by EBSCO Medical Review Board
(Drowning; Submersion Incident)

Definition

Near-drowning is when a person has almost drowned from not being able to breathe due to being under a liquid, such as water.

Causes

This problem is caused by a liquid filling the lungs and blocking normal breathing.

Risk Factors

Things that may raise the risk of this problem are:

  • Having health problems, such as seizure disorder, fainting, and heart problems
  • Use of drugs or alcohol before the event
  • Trauma, such as unsafe diving
  • Attempting suicide
  • Not knowing how to swim or being very tired from swimming

This problem is more common in young boys between 5 and 14 years old. Risk factors for children are:

  • Being unsupervised around water
  • Rough play around water
  • Not knowing how to swim or being very tired from swimming
  • Underwater breath holding

Symptoms

Symptoms may be:

  • Drowsiness
  • Being less alert
  • Not being able to breathe
  • Gasping for air
  • Vomiting
  • Coughing or wheezing
  • Blue skin color
  • Stopped heartbeat and breathing

Diagnosis

A physical exam will be done. Near-drowning is diagnosed based on events and symptoms.

Brain Damage from Lack of Oxygen
Brain Damage Oxygen
Copyright © Nucleus Medical Media, Inc.

Treatment

The first goal of treatment is to restore breathing as soon as possible. This may be done with:

  • CPR—to provide oxygen-rich air to the body
  • Endotracheal intubation—to open the airway using a tube placed in the windpipe
  • Warming treatments—to raise the body temperature of people who may have been in very cold water

Medication may be given to treat infection in those who were exposed to liquids that may be dirty, such as sewage.

Nasogastric (purple) and Endotracheal Intubation
FI00035 96472 1 Endotracheal and Nasogastric Tube Insertion
Copyright © Nucleus Medical Media, Inc.

Prevention

To lower the chances of near-drowning:

  • Do not leave children alone with any body of water, such as a pool, bathtub, or spa. Stay within arm's length of infants and toddlers at all times.
  • Do not allow anyone of any age to swim alone.
  • Secure pools and spas with child-proof fences and locking gates.
  • Teach children how to swim.
  • Wear life vests when boating.
  • Body parts and hair can be trapped in pool drains. Be sure that the pool has drain covers or a filter system to release the suction.
  • Teach children to stay away from ice that is not fully frozen.

RESOURCES

American Red Cross  http://www.redcross.org 

Healthy Children—American Academy of Pediatrics  https://www.healthychildren.org 

CANADIAN RESOURCES

Canadian Red Cross  http://www.redcross.ca 

Children’s Health and Safety Association of Canada  http://www.safekid.org 

References

Near-drowning. EBSCO DynaMed website. Available at:  https://www.dynamed.com/condition/near-drowning . Updated May 31, 2019. Accessed December 10, 2019.

Szpilman D, Bierens JJ, et al. Drowning. N Engl J Med. 2012 May 31;366(22):2102-2110.

Revision Information

  • Reviewer: EBSCO Medical Review Board James Cornell, MD
  • Review Date: 09/2019
  • Update Date: 08/04/2020