What Is Dry Drowning? A Pediatrician Tells All

You may have heard stories on social media or on news reports in recent years about children "dry drowning." However, this term is greatly misunderstood, and the risk to your child or loved one suffering from a "dry drowning" event is extremely rare.

Even so, drowning of any sort is a very real threat to children, and it's important to understand the factors that can lead to dangerous respiratory distress as a result of water aspiration. Likewise, it's important to understand how to prevent water accidents using some common-sense precautions.

What Is the Difference between Drowning and "Dry Drowning?"

According to the World Health Organization, drowning is "the process of experiencing respiratory impairment from submersion, or immersion, in liquid." In the worst cases, drowning causes breathing to stop and a person requires CPR to survive. And while drowning can result in death, this is not always the case. In fact, there is an estimated 8,000 nonfatal drownings every year in the United States.

"Dry drowning" is a misnomer-and in fact, isn't a real medical term. If a child is involved in a near-drowning incident and experiences significant coughing, choking, sputtering or gasping after ingesting water, this means water likely entered the trachea and is making its way toward the lungs. The medical term for this process is aspiration-and aspirated water can cause lung damage.

It's important to note that it's impossible to "nearly aspirate" water-it either enters the airway or it doesn't. Because of this, it is impossible to "nearly drown." Every significant event in a body of water where the top of the airway was under water, and water entered the airway, is a drowning.

It's important to emphasize that all kids swallow a swig or two of water when splashing around. This swallowed water completely bypasses the trachea and the lungs and therefore cannot cause lung damage. There is no reason to be alarmed about a few coughs in an otherwise unbothered child after swallowing water-and this type of event is certainly not "dry drowning." When drowning occurs, it causes significant distress, during which time your child (and you) will probably be alarmed and possibly panicked.

What Are the Warning Signs of Drowning?

Along with the significant coughing and gagging frequently associated with drowning, other warning signs of drowning or aspiration after a water incident include:

• Vomiting
• Shortness of breath
• Wheezing
• Chest pain

If your child experiences these symptoms after an encounter with water or near-drowning, take them to the nearest emergency room immediately. While these symptoms can certainly happen in the minutes and hours following a drowning event, they are not considered dry drowning. They are simply results of the initial drowning incident that happened.

Does My Child Need Medical Attention after a Near-Drowning Incident?

Short answer: Yes. If there is a drowning event where a child was pulled out from under the surface of the water and resuscitated, or had a significant coughing and gagging spell after being in the water, they should get medical attention right away. These events mean water has likely crossed the threshold into the airway and could continue to cause damage to the lungs.

Types of damage that can occur following a drowning incident include:

• Spasm of the vocal cords, which can make it hard to breathe in air
• Inflammation of the lung tissue, which can prevent the transfer of oxygen to the blood
• Pulmonary edema, where fluid accumulates in the lungs, causing swelling

Since it's impossible to know the extent of lung damage after a drowning event, ALL victims of drowning should be evaluated in an emergency room without delay to ensure the aspirated water does not continue to cause lung damage.

Water Safety Tips to Prevent Drowning

While it is important to know the signs of drowning, the best defense against drowning is prevention.

Here are some steps you should take anytime your child of any age is playing in or around water:

• Ensure any child playing in water has a set of eyes watching them at all times without distraction, whether it's you, another caregiver, or a trained lifeguard. While other adults may be in the vicinity, it's important to have a dedicated, sober, adult watching children as they swim. No supervision = no swimming.
• Use "touch supervision." The American Academy of Pediatrics recommends that an adult should remain within an arm's length of any inexperienced swimmer in or around the water.
• Enroll your kids in swimming lessons: Kids are less likely to struggle and be at risk of drowning if they can navigate the water confidently.
• Follow water safety measures like wearing floatation devices on boats, having fencing around pools, and never leaving a child alone near standing water.

With accurate information about drowning, the warning signs to look for in your child, and a few simple safety tips, you and your family should be off and running (or should we say, swimming!) to a fun summer season.

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