Virtual Children's Hospital: CQQA: Near Drowning

Pediatrics Common Questions, Quick Answers

Near Drowning

Donna D'Alessandro, M.D.
Lindsay Huth, B.A.
Peer Review Status: Internally Reviewed
Creation Date: June 2002
Last Revision Date: June 2002

Common Questions, Quick Answers

What is a near drowning?

A near drowning is when a person is underwater for a period of time without oxygen.
A near drowning does not result in death.
The term "asphyxia" is often used when talking about a near drowning. Asphyxia means there is no oxygen in the blood.

What situations commonly lead to a near drowning?

What are signs of trouble?

A person who is drowning may not be able to shout for help. Young children often drown without making a sound.
A child who looks tired while swimming, could actually be drowning.
If she is splashing in the water and keeps sinking, she could be drowning.
If you can only see a person's head, she may be drowning.
If the person is wearing clothes instead of a swimming suit, she may be drowning.
If the victim's skin is pale or blue, she may not be breathing.
A person who is not breathing will usually have cold skin. Her stomach may be swollen.
Check breathing. Can you hear her breathing? Can you see her chest move up and down as she breathes? Can you feel her breath if you put your cheek close to her nose or mouth?

What happens to the body during a near drowning?

When a person is underwater, she can't breathe.
The body doesn't get enough oxygen if a person stays underwater too long.
Water can fill up the lungs. When this happens, oxygen can't be put into the blood. As a result, the blood can't take oxygen to the heart and the brain.
Without oxygen, the heart and brain can't work and a person will die.
If a person is under very cold water, sometimes the body protects itself with a diving reflex.
The cold water gets the reflex working. It slows the heartbeat and sends blood from the hands, feet, and intestines to the heart and brain.
The reflex helps people stay alive longer under cold water.

What treatment should be given at the scene?

Call 911 immediately. Never assume that the person cannot be saved.
Pull the person from the water if it is safe.
Take the victim away from danger. Move her as little as possible if you think she has a neck or back injury.
Lay her on a flat, firm surface.
If the victim isn't breathing, start mouth-to-mouth resuscitation immediately. It is best to find someone who is trained.
If the victim doesn't have a pulse, someone who is trained should give CPR (cardio-pulmonary resuscitation).
Always try to restore breathing and pulse, even if the person looks like she can't be saved.
Treat other problems if the victim is breathing okay. If the water was cold, the victim's body will need to be warmed up. Take off her wet clothes and cover her with warm, dry clothing or a blanket.

What other treatment is needed?

All near-drowning victims must go to the hospital, even if they have started breathing.
The victim may have health problems even if she seems okay.
The doctor will want to examine the patient and may run tests to make sure she is okay.
She may need medicine to help keep her lungs and blood healthy.
She may need special machines to help her breathe.

Will the victim be okay?

In a near drowning, the person does not die at the scene.
How well the victim recovers depends on the water's temperature, her age, and how long she went without oxygen.
In cases where the victim did not have oxygen for a long period of time, there may be brain damage. Brain damage may be mild, moderate, or severe.

How can a near drowning be prevented?

Never leave a child unsupervised around water, including in a bath, pool, kiddy pool, or even near toilets or buckets.
Pools and hot tubs should be fenced in on all 4 sides. A house does not count as one side. Children can reach the pool by just going through the door.
Pool fences should be locked. They should be at least 5 feet tall. Boards should be placed closed together so children cannot slide through them or under them.
Keep toys away from pools so children are not tempted to play around pools or try to get toys out of the water.
It's best if pools have an alarm.
Do not drink alcohol around water. Alcohol can lead to bad decisions, poor coordination, and poor supervision.
Do not try to rescue a person in water that is not safe. Call 911.
Do not step out on ice to rescue someone. Lay on solid ground and pull them in using a shirt or board.
If your child is missing, check the pool first.
Take a class to learn lifesaving and CPR.

Quick Answers

A near drowning is when is person is underwater for a period of time without oxygen.
Near drownings are common. They can happen in any standing water. Drownings can happen in pools, bathtubs, buckets, and even toilets.
Watch for signs that a child could be drowning. If she is splashing and sinking, or if you can only see her head, she may be drowning.
When a person is underwater, she can't breathe. Without oxygen, the brain and the heart can't work and the person will die.
If a person is drowning or has had a near drowning, call 911.
Always take a person who has had a near drowning to the hospital right away.
How well the person recovers depends on the temperature of the water, her age, and how long she went without oxygen.
To prevent drownings, never leave a child unsupervised around water.

References

HealthSquare. Asphyxia. PDR Family Guide Encyclopedia of Medical Care. http://www.healthsquare.com/ (cited 2002 May 10).
MEDLINEplus: Medical Encyclopedia. Near Drowning. http://www.nlm.nih.gov/ 2002 February 18 (cited 2002 May 10).
The Merck Manual. Near Drowning. http://www.merck.com/ 1995-2002 (cited 2002 May 10).

See related Provider Topics Injuries and Wounds or Safety.

http://www.vh.org/pediatric/patient/pediatrics/cqqa/neardrowning.html