What parents need to know about ‘dry’ and ‘secondary’ drowning

On average, 10 people will die in the United States today as a result of drowning.

The image most of us have of a drowning is one of a person flailing in deep water then going under and not coming back up. However, something many people may not know is that not all drownings happen while the person is in the water.

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To that end, water safety and medical experts are encouraging parents to think of drowning as a process and not an end result of being under water for too long. The prospect of a child drowning after leaving the pool or beach is one not many parents have considered.

Here’s a quick look at two ways – dry drowning and secondary drowning – a person can drown hours after leaving the water.

What is “dry drowning?”

Dry drowning happens when water irritates the larynx (vocal chords), and the person has a severe inflammatory reaction to it. The reaction causes the vocal chords to spasm (laryngospasm reflex) and that causes them to close. The person then has trouble or cannot pass air into their lungs. Laryngospasm can cause something called neurogenic pulmonary edema which causes an increase in pressure in the lungs and heart, reducing the body's ability to get oxygen. Laryngospasm can be triggered by something as simple as droplets if water hitting the larynx. High-speed submersion, such as when you go down a water slide or jump from a high dive, can also cause the reaction.

How is it different from “secondary drowning?”

Secondary drowning happens when water gets into the lungs. It is usually a small amount of water, but it fills the air sacs of the lungs, causing pulmonary edema – or fluid in the lungs. With water in the air sacs, there is no room for air, so the person begins to drown. Secondary, or delayed drowning as it is sometimes called, can happen hours after inhaling the water.

What are the symptoms?

The symptoms of dry drowning and secondary drowning are similar and can be seen from between one hour to 24 hours after the incident. Usually sooner rather than later with dry drowning.

The symptoms include:

Coughing
Gasping
Chest pain
Trouble breathing
Feeling extremely tired
Lips or skin turning blue
Changes in behavior
A high-pitched breathing sound called stridor
Foam around the mouth – Anyone pulled from the water who is coughing or sputtering and has foam around their mouth needs emergency care immediately.

If a person who has been in water shows any of these symptoms, call 911 or get them to a hospital emergency room as soon as possible.

How is it treated?

It depends. Treatment can range from observation for a few hours, to administering oxygen, to chest x-rays or more advanced medical support – intubation or use of a ventilator – in the most severe cases. (that is rare).

How do I prevent it?

Here are a few tips:

Obviously, watch your children when they are in and around water, any water. It takes only moments to take in enough water to cause drowning.
Make sure kids know how to swim and watch to make sure weak swimmers don't go out beyond their abilities.
Don't let kids get too tired in the water.
Encourage them to keep their mouths closed when going under water or when their faces are near the water.
Remember the symptoms. If you see any in your child, take him to the hospital.