Durban - With a cough and a splutter, a 3-year-old girl survived drowning in a tidal pool near Amanzimtoti when quick thinking lifeguards and a bystander came to her rescue on Sunday.Netcare911 spokesperson Chris Botha said the girl and her 4-year-old sister were playing in the pool when they disappeared under the water.The bystander and lifeguards immediately sprang into action and plucked them out and started doing CPR on the younger girl while they waited for the paramedics.After a few minutes the child started coughing, to the joy of everyone. Botha said the relief when that happens is palpable."It is unbelievable, the relief people feel. You can actually hear the relief, it is a very emotional time."But the girls were not out of the woods yet. They showed near-drowning symptoms and paramedics immediately set to work on the vital next phase of their recovery.The children were still coughing a lot - a sign that they were still not out of danger.After an event like that, they could still have fluid on their lungs, and in the case of salty sea water it can be even more life-threatening, Botha explained.This is because the body draws more liquid into the lungs to dilute the salt in the water that entered their lungs.If it is not treated, it is quite possible to die from secondary drowning later."People go home and then don't think much of it. The next morning they have died," he said, stressing that it is important to go for follow-up treatment after a near-drowning.Typical other symptoms of near-drowning are lethargy, slow breathing and a high pulse rate.He had high praise for the lifeguards and the bystander, saying the early CPR they did was crucial to survival."I take my hat off to the lifeguards and the member of the public."The paramedics started treating the sisters for those symptoms before they were taken to hospital with an advanced life support paramedic and their mother, where they will receive further treatment and monitoring.