This page is for information only. Fit to Dive does not provide medical advice. If you have concerns about your health or a diving-related incident, please consult a doctor or diving medical specialist. For further information on medical conditions related to diving, you can visit diving medical resources e.g. Divers Alert Network.

Links to Diving Medical Resources

Three Key Issues for Divers

  • Past Drowning Experiences Can Resurface

    For a small number of people learning to dive, certain skills trigger an unexpectedly strong stress reaction. This response is sometimes linked to a past non-fatal drowning, often in childhood. The incident may not have required medical attention, but it was terrifying—and the brain can store that fear. Diving can bring on a trauma response, even if the person had no conscious memory of the original event until that moment.

  • Not All Drowning Incidents Are Obvious - Seek Medical Advice

    A diver may surface feeling shaken after inhaling a small amount of water; often it’s nothing serious, but occasionally even mild aspiration can lead to complications of drowning, such as pulmonary oedema or lung infection. That’s why it’s important to report and monitor any incident involving water inhalation—especially if symptoms appear later. Seeking medical advice can help rule out or manage delayed effects.

  • Drowning in Diving is Not Only About Drowning!

    Being underwater is an immediately dangerous to life or health (IDLH) environment. Drowning is a common outcome in fatal diving incidents, but while it’s often recorded as the cause of death, it’s usually the end result of something else—a medical event, panic reaction, equipment issue, etc. To really understand and prevent drowning—as with all adverse outcomes in diving—we need to look wider: to the systemic issues and human factors.

Drowning is often listed as a leading cause of death in diving accidents, however experts state that there are usually other causes. Read more about the issues with identifying drowning and other causes here: https://dan.org/health-medicine/health-resource/health-safety-guidelines/medical-examination-of-diving-fatalities/

What Does 'Drowning' Really Mean?

A Clear Definition for Divers

Drowning is 

the process of experiencing respiratory impairment  from 

submersion/immersion in liquid. 

From the World Congress on Drowning in 2002; later published in: van Beeck EF, Branche CM, Szpilman D, Modell JH, Bierens JJ. A new definition of drowning: towards documentation and prevention of a global public health problem. Bull World Health Organ. 2005 Nov;83(11):853-6. 

In simple terms, this means a person is unable to breathe properly—either because water is blocking their airway and forced to breath-hold, or water inhaled and airway closed. Submersion or immersion refers to the nose and mouth being in or under water, whether fully or partially. This definition emphasises that drowning is a process that happens when breathing is impaired in water—it does not refer to the outcome. Whether the person survives or dies comes later; the term “drowning” itself describes the breathing difficulty that results from being in/under water (or other liquid). 


What are the outcomes of drowning?

According to international guidelines, drowning has three possible outcomes:

  1. Fatal drowning – the person dies.

  2. Non-fatal drowning with morbidity – the person survives but experiences injury (e.g. lung damage, brain injury).

  3. Non-fatal drowning without morbidity – the person survives without lasting physical effects.


Why does this definition of drowning matter for scuba divers?

  • Drowning doesn’t have to be fatal. The term applies to anyone who experiences breathing difficulty due to water entering the airway—regardless of whether they survive.

  • This modern definition replaces older, misleading terms like near-drowning, dry drowning, and secondary drowning, which are now considered outdated and inconsistent. (e.g. British Medical Journal, 2025 https://bestpractice.bmj.com/topics/en-gb/657)

  • It highlights that even brief breathing impairment counts as drowning—for example:

    • During a panic response at the surface or underwater

    • Delays or obstructions in gas-sharing, switching regulators or loss of regulator

    • If a diver inhales water accidentally during equipment use or mask clearing

  • A diver may survive the incident but still face medical consequences (such as pulmonary issues) or psychological impacts (such as anxiety, avoidance, or panic on future dives).

Understanding drowning as a process with a range of outcomes helps divers, instructors, and health professionals better recognise and respond to incidents.



Drowning: "A Silent Epidemic"

The third leading cause of unintentional injury death worldwide, (United Nations).

  • Drowning is a serious global health concern, with estimates suggesting that more than 30 lives are lost to drowning every hour, and close to 300,000 people died from drowning in 2021, (WHO 2024 Global Report on Drowning Prevention).

  • Nearly half of all drowning deaths involve individuals under the age of 29, with about one in four occurring in children under 5. Young children are particularly vulnerable, especially when they are unsupervised around water (WHO 2024 Global Report on Drowning Prevention).

  • Globally, the vast majority of drowning deaths—around 90%—occur in low- and middle-income countries. (WHO 2024 Global Report on Drowning Prevention).

  • Most drowning deaths are preventable through measures like supervision, barriers, water safety education, and rescue training.

  • "An average of 328 UK and Irish Citizens lose their life to accidental drowning EVERY YEAR and many more have non-fatal experiences, sometimes suffering life-changing injuries. Royal Life Saving Society.

Drowning Prevention

International Organisations

UK-Based Organisations

Urgent Help

If you require urgent assistance or medical help for a diving incident in the UK / UK resident.

  • COASTGUARD - For immediate assistance, rescue and urgent medical help on the water or suspected diving injury/illness, contact the Coastguard via Channel 16 or phone 999 and ask for the coastguard.

  • 24hr National Diving Accident Helpline - England & Wales 07831 151 523; Scotland 0354 408 6008

  • Medical Advice Helpline - DDRC (24hrs) for health worries as a result of diving 01752 209 999

  • [DAN Europe Members] Emergency Hotlines - Diving Accidents out of the UK call DAN Europe International Hotline +3906 42 11 5685 or in the UK Midlands Diving Chamber/DAN Europe National Emergency Hotline 07931 472 602

Strong Reactions when Learning to Dive?

