Near Drowning

The immediate aftereffects of prolonged submersion under water. This may occur with or without aspirating water into the lungs. Approximately 10% to 15% of all drownings or near-drownings occur without aspiration. There have been a few reports of survival following submersion up to 40 minutes when the water was very cold. Submersion in warm or hot water results in more rapid death. Drowning accounts for approximately 10,000 deaths in North America each year.

Causes

Submersion under water, resulting in either of the following:

Spasm of the larynx (the tube from the throat to the lungs). After rescue, this spasm prevents oxygen from reaching the lungs unless air is forced through the spasm by a respirator or CPR procedures.
Water in the lungs, causing life-threatening changes in the circulating blood.

Signs and symptoms

Confusion or unconsciousness.
Little or no breathing or heartbeat.
Bluish-white paleness.

Diagnosis

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.

Treatment

First Aid

If the victim is unconscious and not breathing, yell for help. Don't leave the victim.
Begin mouth-to-mouth breathing immediately.
If there is no heartbeat, give external cardiac massage.
Have someone call 0 (operator) or 911 (emergency) for an ambulance or medical help.
Don't stop CPR until help arrives.
The near-drowning victim should be taken to the nearest hospital for intensive care-even if the victim has regained consciousness. Complications or death due to heart-rhythm disturbances may occur 24 to 48 hour after the accident.
Remain with a recovering patient to provide support and reassurance. Near-drowning is a traumatic experience.

Medical Treatment

Immediate cardiopulmonary resuscitation (CPR).
Hospitalization (sometimes) to lower body temperature, to induce coma with medicines and to monitor spinal-fluid pressure.
Hospitalization for observation for delayed, serious reactions.

Medication

Your doctor may prescribe:

Oxygen.
Cortisone drugs to prevent or treat lung inflammation.
Antibiotics to prevent lung infection.
Bronchodilators to enable oxygen to enter the lungs.

Prevention

Learn cardiopulmonary resuscitation (CPR).
Encourage all family members-including infants-to learn to swim. Never leave a child, even one who can swim, alone near the water.
Never swim alone.
Observe water safety rules.
Don't drink alcohol and swim.
Fence all pools and spas. Secure all the doors to the outside, and install pool and door alarms.

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