Near Drowning
What is it?
Near drowning occurs when a person is submerged under
water long enough that the body is severely deprived of
oxygen (suffocation), but the person survives.
Who is affected?
Almost half of all near drownings reported each year
occur in children under the age of four. Of this group,
most near drownings occur at homes with swimming pools.
Young males are more likely to be the victims of near
drownings because of reckless behavior and the use of
drugs and alcohol.
What causes it?
Near drowning can occur in deep or shallow water.
Infants who are old enough to sit up on their own may not
be able to pull themselves up if they slip under the water
even in something as shallow as a bathtub. Near drowning
can also occur if the child is hurt in the water, such as
by a head or spinal injury caused by diving into shallow
water. When anyone remains under water for too long, the
larynx relaxes and lets water enter the lungs, which means
the lungs can’t function normally and transfer oxygen to
the blood. The person loses consciousness and, eventually,
the lungs collapse. Being deprived of oxygen for too long
damages the body’s major organs. However, if a child is
submerged in cold water, a natural reflex slows the
heartbeat and redirects blood flow to the heart and brain,
where it is needed most. As body temperature goes down,
the body tissues need less oxygen. This is a key factor in
survival.
What are the symptoms?
A child who has nearly drowned will have low oxygen
levels in the blood, called hypoxemia. He or she may go
into cardiac arrest, which means the heart stops beating.
If the child has been submerged in very cold water for too
long, body temperature becomes dangerously low, called
hypothermia. The child may or may not be unconscious,
depending upon the amount of time under the water. If the
child is conscious, he or she may be extremely drowsy,
confused, or irritable. Other symptoms can include a
bluish tinge to the skin (cyanosis), coughing and rapid,
labored breathing. Near drowning can cause coma and
permanent neurological damage.
How is it diagnosed?
To diagnose near drowning, the child is examined and
tests are performed to measure blood oxygen, volume, and
chemical levels. The water that has been inhaled causes
chemical imbalances in the blood and can affect the amount
of blood circulating through the body. The hospital will
also perform tests and X-rays to check for injury and
organ damage.
What is the treatment?
The first step is to get the child out of the water.
Whether conscious or unconscious, resuscitation efforts
should be started immediately at the scene until medical
personnel arrive to transport the patient to the hospital.
Cardiopulmonary resuscitation (CPR) can restore breathing
and get the heart beating again, but should only be
performed by someone with CPR training. Medical personnel
will continue CPR and give the child oxygen. If he or she
is having difficulty breathing, they may need to insert a
tube into the child’s trachea to open the airway. This
procedure is called intubation. In the hospital, the child
may need the help of a respirator or mechanical ventilator
to reinflate the lungs and help with breathing for a
period of time. Hypothermia is treated in a variety of
ways, with the goal of bringing body temperature back to
normal. All vital signs are monitored constantly so oxygen
levels can be adjusted as needed and any problems can be
treated immediately. Near drowning patients are generally
observed for at least 24 hours before being released.
Hospitalization and recovery time depends upon the amount
of organ damage. The sooner the victim is removed from the
water and administered CPR, the better the chance of
complete recovery.
Self-care tips
Near drowning can be prevented. Never allow young
children to swim or play around a pool unsupervised, or to
be around any type of water (bathtub, toilet, buckets,
ponds, etc.) alone. Pool areas should be fenced, with a
locked gate. An alarm that indicates when someone has
approached the pool is also a great safety device. Make
your children aware of water safety rules for diving,
boating, and swimming. Learn CPR so you will be prepared
in the event of a medical emergency. Never combine water,
drugs, or alcohol.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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