Drowning vs. Dry Drowning
As the summer comes to a close, we thought that we would take a moment to discuss the topic of “Dry Drowning”. Every summer, this concept receives a lot of media attention and causes significant distress among many parents. We hope that the following discussion helps to debunk some of the misinformation in the media, as well as provide some evidence-based knowledge to allay fears.
The simplest place to start our discussion is with the medical definition for drowning. This medical definition is “the process of experiencing respiratory impairment from submersion/immersion in liquid”. (Definition of Drowning: A progress Report. Bierens J, Drowning 2e Berline: Springer, 2014) One of the following outcomes occurs from drowning. (1) death (2) injury without death (3) no injury or illness following drowning.
In the medical community, “dry drowning” is not considered an accepted medical condition. This would also include the terms “near drowning” or “secondary drowning”. The main issue is that the media and lay person associate drowning with death. It is important that we change our way of thinking so that we see drowning as a process where there is a spectrum of outcomes (which we listed above). An example that may make this more understandable is that a person may have a heart attack and still survive (with or without major consequences). This is the same way that a person could drown and still survive with or without major consequences.
Dry Drowning does not have an actual medical definition. The term came about when people described an aspect of drowning that found that the lungs of individuals who had drowned did not have water in them. 10-20% of the time, very little water every enters the lungs. This equates to about one ounce of water entering the lungs of a 30lb child.
The main issue when a child is submerged under water is the lack of oxygen. The treatment would be to start CPR immediately. If the CPR is successful, and the child starts breathing again, then the little amount of water that did enter the lung is absorbed by the body with no issue. It may also cause coughing that may get better or worse over the next few hours. There are instances where respiratory symptoms such as coughing and comfortable breathing may worsen after a drowning incident. These individuals should seek medical help. There is usually a 2-3 hour period where a person will either improve drastically or worsen.
Parents often ask “how much is too much” in terms of submersion under water or inhaling water. Minimal symptoms are what one experiences from taking a drink at dinner and feeling like it has “gone down the wrong pipe”. You will sputter and cough and clear it over a few minutes. If you feel that your child is experiencing symptoms that are worse than “the wrong pipe scenario”, and they are not improving over several minutes, then you can seek medical attention. The good news is that it is RARE for minimal symptoms to actually progress to death. The symptoms will progress and worsen and give you time to seek medical attention.
Here are warning signs for drowning or submersion/immersion in liquid: Difficulty breathing, excessive coughing, foaming in mouth, and not acting normally.
Drowning is the leading cause of preventable death in pediatrics. This is a serious risk, and one that should be taken seriously. We encourage all children to get swim lessons if able. Non swimmers should wear life jackets, and toddlers should have touch supervision. A pool should have fencing on four sides with locking gates. There should be continuous supervision at all times when children are in the water, even if a life guard is present.