People drown when they get too much water in their lungs. You can drown in as little as an inch or two of water. Babies can drown in a sink or bathtub. Preschoolers are most likely to drown in a swimming pool. People who have seizure disorders are also at risk in the water. Drowning can happen quickly and silently.

Drowning precautions should include

• Fences around pools
• Supervising children near any body of water, including tubs
• Not swimming or boating when under the influence of alcohol or sedatives
• Wearing life jackets when boating
• Learning CPR

What to know

• Drowning is a leading cause of death for children.
• Drowning can be fatal or nonfatal.
• Nonfatal drowning can result in long-term health problems and costly hospital stays.

What is drowning?

Drowning is the process of experiencing respiratory impairment from submersion or immersion in liquid. Drowning happens when a person's nose and mouth are under water for too long, making it impossible to breath. Drowning is not always fatal.

Fatal drowning happens when the drowning results in death.

Nonfatal drowning happens when a person survives a drowning incident. Nonfatal drowning has a range of outcomes or results, from no injuries to very serious injuries such as brain damage or permanent disability.

Fast facts

Every year in the United States there are an estimated:

• 4,000 fatal unintentional drownings—
  • that is an average of 11 drowning deaths per day.
• 8,000 nonfatal drownings—
  • that is an average of 22 nonfatal drownings per day.

In the United States:

• More children ages 1–4 die from drowning than any other cause of death.
• For children ages 5–14, drowning is the second leading cause of unintentional injury death after motor vehicle crashes.

You can prevent drowning

Learn basic swimming and water safety skills

Formal swimming lessons can reduce the risk of drowning.Children who have had swimming lessons still need close and constant supervision when in or around water.

Build fences that fully enclose pools

Construct and use a four-sided fence that is at least four feet in height and fully encloses the pool. The fence should separate the pool from the house, with self-closing and self-latching gates. Remove all toys from the pool area that might attract children to the pool when the pool is not in use.

Supervise closely

Designate a responsible adult to supervise closely and constantly when children are in or near water (including bathtubs). You can assign a specific adult to supervise each child when they have access to water. Adults watching kids in or near water should avoid distracting activities like reading, using the phone, and consuming alcohol or drugs, because drowning happens quickly and quietly.

After swim time is over, shut and lock doors that give access to water. Be proactive and learn about any risks when visiting another home or unfamiliar location. Adults should supervise children closely even when lifeguards are present.

Wear a life jacket

Life jackets reduce the risk of drowning while boating for people of all ages and swimming abilities. Life jackets should be used by children for all activities while in and around natural water.

Life jackets can also be used by weaker swimmers of all ages in and around natural water and swimming pools. Do not rely on air-filled or foam toys, as these are not safety devices.

Learn CPR

Your CPR skills could save someone's life in the time it takes for paramedics to arrive. Many organizations such as American Red Cross and American Heart Association offer CPR training courses, both online and in-person.

Know the risks of natural waters

Lakes, rivers, and oceans have hidden hazards such as dangerous currents or waves, rocks or vegetation, and limited visibility. Check the forecast before activities in, on, or near water. Local weather conditions can change quickly and cause dangerous flash floods, strong winds, and thunderstorms with lightning strikes.

Avoid alcohol

Avoid drinking alcohol before or during swimming, boating, or other water activities. Alcohol impairs judgment, balance, and coordination. Do not drink alcohol while supervising children.

Use the buddy system

Always swim with a buddy. Choose swimming sites that have lifeguards when possible. The buddy system is especially beneficial for people with seizure disorders or other medical conditions that increase their risk of drowning.

Take additional precautions for medical conditions

Know if your medical condition might increase your risk for drowning and take extra care. For example, if you or a family member have a seizure disorder like epilepsy, have one-on-one supervision around water. People with seizure disorders can also consider taking a shower rather than a bath. Take extra precaution around water if you or a family member has other conditions that can increase drowning risk, like heart conditions or autism.

Consider the effects of medications

Avoid swimming if you take medications that impair your balance, coordination, or judgement. These side effects increase the risk of drowning. Several medications can produce these side effects, such as those used for anxiety and other mental health conditions.