For a small number of people learning to dive, certain skills trigger an unexpectedly strong stress reaction. This response is sometimes linked to a past non-fatal drowning, often in childhood.

When Panic in Dive Training Reveals a Past Drowning Experience

As a scuba diving instructor, a pattern that many of us observe occassionally is a diver-in-training who appears confident and has no history of difficulty—until a specific skill triggers an unexpected and intense stress response. This is most commonly seen with mask and regulator skills. 

  • The diver suddenly panics or refuses to continue.

  • The stress seems out of proportion to the task.

  • Only afterward does the diver recall or disclose a past drowning event.

  • Sometimes, they remember the incident for the first time during training.


Why This Happens: Drowning as a Hidden Trauma

Drowning is common, especially in childhood. The World Health Organization estimates hundreds of thousands of non-fatal drowning incidents each year. Many involve children who are rescued quickly and may not even receive medical attention.

These experiences often go unrecognised as traumatic, especially if the child “seemed fine” afterwards. But from a psychological perspective, the overwhelming fear, loss of control, and sense of helplessness are key features of trauma.

When a diver later practises underwater skills that simulate loss of air, water in the nose, or impaired vision, it can activate unprocessed trauma memories—emotional and bodily reactions stored in the nervous system, even if the person had not previously been bothered by the event.


Why Dive Training Can Trigger a Trauma Response

This helps explain why some divers:

  • Have no issues until they reach a particular skill that brings on fear, panic, or tears

  • Only later remember a childhood experience of nearly drowning—being pulled out of a pool or panicking in the sea

  • May never have thought of it as trauma, but still experience a strong fight/flight response underwater

This isn't a sign of weakness or poor instruction. It’s a normal human response to a past threat the brain and body still recognise.


Unresolved Trauma can Block Progress 

For some divers, this unprocessed memory of drowning becomes a real barrier to progress:

  • Repeated panic or shutdown during specific skills

  • Growing avoidance or loss of confidence

  • In some cases, abandoning training altogether

Unless this underlying trauma is acknowledged and addressed, repeated exposure to triggering dive situations can actually reinforce the fear and make it harder to move forward. This can sometimes lead to certified divers who are uncomfortable with important skills, and therefore at risk of getting into difficulties when diving. 

SAFER DIVING

An option for divers who are keen to improve the safety of their future diving.

Conditions That Create Risk for Drowning

Exploring how behaviour, equipment, and the diving environment can interact in ways that increase vulnerability

Drowning in scuba diving rarely comes out of nowhere—it often develops from a complex interaction of stress, skill gaps, and emotional overwhelm. In many cases, the diver encounters a stressor—such as entanglement, disorientation, or a sudden worry about air supply. If they lack the readiness to respond (for example, difficulty with mask clearing, buoyancy control, or air-sharing), and struggle with regulating their emotions, panic can quickly take over. This is where things can unravel: panic may lead to dropping the regulator, uncontrolled ascent, or gas depletion—any of which can result in drowning.


These elements—readiness, emotion regulation, and the stressor—form what’s known in diving psychology as the Panic Triangle. Understanding and addressing each side of this triangle is a powerful way to reduce risk.

How Can You Tell If Someone Is Drowning?

Drowning doesn't always look like what you see in films. In real life—and especially in diving—it’s often quiet, quick, and easy to miss. Recognising the signs early can be life-saving.

According to Divers Alert Network, people who are drowning often cannot call for help, wave, or splash dramatically. Instead, they may show subtle or even silent signs of distress.

🧍 On the Surface (General or Non-Diving)

  • Quiet or glassy-eyed appearance

  • Vertical in the water with no kicking

  • Head tilted back, mouth open

  • Attempting to swim or roll over without making progress

  • Gasping or hyperventilating

🤿 Diver on the Surface

  • Regulator out, struggling to breathe or speak

  • Weak or ineffective arm signals; or struggling with equipment

  • Kit can be part of the problem! An underinflated BCD, over-weighting or entanglement with ditched weights

  • Silent, passive, or drifting away from the group - possibly sinking unnoticed

🌊 Diver Underwater

  • Unresponsive to buddy or hand signals

  • Wide eyes or rapid, uncoordinated movements

  • Panic swim, rapid ascent, or uncontrolled descent

  • Losing or removing the regulator

  • Remaining motionless and not responding

Looks like drowning?

One other condition that causes difficulty breathing, while underwater, and is not drowning, is Immersion Pulmonary Oedema. This condition puts divers at significant risk.

Learn about IPO/E

Be Ready to Help: Why Rescue and First Aid Training Matters

Recognising the signs early and responding quickly can save lives. One of the best ways to prepare is by completing a CPR and first aid course, especially one focused on aquatic or diving-related scenarios. These courses help you learn what to look for, when to act, and how to respond safely and effectively. You’ll gain practical skills in recognising distress, performing rescue breaths, and using emergency oxygen—tools that could make all the difference.

👉 Look for a course from your local dive centre, training agency, or water safety organisation.


Watch for Delayed Symptoms After a Drowning Incident

Even if someone seems fine, symptoms can develop hours later— seek medical help after drowning. (List from StatPearls https://www.ncbi.nlm.nih.gov/books/NBK430833/ last update 2023).

  • Shortness of breath or difficulty breathing

  • Persistent coughing or chest tightness

  • Unusual fatigue or extreme tiredness

  • Irritability, confusion, or sudden changes in behaviour

  • Bluish lips or skin