Dry Drowning

Dry Drowning: What Every Parent Needs To Know

A breakdown of what information technology is, what to watch for, and how likely it is to actually happen

by Steve Silvestro, MD@zendocsteve

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Your child is in the pool, she swallows a bit of water and goes on playing—but a few hours later on, she's in the infirmary on life support.

Information technology sounds a bit extreme, doesn't it? Yet this is a genuine concern that has bubbled through the parenting community in the by several years. Viral social media posts are spread at the start of each summer, warning of the dangers of "dry drowning." And as a consequence, pediatricians get dozens of phone calls, emails, and Facebook messages from friends and patients' parents worried nearly their kids in the puddle or fifty-fifty the bathtub.

But what is "dry drowning"—and, more than importantly, how much practise you have to worry nearly information technology?

This article is going to requite you everything you need to know about "dry drowning" and "secondary drowning," including what they are, what symptoms to watch for, and how worried yous should exist. We'll also comprehend what to do if you recall your child might exist experiencing secondary drowning, plus the best ways to prevent information technology and proceed your children safe.

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Why is Dry Drowning in the News?

The phenomenon of "dry drowning" first gained national attention in 2008 through the tragic story of John Jackson, who was a 10-year-old boy with autism and ADHD. John accidentally inhaled some h2o while swimming in a puddle. At the fourth dimension, he coughed for a flake, but then calmed down. Equally the twenty-four hours went on, however, he started to seem a bit off—he had two poop accidents in his pants and he was overly tired, eventually putting himself to sleep earlier than usual. When his mom checked on him afterward, he was unresponsive and, ultimately, died.

John's story is a terrible one that, obviously, no parent would e'er want to experience. And and then his story and those of others take inspired warnings nearly what has been framed as "dry drowning," with these cautionary tales getting passed around online and on morning news programs every summer.

Now, technically, John Jackson didn't actually experience dry drowning—he suffered from what'due south called "secondary drowning." And then let's talk about each of these and what the difference between them is.

"Dry out Drowning" vs. "Secondary Drowning"

What is "dry drowning?"

Truthful dry drowning normally occurs when water is quite common cold and of a sudden enters the airway very apace. This might happen if yous jump face-first into water with your oral cavity open—h2o rushes in and so quickly that instead of going toward your stomach, it passes downwards toward your vocal cords.

This sudden rush of common cold water causes the vocal cords to spasm, meaning that they tightly clasp shut. They do this to protect your lungs—to make sure nothing gets inside—merely they finish up substantially closing off the airway. With the vocal cords clamped downward and the airway closed, the affected person tin can't breathe. So in the case of dry drowning, h2o never actually reaches the lungs at all—hence, "dry" drowning.

Unfortunately, the symptoms of dry out drowning are oftentimes fairly nonexistent—the furnishings are so fast that most people who feel it never come up upwardly from the water.

Luckily, true dry drowning is exceedingly rare, which we'll get to in a moment.

What is "secondary drowning?"

Now what the children in the stories we hear about normally endure from is not technically "dry drowning," just instead is a process called "secondary drowning" or "delayed drowning."

In secondary drowning, the kid accidentally inhales an corporeality of water down into the lungs while playing or swimming in water. This is more similar to true drowning than to dry out drowning, every bit water is really making information technology into the lungs.

This inhalation of water, likewise called aspiration, might exist demonstrated in the moment it happens by just a modest bout of coughing or gasping. That first coughing fit may finish afterwards a few moments. However, over the next several hours, the small amount of water that got into the lungs begins to wreak havoc. Later all, we're non meant to have pool, lake, or body of water water in our lungs, and then over time it begins to cause swelling and inflammation.

That inflammation, in plow, causes some of the body's ain fluids to beginning building up inside the lungs—which makes information technology difficult for the lungs to do their job and bring oxygen into the blood. Air is coming into the lungs with each jiff, but the tissue can't pull the oxygen out because the fluid is in the mode.

