Recent news stories have reported children dying or being hospitalized hours or days after an incident in the pool or other bodies of water.
The reports have used the terms secondary drowning and dry drowning interchangeably. They have prompted concern about the effects of swallowing or inhaling small amounts of water, even though the child seems fine after the incident.
“There is a lot of confusion about what drowning means and how it can happen,” said Dr. Edward Fernandez, a Marshfield Clinic pediatric intensivist.
He cleared up the definition of drowning and some other terms used to describe it.
Dry drowning and secondary drowning are both drowning
Drowning means breathing difficulty caused by being immersed in liquid. The type of liquid doesn’t matter. Someone can drown without dying.
Dry drowning refers to a drowning event in which water enters the mouth and nose and causes a severe spasm when it touches the larynx. Neither water nor air can enter the lungs, and the patient can die from suffocation. Water enters the lungs after the patient has died because the spasm ends. In wet drowning, the patient is unable to breathe and can die because water enters the lungs.
“These definitions are frowned at because in both cases the person can die from lack of oxygen,” Fernandez said.
Secondary drowning refers to complications of drowning. It usually involves acute respiratory distress syndrome (ARDS), a condition caused by lung injury. ARDS causes fluid to build up in the lungs and prevents oxygen from reaching your blood stream. Symptoms escalate during a 24-hour period after the incident.
Secondary drowning sometimes has been called near drowning if the patient dies from complications more than 24 hours after being submerged in liquid. Some people use secondary drowning to refer to a drowning that follows another incident, like having a seizure and losing consciousness while in the water. The unconscious person drowns because he can’t protect himself.
Both dry and secondary drowning fit the definition of drowning.
When is medical attention needed?
Seek medical attention if a drowning event causes your child to lose consciousness.
Your child may need medical attention if a non-fatal drowning event involved unusual circumstances. For example, if your child fell in contaminated water like a sewer, he may need antibiotics. Get medical help if a seizure or fainting episode caused your child to slip under water or if he hit his head during the accident, even if he appears fine afterward.
Children who swallow or inhale small amounts of water and cough it out usually don’t need medical attention. To be safe, monitor your child for 4-6 hours after an incident for signs of breathing difficulty.
If your child is struggling to breathe or breathing faster, you need to bring him in,” Fernandez said.
Prevention and immediate care are most important
Practicing swimming safety and supervising children around water are the best ways to prevent drowning. If an accident happens, take immediate life-saving steps to increase the victim’s chance of survival and successful recovery.
If someone’s having trouble in the water, get him or her out as quickly and safely as possible. Begin CPR if the person isn’t breathing or doesn’t have a pulse. Remove wet clothes to prevent hypothermia even if the weather isn’t cold.
“Good pre-hospital care makes a difference in prognosis and saves lives,” Fernandez said.