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Secondary and dry drowning: Should you be worried?

three kids in a swimming pool posing for the camera / dry drowning
If your child inhales or swallows water, monitor him or her for 4-6 hours. Watch for rapid breathing or signs your child is struggling to breathe.

You may have come across news stories over the years about children dying or being hospitalized hours or days after an incident in the 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 Health System pediatric intensivist.

The differences between dry drowning and secondary drowning

Drowning in general means breathing difficulty caused by being immersed in liquid. The type of liquid doesn’t matter. Most commonly, when we think of drowning we think of someone in the water. They’re unable to breathe and can die because water enters the lungs.

“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,” said Dr. Fernandez. “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.”

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 them in,” Dr. 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,” Dr. Fernandez said.


For immediate care, visit Marshfield Clinic Health System.

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One response to “Secondary and dry drowning: Should you be worried?”

  1. Dean

    Interesting article.During the 1940's a grade school classmate of mine died in the water at Yellow River swimming pool. At the time, we thought he had drowned. Later, it was announced that he died from a heart attack because there was no water in his lungs. I wonder how one would know the difference, dead is dead!

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