The effect is that over time, the affected person isn't getting enough oxygen and effectively suffocates fifty-fifty though they're breathing. This tin happen many hours later, in some reports fifty-fifty every bit far out as 3 days after the initial aspiration, though that'southward really quite rare. So this is why in many of these stories that we hear, the child passes away while napping or after they go down for bed at dark—hours later the outcome in the pool.

It actually is every parent's worst nightmare. And the way that the stories are frequently told, it seems even worse—because the articles will often imply that the child was perfectly fine before they passed.

Just the truth is, in that location ARE signs that you tin watch for that can permit you know that something is wrong. Y'all but have to know what y'all should expect for.

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What to Watch For

And so allow's talk most the symptoms of secondary drowning then y'all know what to watch for, should your child have an event in a pool that has yous concerned:

  • Coughing – This is the beginning and most common symptom. In fact, you are highly unlikely to see secondary drowning arise without a big coughing event in the water.

But kids swallow h2o and cough in the pool all the time, correct?

What nosotros're really talking about here is coughing after the outcome in the water. For example, if your child sputtered and coughed while pond, but and so an hour or two hours later starts having progressively worse bouts of coughing seemingly out of nowhere, so that's a business.

  • Chest pain – Any pregnant chest pain after a pool-related cough event should be a worry, as it might bespeak difficulty animate or a feeling of fullness in the lungs. So might impressive belly pain, considering kids will often complain that their tum hurts when the existent consequence might really exist in the chest.
  • Shortness of jiff – This might seem obvious to some, but another sign of worry would be shortness of breath. If your child is breathing faster than normal—and non simply for a few seconds, but sustained over several minutes—and so this may be cause for concern.
  • Beliefs alter – Hither, your child might be confused, might speak more slowly than normal, or might practice things that don't quite fit with her usual behavior. In the example of John Jackson, he had two poop accidents after his tour of coughing in the pool—something that wasn't normal for him.
  • More tired than usual – Perhaps the most notable symptom is that your child is more tired than usual.

This tin sometimes be hard to tell because you might think that your child is simply tired after a long day at the pool or the beach. Merely if your child seems similar he'south excessively tired, more than you might think would make sense, more than you lot think is reasonable for the activity he's done—and especially if information technology's occurring after your child had a notable coughing spell while in the water—then information technology may exist worth to talk to your pediatrician.

Knowing these symptoms is key, because as scary every bit information technology is to hear stories of kids who go to sleep after swimming and never wake up from their nap, etc., the vast bulk of these and other children who experience secondary drowning are going to show at least some of these symptoms.

If we think back to the story of John Jackson, he coughed significantly in the puddle, and then showed signs of behavior alter by soiling himself twice, and later was excessively tired and put himself to bed earlier than expected.

Of course, hindsight is 20/20. Only now that you lot know the symptoms of secondary drowning, you'll be able to run into the red flags equally they occur.

What Should Yous Practice?

If you run into any of these symptoms after your child has been swimming—and especially if you know that your child had a coughing spell in the water—then phone call your pediatrician urgently. If your pediatrician is taking longer than 30 minutes to return your call and your child is nonetheless experiencing these symptoms, then seek medical attention right away.

Notice, still, that secondary drowning becomes a consideration if you see these symptoms, non if the only thing that has happened is a cough spell in the water. Tons and tons and tons of kids—and adults, besides—cough in the h2o every single day. But dry drowning and secondary drowning are, in reality, exceedingly rare.

So How Worried Should You Be?

While some of the articles that get passed around online every summer state that dry drowning and secondary drowning comprise 10% of drowning deaths in the United States, I have seen articles from medical professionals that state that the number is actually much lower—closer to but 1 or 2%.

In the U.s.a., a picayune less than iv,000 people drown each year. And so i-2% of that would mean near xl-80 people a yr dice from dry and secondary drowning.

