Most of us know someone who has been a victim of drowning. The tragic reaction to unexpected, overwhelming stress that results in losing consciousness and then sinking underwater is recognizable by all. Unless you are living under a rock, you’ve likely seen that viral clip of the little boy who lost his balance on the edge of the pool, tumbled under the surface and basically couldn’t get out — until his older brother came to his rescue.
It happens often enough that it’s known as Secondary Drowning: an adult or child suddenly losing consciousness and then entering what researchers call Darkness from Agonistes (agonistic hypoxia), also called DAFDIH: distressful breath-holding, goggles or face-mask immersion, agonal breathing (the final gasps before death) being common. More than 5,500 secondary drowning victims were identified in 2016 alone according to the National Center for Health Statistics. It’s preventable but too many people are unaware of its dangers.
What Is Secondary Drowning?
Secondary drowning is the phenomenon when the involuntary response to a respiratory or cardiac event leads someone to enter water and then become unresponsive.
The most common secondary drowning type is agonal breathing, also known as DAFDIH: distressful breath-holding, goggles or face-mask immersion, agonal breathing (the final gasps before death). Secondary drowning can happen in any age group and anything can trigger it: asthma attack, heart attack, epileptic seizure, drug overdose, high-altitude illness, or hyperventilation.
The first part of this process is called darkening from agonistes (agonistic hypoxia), also called DAFDIH: distressful breath-holding. With the onset of agitation, sometimes people are able to turn themselves around and swim back to safety. But for the most part they sink and drown.
It’s important that you know the signs of secondary drowning so that you can act quickly if a loved one goes into distress when near water and under stress. Some signs include:
- Struggling for breath
- Excessive spitting up of frothy material
- Sinking underwater without using arms or legs to fight off lack of buoyancy
Signs and symptoms of secondary drowning
These signs and symptoms can occur in people who have been immersed in water for a long time, whether it be cold or warm. The corresponding levels of risk are different depending on the type of water, how deep you’re submerged, and your age.
Signs and Symptoms of Secondary Drowning:
- Loss of consciousness
- Rapid breathing
- Gasping or snorting sounds
- Weakness or fatigue
- Confusion and disorientation
- Brief loss of memory (e.g., where they are)
- Shallow breathing
- Slow heart rate (bradycardia) or no heart beat at all (asystole)
Causes of secondary drowning
The causes of secondary drowning can vary depending on the situation but are commonly due to the following factors:
• Physical exhaustion
• Strenuous physical activity
• Any activity that requires a person to hold breath or dive below water
• Heat stroke or fainting related to heat exposure
A common cause is physical exhaustion. This includes situations in which people are working out too hard and become physically exhausted. An individual may also suffer from convulsions during exercise, increasing their risk of secondary drowning.
Another possible cause is strenuous physical activity, where someone is forced to perform activities that require hyperventilating in order to breathe. This leads to an imbalance of oxygen and carbon dioxide levels in the body, which can lead to a person losing consciousness without warning. Finally, someone may be at risk for secondary drowning because they have a medical condition that makes it difficult for them to regulate their blood pressure or heart rate with strenuous physical exertion (ex. seizure disorders).
Prevention of secondary drowning
The first step in prevention is understanding that secondary drowning is a real thing. A lot of people are misinformed about what exactly it entails and how to stop it. Yes, the majority of people who drown are children who succumb to drowning from the weight of their own body pushing them underwater.
But adults can also fall victim to this condition.
Despite being able to recognize the signs, many adults still underestimate its dangers and continue activities that put them at risk for secondary drowning, like walking in shallow water or going into a pool not knowing how deep it is. This is due to lack of education about the reality of the condition and fear of embarrassment if they were involved in a situation where someone else drowned. Prevention starts with education, which starts with awareness and information. There are some things you should keep in mind while you’re out and about:
- If you don’t know how deep a pool is, don’t jump in
- If you see someone struggling while they’re swimming, swim towards them instead of away
- If you see someone struggling while they’re walking on dry land, help them by pulling them out
- If you have any kids under 5 years old and they start playing near water without adult supervision, be sure to keep an eye on them
Things you can do to help prevent secondary drowning.
- Know the symptoms of secondary drowning.
- If you or someone else is in trouble, try to keep them still and stop their breathing by holding their nose and mouth closed. If they are conscious, turn them on their side to help prevent them from swallowing water.
- If all else fails, call for help immediately!
When Can You Say Safe From Drowning?
Several factors play a role in determining whether an individual is safe from drowning. The purpose of this article is to provide some insight into what drowning experts think is safe and what might be unsafe, especially as it relates to children.
A person who is not in immediate danger should swim with a lifeguard present, or use an infant or child floatation device. This will help them stay afloat and out of the water while they recover from the initial shock of the situation.
A person who has received CPR is considered safe from drowning for a short period of time following that treatment but must remain near current medical care providers in order to ensure their safety.
If someone can stay on their back and breathe normally, they are safe from drowning for about 10 minutes, after which time they will likely experience respiratory synkinesis (respiratory arrest).
Tips for Swimming Safety Everyone Should Know
The Centers for Disease Control and Prevention (CDC) offers these tips for staying safe in a pool or at the beach:
• Never swim alone; always swim with a lifeguard.
• All water-related sports should include swimming lessons from an accredited program.
• Always wear your lifejacket, even if you don’t feel comfortable doing so.
• Never dive or jump into the water from a high place.
• No matter how much you might want to cool off during the summer heat, don’t drink alcohol while swimming.
Conclusion Secondary Drowning
It has been estimated that more than 300,000 people drown each year worldwide, making it the leading cause of unintentional death. Secondary drowning is the medical term for a person who is not drowning but has inhaled water or liquid into the lungs and is then unable to breathe. This condition is often caused by recreational activities, such as swimming or playing with a child in the pool or bathtub. In order to prevent secondary drowning, make sure you practice good water safety habits and be aware of your surroundings.