Don't hyperventilate or hold your breath for a long time

Do not hyperventilate before swimming underwater or try to hold your breath underwater for long periods of time. This can cause you to pass out and drown. This is sometimes called "hypoxic blackout" or "shallow water blackout".

Key points

• Drowning is the leading cause of death for children ages 1-4 in the U.S.
• Participating in formal swimming lessons can reduce the risk of drowning among children and young adults.
• Life jackets can prevent drowning during water activities, especially boating and swimming.
• Proper pool fencing can prevent young children from gaining access to the pool area without caregivers' awareness.

U.S. populations at increased risk

Children

• Drowning is the leading cause of death for children 1-4.
• Most drownings in children 1–4 happen in swimming pools.
• Drowning can happen even when children are not expected to be near water, such as when they gain unsupervised access to pools.
• Drowning is the second leading cause of unintentional injury death for children 5-14, behind motor vehicle crashes.

Males

Nearly 80% of people who die from drowning are male. Many factors might contribute to higher rates of drowning among males, including increased exposure to water, risk-taking behaviors, and alcohol use.

Conditions that can increase risk

• People with seizure disorders such as epilepsy are at a higher risk of fatal and nonfatal drowning than the general population.
• Drowning is the most common cause of unintentional injury death, with the bathtub being the most common site of drowning, for people with seizure disorders.
• Heart conditions are also associated with a higher risk of drowning.

Autism Spectrum Disorder (ASD)‎

Deaths among children with autism spectrum disorder are nearly 40x as likely to be caused by drowning as deaths in the general population.

What makes the impacts worse

Not being able to swim

• Many adults and children report that they can't swim or that they are weak swimmers.
• Participation in formal swimming lessons can reduce the risk of drowning among children and young adults.

Lack of close supervision

• Drowning can happen quickly and quietly anywhere there is water, especially to unsupervised children.
• It happens in lakes and oceans, pools, bathtubs, and even buckets of water.

Not wearing life jackets

• Life jackets can prevent drowning during water activities, especially boating and swimming.
• The U.S. Coast Guard reported 658 boating-related deaths in 2021—81% died by drowning, and 83% of these people were not wearing life jackets.

Drinking alcohol

• Among adolescents and adults, alcohol use is involved in:
  • up to 70% of deaths associated with water recreation, like boating or swimming,
  • nearly 1 in 4 emergency department visits for drowning, and
  • about 1 in 5 reported boating deaths.
• Alcohol impairs balance, coordination, and judgment, and it increases risk-taking behavior.

Using drugs and prescription medications

• Certain medications can increase the risk of drowning, especially psychotropic medications commonly prescribed for depression, anxiety, bipolar disorder, schizophrenia, and other conditions.
• Side effects from these medications can be similar to the effects of alcohol, such as difficulty thinking clearly and decreased motor skills.
• Other drugs and prescription medications might also increase drowning risk.

Places with increased risk

Pools with missing or ineffective fences

Proper pool fencing can prevent young children from gaining access to the pool area without caregivers' awareness. A four-sided isolation fence which separates the pool area from the house and yard reduces a child's risk of drowning by 83% compared to three-sided property-line fencing (which encloses the entire yard, but does not separate the pool from the house).

Bathtubs, swimming pools, natural water

The highest risk locations for drowning vary by age.

• Among infants under 1 year old, three quarters of all drownings occur in bathtubs.
• Most drownings happen in home swimming pools among children ages 1–4.
• Over 40% of drownings among children 5-14 occur in natural water, and over 35% occur in swimming pools.
• Almost half of fatal drownings among people 15 years and older occur in natural waters like lakes, rivers, or oceans.

Key points

• For Black people under age 30, drowning rates are 1.5x higher than White people the same ages.
• For American Indian and Alaskan Native people under age 30, drowning rates are 2x higher than White people the same ages.

Who's affected

Drowning risk factors vary by race

Drowning death rates for American Indian or Alaska Native people under age 30 are 2 times higher than the rates for White people. The highest disparities are among American Indian or Alaska Native people ages 25-29 with rates 3.5 times higher than White individuals of the same age.