At present, I don't mean to trivialize that in any way. Each of those 40-80 people is somebody's child or loved i. On height of that, drowning in general is the 2nd most mutual crusade of expiry for kids anile 1-4, and then it's not to be taken lightly.

But to put it in perspective, have a trip to your community pool and you volition likely hear 10 kids coughing at some point within just an 60 minutes or two of existence there. Or, maybe a amend perspective: roughly the same number of people every bit those who dice from secondary drowning are killed by lightning strikes in the The states—an average of thirty-fifty people a year. And however the vast majority of us don't worry about getting struck past lightning every time we get exterior.

And so in the same fashion, fears of secondary drowning shouldn't proceed you from enjoying the water with your family or crusade you to worry every time your child has a small cough in the pool or bathtub.

How to Prevent All Types of Drowning

Instead, take precautions and be prepared. When it comes to lightning strikes, we all know that the safest thing to do when you see lightning is to head indoors. And definitely no kites with keys fastened.

When it comes to secondary drowning, these are the most important precautions you tin can take:

The first is to teach your children how to swim. While not bulletproof, this is the number one way to reduce the odds of any blazon of drowning.

The second is to stay shut to your children, especially if they are under 4 years old. I'k a big fan of letting kids become off and exercise their own thing. I believe in giving kids plenty of unstructured, fairly unsupervised fourth dimension so that they can explore, be creative, and become self-reliant. But kids iv and under really should be inside arms' achieve of an adult whenever they're in the puddle, no matter how good a swimmer you think they are.

And finally, arm yourself with the data we covered in this article. Know the symptoms of secondary drowning—because at that place are symptoms. Kids swallow water and cough now and and then when they swim. Heck, adults do, too. But if we all panicked every time someone sputtered and coughed around water, pools would be empty and ERs would be full.

So instead, know what to spotter for—not then that yous have to be anxiously vigilant, simply so that when the symptoms exercise ascend, they stand out and yous know what to do.

In the meantime, enjoy that time in the h2o with your loved ones!

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[Update: There has been a shift amid fellow medical professionals to motility away from using the terms "dry" and "secondary" drowning, and to instead phone call all types of expiry in the h2o simply "drowning." Afterward conversations with several other physicians in the field, I believe information technology is still of import to make distinctions betwixt what is typically associated with "drowning"—that is, inhaling water and dying in the water—and these very rare occurrences of inhaling h2o and dying many hours later. Here'southward why: The option to call all of these mechanisms of water decease by the one uncomplicated term of "drowning" is thought to be a preventative safety measure—the idea being that we proceed to say that drowning is a leading cause of expiry in children, and then you should exist careful and closely monitor your kid at all times when in the water. This is certainly a noble effort—later all, who would argue confronting encouraging parents to be safety? Yet, our office as pediatricians is non just to keep kids safe, simply also to properly and astutely allow parents know when they do and do not have to worry when something does happen. My fear is that by no longer distinguishing between "typical" drowning and "secondary" drowning—and past saying just that drowning is a leading cause of death and can occur many hours subsequently—nosotros will neglect in our chore of appropriately managing parents' anxieties. When nosotros cease distinguishing between the dissimilar mechanisms of drowning, that means we besides no longer inform parents that inhaling h2o and dying several hours subsequently ("secondary" drowning) is extremely rare—the upshot being that we don't just make parents more than vigilant when their children sputter in the water, nosotros also dramatically ramp upwardly the amount of fear and anxiety that many parents volition face every time their child does something every bit common as cough in the pool. Every pediatrician who answers phone calls in the summer knows that there is already far greater worry almost secondary drowning than there are actual occurrences of it. At that place must be some way to strike a reasonable residual between vigilance and anxiety — and there is: education. With all of my manufactures and podcasts with The Child Repair Guide, I aim not to impaired things down, just instead to conspicuously explicate. Calling everything "drowning" is the sometime; this article seeks to exercise the latter. I hope you agree and take found this work informative.

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Dry Drowning

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