CNP
Certified Nurse Practitioner, Physicians Plus Urgent Care

Drowning remains one of the leading causes of accidental death in the United States, especially among young children, and it can happen quickly and silently. Children between the ages of 1 and 5 are at the highest risk of drowning, often due to inadequate supervision around swimming pools, bathtubs, lakes, or even small containers of water. Adult drownings can also occur, and are commonly seen in rivers, lakes, and oceans, with alcohol playing a major contributing role. 

Fatal drownings occur in six stages. First, the swimmer will struggle to keep their airway clear of the water, leading to panic and exhaustion. Once the swimmer goes underwater, they’ll attempt to hold their breath, but eventually they will gasp for air.

This leads to stage 3, the aspiration, or inhalation, of water. After water enters the lungs, the oxygen levels in the swimmer’s bloodstream will drop, and they will fall unconscious. Once unconscious, their blood pressure will fall, breathing may become irregular or stop altogether, and cardiac arrest can begin, which can lead to death. These six stages can happen in a matter of minutes.

Drowning incidents are unfortunate accidents that, in most cases, are preventable with proper water safety. Many drowning incidents occur when pools are not properly secured. Building four-sided fences at least 4 feet tall with self-latching gates can reduce childhood drowning incidents by up to 80 percent. When children are swimming, they should be under constant supervision by a trusted adult. When supervising children near water, it is essential that you remain undistracted and avoid activities such as reading or using your phone. Other ways to prevent drowning for both children and adults include taking swimming lessons, learning basic CPR and water safety skills, swimming in pairs, wearing a life jacket, wearing brightly colored swimwear that is easy to see underwater, and avoiding alcohol and drugs while swimming or boating. 

You may have heard the terms “dry drowning” or “secondary drowning,” which refer to situations in which a person inhales small amounts of water, but these events are now referred to as simply nonfatal drowning with delayed symptoms. In these cases, symptoms may not appear immediately and can worsen several hours after the event. Warning signs of nonfatal drowning with delayed symptoms include persistent coughing, trouble breathing, chest pain, vomiting, unusual sleepiness, confusion, blue lips, and difficulty waking. 

Anyone who experiences breathing problems, loss of consciousness, excessive coughing, abnormal sleepiness, or abnormal behavior after a water incident should be evaluated immediately in an emergency department. Delayed respiratory complications can become life-threatening without prompt treatment and have long-lasting effects, including permanent brain damage, aspiration pneumonia, long-term disability, or death.

Drowning can occur in seconds and in very shallow water. Awareness, supervision, and quick medical attention can save lives at any age. The more you know about drowning prevention, the more confident you’ll feel protecting yourself and those around you in the event of a water emergency.