A boy of 10 died of 'drowning' several hours after he got out of the pool. Apparently if you ingest water and breath it into your lungs you can appear totally fine, but run the risk of 'secondary drowning' for up to 72 hours later.

The lad from South Carolina died last weekend several hours after he swallowed water in a swimming pool.
Police say he later complained he was tired and took a nap. When someone checked on him, water was coming out of his nose and he was having trouble breathing.

Addendum for all worried parents

Treatment for Near Drowning Victims

Outdoor treatment for near drowning victims
Administering CPR and assisting an individual in breathing are clearly the most important treatment interventions in victims of near drowning episodes. Mouth to mouth ventilation is still the treatment of choice in the outdoors. Attempting to perform cardiac compressions in the water is also a possibility, although very difficult to perform. In the last 30 years, this author has attempted to perform cardiac compressions on two occasions, one with success and one not.

There are really no available studies showing good circulation with cardiac compressions in the water. However the attempt should be made if there is cardiac arrest. Mouth to mouth ventilation should continue.

The following treatment discuss is based on having next to nothing on hand with you in an outdoor setting. Most individuals in the outdoors will not have float boards. However if one can improvise and has anything hard that can be placed on a victim’s back, this can be beneficial. This can be anything from a paddle to a boat seat that can be taken off and used in the water to help perform compressions. It is also helpful to have another individual with you. Once ashore, the individual should be laid in a supine position, with the head neither up nor down, parallel to the beach, as in a head up position, there is concern about intracranial pressure building. Respirator drainage and gastric drainage by pushing on the victim’s belly, or turning the victim over and perform the Heimlich maneuver have shown no great improvement in outcome. However if an individual has swallowed a large amount of water, and their stomach is distended, this can interfere with mouth to mouth ventilation, so it may be very beneficial in this situation to push on the stomach to expel water, turning the victim’s head sideways, or rolling the victim on his side, at which point ventilations would begin.

Regarding near drowning incidents, The American Heart Association advises against the Heimlich maneuver unless there is gross blockage.

Healthcare Provider: Medical Treatment
In-hospital management of asymptomatic victims of submersion incidents

1. Check the airway.
2. Supplemental oxygen, 12-15 liters/minute.
3. Pulse Oximetry and/or arterial blood gas.
4. Obtain a thorough history of the incident
5. Underlying causes, any history of epilepsy, drugs, heart attack, arrhythmias, or cerebral vascular accidents.
6. Take the vital signs every 10 minutes.
7. Draw bloods: CBC, complete metabolic panel, assess blood urea, nitrogen, platelets, PT and PTT.
8. Strongly consider a blood alcohol level and toxicology screen.
9. Observe all patients; they should be kept for at least 4-6 hours before discharge.

In-hospital management of symptomatic victims of submersion incidents

1. Check the airway.
2. Supplemental oxygen with a non-breathing mask, 12-15 liters/minute.
3. Consider endotracheal intubation for comatose patients and patients unable to maintain an oxygen level above 90 mm. of mercury on a high flow oxygen mask.
4. Check vital signs.
5. Start an intravenous line.
6. Draw blood for electrolytes, BUN, platelets, PT, PTT, arterial gas studies are imperative, urinalysis.
7. Administer bi-carb according to blood gas results.
8. Chest x-rays, cervical spine x-rays, if concerned about neck trauma.
9. Nasogastric tube and in-dwelling urinary catheter.
10. Admit all patients with abnormal vital signs and abnormal findings on blood values.