Full-Face Snorkeling Masks Carry a Risk of Hypercapnia and Drowning in Younger Children: A Case Series

Background: Recently, a new type of full-face snorkeling mask (FFSM), called "Easy-breath" masks, has become extremely popular both in adults and children due to their effective marketing and relative comfort. However, these masks are complex engineering systems that, in case of malfunctioning or if used by young children, may readily cause CO₂ rebreathing, especially in young children. Case Presentation: We present three cases of children under six years of age admitted to the emergency department, with two of them due to non-fatal drowning incidents and one following a cardiac arrest induced by drowning. All incidents occurred during brief submersions while using full-face snorkeling masks. Conclusions: When inappropriately used by younger children, full-face snorkeling masks may have a mechanical dead space larger than tidal volume, with a significant increased risk of rebreathing of CO₂ and consequent risk for hypercapnic hypoxia. The hypercapnia may cause dizziness and respiratory distress, while hypoxia may cause confusion. Both may lead to loss of consciousness, which could be a potential cause of drowning, particularly in younger children.