Drowning death rates for Black people under age 30 are 1.5 times higher than the rates for White people. Disparities are highest among Black children ages 5-9 (rates 2.6 times higher) and ages 10-14 (rates 3.6 times higher).

In swimming pools, Black children ages 10-14 years drown at rates 7.6 times higher than White children.

Black children and youth are more likely to drown in public pools, and white children and youth are more likely to drown in residential pools.

In natural water, American Indian or Alaska Native people under age 30 have the highest drowning death rates, with rates 2.7 times higher than White people.

SURPRISE – In this stage, the victim recognizes danger and becomes afraid. The victim assumes a near-vertical position in the water, with little or no leg movement. The arms will be at or near the water’s surface, making random grasping or flipping motions. The head will be tilted back with the face turned up. Victims rarely make any sounds; they are struggling just to breath.

INVOLUNTARY BREATH HOLDING – The victim has now dropped below the static water line and the body, in an attempt to protect itself initiates involuntary breath holding. This occurs because water has entered the mouth and causes the epiglottis to close over the airway. Though a victim may continue to struggle, he/she will not usually make any sounds as he/she cannot breathe. Without oxygen, the victim will lose consciousness.

UNCONSCIOUSNESS – Because the victim has been without oxygen, the body shuts itself down as unconsciousness results. In this stage, the victim will be motionless. Because breathing has stopped, he/she is in respiratory arrest. There is no chest movement or breathing sounds. At this point, the victim sinks to the bottom of the water, either slowly or rapidly, depending on factors such as the amount of air trapped in the lungs, body weight, and muscle mass. The victim will remain unconscious unless breathing is reestablished.

HYPOXIC CONVULSION – Due to the lack of oxygen in the brain, the victim may look as if he/she is having a convulsion, which is why this stage is called the hypoxic convulsion stage. The victim’s skin turns blue, especially in the lips and fingernail beds, and the body may appear rigid. There may be violent jerking of the body and frothing (foaming saliva).

CLINICAL DEATH – The final stage in the drowning process is death. Clinical death occurs when both breathing and circulation stop. The victim is in cardiac arrest. The heart stops pumping blood. The organs are no longer receiving oxygen rich blood. The lack of oxygen causes the skin to turn blue.

Use extreme caution to avoid direct contact with the victim. A panicked victim may accidentally drown the rescuer as well.​​

If the victim is conscious:​

• Push a floating object to the victim or try to extend a long branch, pole, article of clothing or other object that the victim can grab. Rescuers should not place themselves in danger.
• Call 911 for help.

If the victim is unconscious:​​​

• If you have to enter the water to reach the victim, take a flotation device with you if possible. Get the victim out of the water at once, being careful
• to support the neck and back in straight alignment. Once ashore or on the deck of a pool, the victim should be placed on his or her back.
• If the victim is not breathing, check for airway obstructions and clear the airway if necessary. If after a few seconds the victim is still not breathing, immediately begin CPR (see the CPR section on page 23). Call 911 for help.
• If the victim is conscious, keep him or her warm (under a blanket, coat or other object) and lying down while you wait for help to arrive.

Swimming pools and spas are great places for family fun. It’s important to ensure everyone follows these simple safety steps to stay safer in and around the water.

1. Supervise Children: Always watch children in or near water, never leave them unattended.

Always watch children when they’re in or near water, and never leave them unattended. Designate an official Water Watcher, an adult tasked with supervising children in the water. That should be their only task – they shouldn’t be reading, texting or playing games on their phone. Have a phone close by at all times in case you need to call for help, and if a child is missing, check the pool first.

Even if a lifeguard is present, parents and caregivers should still take the responsibility of being a designated Water Watcher. When any lifeguard chair is empty, the remaining lifeguards may not be able to see the entire pool and when lifeguards are seated in low chairs, their view can be blocked by patrons in the pool.

2. Learn to Swim: Teach children how to swim.

Swimming is not only fun, it’s a lifesaving skill. Enroll children in swimming lessons; there are many free or reduced-cost options available from your local YMCA, USA Swimming chapter or Parks and Recreation Department.

