Secondary drowning in children: when parents have to call 911

Outdoor pool, quarry lake, sea or paddling pool – in the summer, bathing and playing with water are simply included. However, water is always a danger, especially for young children. drowning accidents is the second leading cause of accidental death in children. According to the German Lifesaving Society (DLRG), 18 preschool children and five primary school children died in the water in 2021. Children who are not yet able to swim should therefore never be left unattended near water, even if it is very low.

A phenomenon that also worries parents is the so-called secondary drowning. An incident where children do not drown in the water but die hours after a swimming accident because they got water in their lungs. After such isolated cases have been reported in the media in recent years, worried parents are afraid that their child may die in their sleep, for example, because they were suffocated in water while bathing in the lake during the day.

But doctors have stopped using the term “secondary drowning” because it is inaccurate. Raik Schäfer, deputy federal doctor at DLRG, explains in an interview with FOCUS Online what the phenomenon is about and when parents should call the emergency number.

FOCUS Online: Mr. German Shepherd, what is meant by the term “secondary drowning”?

Raik Schäfer: The term is no longer used in this way – neither scientifically nor professionally, because it is misleading. The real problem with drowning is the lack of oxygen.

Can you describe a typical situation?

Shepherd: It can happen if someone has been in a drowning accident, was initially able to get out of the water or was rescued, but inadvertently inhaled – did not swallow it, but inhaled it – then the breathing may worsen during the next half hour. The patient may then experience wheezing and increased shortness of breath. In such a case, make an emergency call immediately (112).

Can something like this also happen if there was not a real accident, but for example a child was suffocated heavily in the water?

Shepherd: Usually we have a reflex that makes sure that when fluid enters the pharynx, it does not go to the lungs, but to the esophagus. This is the swallowing reflex. It is even more pronounced in children than in adults.

And if a child really gets his head under water?

Shepherd: When humans, including children, fall under water, they instinctively hold their breath. If it is not possible to hold the head and thus the mouth and nose above the water surface, the incentive to breathe increases until you breathe in, whether it is above or below water. Then water can enter the airways and drowning occurs, which is nothing more than suffocation in a liquid medium.

In what situations should parents pay special attention?

Shepherd: If the children are conspicuous after bathing, behave differently than usual, seem apathetic, if they have difficulty breathing, cough constantly or cough up foam – then you should call an emergency, or at least contact a doctor immediately.

For this reason, people who have been in a drowning accident also belong to a hospital for at least 24 hours, at least for observation.

What other advice do you have for parents about water?

Shepherd: It is very important that children learn to swim as early as possible. From the age of four or five, children can learn to swim if the pool has such a low pool that the children can still stand there. Beginner swimming courses usually run from the age of 6 at the latest.

It is important that parents take care of this and take their children to swimming lessons. Due to the pandemic, closures of swimming pools and canceled classes, the number of non-swimmers has increased significantly. And that, of course, worries us a lot.

In addition, children should never be allowed to bathe unattended! Also think of potential sources of danger such as ponds, ponds and ponds in the garden. Children cannot yet assess the risks. They usually do not have a chance if they fall in there unattended!

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