Drowning is a form of asphyxiation that occurs when liquid obstructs the airway, preventing oxygen exchange. Contrary to popular belief, most drowning deaths are “wet drowning,” where even small amounts of water in the lungs impair gas exchange, while muscle spasms around the larynx (“dry drowning”) account for a smaller proportion. Secondary drowning—where fluid in the lungs causes delayed respiratory distress—can develop hours after rescue.
Recognizing Drowning
- Silent, ineffective efforts to breathe; no calling or splashing
- Vertical, still posture with head low at the surface
- Gasping, wheezing, or inability to cough
- Arms extended laterally, pressing down on water to stay afloat
Immediate First Aid Steps
- Ensure scene safety—never enter the water unless you’re trained and can do so safely.
- Use a “reach or throw” rescue: extend a pole, towel, or rope, or throw a flotation device—don’t wade or swim to the victim if untrained.
- Once the victim is secured, move them horizontally onto a firm, flat surface to prevent shock.
- Check responsiveness by shouting and gently tapping the shoulders.
- Open the airway with a head-tilt/chin-lift (or jaw-thrust if spinal injury is suspected) and assess breathing for no more than 10 seconds.
- If breathing normally, place the victim in the recovery position and monitor vital signs until EMS arrives.
- If not breathing or breathing is agonal, begin CPR immediately:
- Compressions first: 30 chest compressions at 100–120/minute, depth at least 5 cm (2 inches).
- Rescue breaths: give 2 breaths after each cycle of compressions if trained.
- Continue CPR and use an AED if available, pausing only to switch rescuers or deliver a shock.
- Call emergency medical services (e.g., 911) as soon as possible—even if the victim appears to recover initially—to monitor for secondary drowning and other complications.
Secondary Drowning
If a small amount of water enters the lungs, irritation is caused and fluid is drawn from the blood into the alveoli. This reaction could be delayed for several hours, so a casualty who has been resuscitated and apparently recovered might relapse into severe difficulty breathing at a later stage. It is for this reason that any casualty who recovers from ‘near drowning’ should be taken to a hospital immediately.
Preventing Secondary Drowning
After resuscitation and recovery of breathing, keep the person under medical observation for at least 24 hours. Watch for cough, chest pain, difficulty breathing, or altered consciousness—rapid transport to a hospital is critical if symptoms develop
Do’s and Don’ts
| Do | Don’t |
|---|---|
| Ensure your own safety and use non-entry rescue methods | Attempt a swim rescue unless trained and equipped |
| Start CPR promptly with 5 rescue breaths and compressions | Delay calling EMS—even minor submersion can cause delayed harm |
| Use an AED if available and follow prompts | Give rescue breaths without clearing airway first |
| Monitor for secondary drowning and seek hospital care | Leave the victim unattended after apparent recovery |
| Keep the victim warm and reassured | Apply ice or home remedies to the chest or back |
Wet Drowning
Wet drowning is defined as the type of drowning wherein the victim inhales fluids in a manner that causes their lungs or airways to get obstructed. As a result of this, their lungs stop performing the function of oxygenating the blood in their system.
Whenever cases of drowning are concerned, the spasm relaxes, causing water to enter into the person’s lungs. This was previously referred to as wet drowning.
Dry Drowning
Dry drowning occurs when a person inhales a small amount of water through their mouth and/or nose, causing a spasm that makes their airway close up. This usually happens after a person leaves the water.
Although some confuse dry drowning and secondary drowning with being the same thing, they are different. Dry drowning and secondary drowning can also occur in adults, but they are more common among young children.
Symptoms of Dry Drowning
The symptoms of dry drowning are similar to those of secondary drowning. However, when kids are involved, there are a few signs you should watch out for and be vigilant about. Apart from coughing and finding it hard to breathe, these are the dry drowning signs they could display:
Prevention of Dry drowning
Drowning happens to be one of the most common causes of death in young kids. Therefore, taking precautions is essential so that water-related accidents can be avoided altogether.
When a child is two years old or younger, water submersion of any kind is a major risk. Be sure to take the kid to an emergency room straight away, even if they have been under the water for about one or two minutes.
Here are some of the things that can be done to reduce the chances of dry drowning:
- Invest in swimming lessons for your child. When kids are aware of how to navigate in water bodies safely, they are more likely to be mindful of the rules of water safety. It enables them to struggle less in such conditions and become skilled at handling themselves well in pools and other water bodies.
- Whenever your kid is swimming, make sure to supervise them constantly and keep an eye out for any possible risks or dangers.
- Ensure that everyone wears a life jacket in situations that involve boating.
- Remember to keep the gates to the pool closed at all times so that the little kids can’t access them without adult supervision.
- Never allow your child to play near the ocean without the presence of a lifeguard.
- If you frequently find yourself supervising kids at beaches or pools, get yourself trained in an infant CPR class in case you ever need to implement the knowledge in emergency situations.
- In addition to boating, see to it that children wear floatation devices on canoes, jet skis, or any other instances where they are surrounded by water.
REFERENCES
- Riva, G., et al. Survival in Out-of-Hospital Cardiac Arrest After Standard Cardiopulmonary Resuscitation or Chest Compressions Only Before Arrival of Emergency Medical Services. Circulation 139.23 4 June, 2019:2600-2609. https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.118.038179>
- John Furst, First aid for Drowning, Updated December 13, 2023, https://www.firstaidforfree.com/first-aid-for-drowning/
- Webmd.com, Stephanie Booth,Drowning Treatment, January 02, 2024, https://www.webmd.com/first-aid/drowning-treatment
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