3. Know Your Drains: Teach children to stay away from drains.

Do not play or swim near drains or suction outlets, especially in spas and shallow pools, and never enter a pool or spa that has a loose, broken or missing drain cover. Children’s hair, limbs, jewelry or bathing suits can get stuck in a drain or suction opening. When using a spa, be sure to locate the emergency vacuum shutoff before getting in the water.

4. Ensure Compliance: Ensure all pools and spas have compliant drain covers.

Virginia Graeme Baker, after whom the Pool and Spa Safety Act is named, died from drowning due to a suction entrapment from a faulty drain cover. All public pools and spas must have drain grates or covers that meet safety standards to avoid incidents like the one that took Graeme’s life. Powerful suction from a pool or spa drain can even trap an adult.

5. Install Safety Devices: Install barriers, covers and alarms.

Proper fences, barriers, alarms and covers can be lifesaving devices. A fence of at least four feet in height should surround the pool or spa on all sides and should not be climbable for children. The water should only be accessible through a self-closing, self-latching gate. Teach children to never try to climb over the gate or fence. Install a door alarm from the house to the pool area, and keep pool and spa covers in working order.

6. Get Certified: Know how to perform CPR on children and adults.

Often, bystanders are the first to aid a drowning victim, so learning CPR can help save a life. And once you’re CPR certified, make sure to keep your certification current. CPR classes are available through many hospitals, community centers, or by contacting the American Red Cross.

7. Take the Pledge: Take the Pool Safely Pledge!

Before heading to the pool or spa with your family, remember to take the Pool SafelyPledge. This online call to action is a reminder to stay safer around the water.

Drowning is preventable. Follow these key prevention tips: learn how to swim and teach children how to swim, supervise children closely and constantly when they are in or near water, properly fence home swimming pools, and wear a properly fitted life jacket.

Leading cause of death

Drowning is a leading cause of death for children.

Keeping children safe in and around water allows everyone to enjoy summer water activities. Drowning is the leading cause of death for children 1 to 4 years old, and the second leading cause of unintentional injury death for children 5 to 14 years old. Drowning can happen in seconds and is often silent. It can happen to anyone, any time there is access to water. This includes pools and lakes, and also smaller water bodies like bathtubs and water-filled buckets.

Water safety

Swimming lessons can reduce the risk of drowning, but over half of U.S. adults have never taken a swimming lesson. Consider enrolling children in swimming lessons. And consider swim lessons for yourself to improve your swimming skills and comfort in the water. It's never too late to learn to swim and the benefits increase as we age.

Keep in mind that children who have had swimming lessons still need close and constant supervision when in or around water, even when a lifeguard is present. An adult should always be within an arm's length from a child who is in or near water. When supervising children, a responsible adult should avoid distracting activities like reading, using the phone, and consuming alcohol or drugs because drowning happens quickly and quietly.

Even non-fatal drowning can result in long-term health problems and costly hospital stays. Drowning injuries can cause brain damage and other serious outcomes, including long-term disability. For every child under age 18 who dies from drowning, another 7 receive emergency department care for non-fatal drowning. Nearly 40% of drownings treated in emergency departments require a hospital stay or transfer for further care. This is 3x higher than the number of other unintentional injuries that require follow-up care.

Pools and natural water

Home swimming pools need a four-sided fence at least four feet high that fully encloses the pool and separates it from the house. The fence needs a self-closing and self-latching gate. All toys that might attract a child need to be removed from the pool when no one is using it.

"Floaties," arm bands, or water wingsdo not prevent children from drowning and can easily slip off, especially when kids jump into the water. Water wings can produce a false sense of safety for parents and children. A U.S. Coast Guard-approved life jacket is more protective.

About 40% of drowning deaths among children ages 5-14 occur in natural water. More than half of fatal and non-fatal drownings among people 15 years and older occur in natural or open waters like lakes, rivers, or oceans. Wearing properly fitted life jackets can be beneficial for many activities in and around natural water, not just boating. When in or around open or natural water—whether in a boat or in the water—children and adults are best protected by wearing U.S. Coast Guard-approved life jackets that are well-fitted to their size and fully fastened. Approximately 85% of people who drowned while boating in 2022 were not wearing a life jacket.