Perhaps the most popular water safety story in the media these days is about Secondary Drowning. Although this phenomenon may be new to the media, it has been studied by physicians for decades. Fortunately, the condition is extremely rare. It most often occurs after a successful water rescue when a child has been pulled from a pool by a parent or lifeguard who at first appears to be perfectly fine. Then hours after the incident, the child shows subtle yet significant symptoms. Inhaling pool water can also cause chemical pneumonitis, or inflammation of the lungs due to harmful chemicals. Symptoms appear 1 to 24 hours after the incident. They can include persistent coughing, shortness of breath, chest pain, lethargy, fever and unusual mood change. If not treated, complications may develop progressing to pulmonary edema hypoxia/anoxia, respiratory and cardiac arrest, and death. This is because water gets into the lungs and injures the alveoli. Initially, this injury does not prevent oxygenation but as the mediators of injury and inflammation arrive, there is swelling, lung edema, and inflammation all of which lead basically to respiratory distress. Secondary drowning has caused deaths to children who have been rescued from the water and it is very real, such that all "near drownings" should be sent to hospital for observation and tests immediately following the incident. As aquatic professionals, I don’t think we need to scare our parents or children with the rare possibility of “Secondary Drowning,” but rather we need to teach everyone including our staff, that all water rescues that involve aspiration of water, regardless of how innocent they may appear, should require immediate follow-up with professional medical care. It is important to emphasize the water rescues NOT requiring resuscitation still need hospitalization. One of my fears relating to Secondary Drowning is now that the public has been alerted to this relatively new malady, whenever a child dies within a day of a swimming event, the aquatic facility and staff may be blamed. Sending all rescued swimmers to the hospital immediately after water aspiration may not only save a life, but also prevent a lawsuit. Secondary Drowning may mask other significant pre-existing medical conditions. The best prevention for Secondary Drowning? Life Jackets!