Why It's Possible to Drown in a Dry Parking Lot | The Survival Doctor

 

Part 3 in my series on drowning. See all my posts about rescuing drowning victims here.

by James Hubbard, MD, MPH

Ever heard of parking lot drowning? That’s what lifeguards anyway. Others may call it secondary drowning.

It can happen minutes to hours after a near-drowning victim is revived. It can even happen to someone who didn’t nearly drown—who just sucked a little too much water down their lungs, coughed and choked, and then appeared perfectly fine.

Later on (maybe, say, sitting in a parking lot), the victim can suddenly become unable to get enough oxygen. If not treated they can, in essence, drown.

Cause

If even an ounce or so of water gets all the way down into the deep part of the lungs, it can damage the alveoli (air sacs where oxygen is exchanged for carbon dioxide). This impedes the lungs’ ability to get oxygen into your body and can become life-threatening.

Clues

Who’s at risk: Anyone who’s been in the water within the past 24 hours and sucked in enough to cause a pretty bad initial choking and coughing spell is at risk for secondary drowning. I guess it could happen to someone who just got choked while drinking, but I’ve not heard of it. If you’re alert at all when drinking, your larynx will spasm early enough to keep all but a little fluid out of the lungs.

Signs: If someone who’s at risk looks fine, then, kind of out of the blue, starts severely coughing or getting short of breath, that person may be secondarily drowning. If the victim is a child, the sign may just be that they become agitated for no apparent reason.

Care

Pure oxygen is key—as much and as soon as possible. If that’s not an option, the person needs to try to at least get fresh air and rest, with hopes that the lungs will heal themselves. If there’s wheezing, an asthma inhaler might help.

Complications

Here are more things that can go wrong with secondary drowning—more reasons getting expert care is important if possible:

  • Organ damage: The lungs’ alveoli (air sacs) are coated with a substance called surfactant that keeps them open. Without the surfactant, the air pockets contract significantly, limiting the amount of oxygen that can get into your bloodstream. With time, the surfactant will come back. But meantime, the lack of oxygen can damage your organs, including your heart.
  • Chemical pneumonitis can develop when the water, and chemicals in it, irritate and inflame the lungs, causing the lining to swell. Again, this impedes the passage of oxygen to the bloodstream.
  • Adult respiratory distress syndrome (ARDS) is when the lungs become so inflamed that they start producing fluid in the air sacs. Many times with ARDS, the only way to get oxygen into the arteries is to pump it into the lungs with positive pressure. This requires expert care involving intubation and a respirator.
What to Do

Anytime anyone becomes severely short of breath, it’s a reason to call 911 if you can. For one thing, the person needs supplemental oxygen before the lack of it starts damaging their brain and heart. And there are other treatments, but only available in a medical facility.

If 911 is not available, the person should get to a hospital as soon as possible.

If both 911 and getting to a hospital are out of the question, then fresh air, rest, and time are the only other alternatives. Some people will get better on their own. Of course if you have oxygen, use it, and an asthma inhaler might help. If you have steroids around, such as prednisone or dexamethasone, they may be useful but not to a great degree. (As with all medicines, use as directed, and note precautions, interactions, side effects, etc.)

What about you? Had you heard of parking lot drowning, or secondary drowning?