Could You Spot Symptoms of Dry Drowning?

A dip in the pool is a great way to cool off and enjoy physical activity throughout the hot summer months, but safety should always be top of mind, especially for parents of young swimmers.

According to David Marquardt, MD, pediatric critical care medicine physician at ProMedica Toledo Children’s Hospital, water-related injuries tend to be more common at the start of summer when people have forgotten pool safety over the winter months or at the end of summer when they start feeling too comfortable around the water.

More than 90 percent of drowning incidents involve lack of adult supervision, so Dr. Marquardt advised that parents pay close attention when their child is in the pool. “If you’re cooking or talking with someone, you’re not watching the kids,” he said.

If a parent isn’t paying close attention, drowning can be easy to miss. It’s not usually the flailing you see in the movies. “When a child goes under water it’s usually a silent thing,” he added.

Dr. Marquardt explained that in a drowning situation, a person’s windpipe opens up and fills up with water. “You can’t exchange oxygen and carbon dioxide,” he explained. “Very quickly, your body becomes deprived of oxygen and within minutes damage begins being done to your brain. The first and most important thing is to get the person out of the water as quickly as possible to try to help reestablish breathing.” This includes hands-only CPR or mouth-to-mouth resuscitation and a call to 9-1-1.

How Dry Drowning Occurs

Each summer, the topic of dry drowning reappears in the news and social media sites, but Dr. Marquardt said that the meaning of the phenomenon is evolving. Dry drowning isn’t a medical term, so it’s hard to say exactly how many cases happen in our region each year.

According to Dr. Marquardt, the reason it’s called dry drowning is because the fluid that fills your lungs comes from inside your body from inflammation as opposed to fluid from the outside that is swallowed.

Here’s how it happens: When someone is submerged under water, before the point where they lose consciousness and their airway opens up, there are a couple of protective instincts that can kick in that may actually cause injury. For instance, the tissue at the top of your airway may spasm to prevent water from entering, but if it shuts while you’re trying to breathe out, the change in pressure inside your lungs can cause them to fill with fluid hours after your injury. Likewise, if you happen to get some water in your lungs (particularly water that contains chemicals or bacteria), that may cause an inflammatory reaction that causes your lungs to fill with fluid.

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This reactions could happen from as little as a glass of water. “It has more to do with how your body reacts than any particular amount of water,” said Dr. Marquardt.

Knowing the Signs

Dry drowning causes your lungs to get very stiff and hard to breathe, so respiratory distress is the No. 1 thing to look for. If you can see that your child is having difficulty breathing–the space between their ribs is standing out, their belly is moving in and out aggressively, their nose is flaring in and out, it’s time to seek medical attention. Persistent coughing (especially that leads to vomiting) and tiredness or lack of interaction 2-3 hours after the incident are also signs.

“When children stop the activity of swimming, their body should return back to normal,” said Dr. Marquardt. “If they don’t return to their normal baseline, it’s very reasonable to have a discussion with your doctor or go to an Urgent Care.”

Signs of dry drowning:
  • No return back to “normal”
  • Difficulty breathing
  • Persistent coughing
  • Vomiting
  • Tiredness or lack of interaction

Instances of dry drowning where a child has shown none of these respiratory symptoms is extremely rare. “The phenomenon we’re talking about with dry drowning is not something that just instantly develops in a kid who looks totally fine, is feeling great, running around playing, went to bed and didn’t wake up,” explained Dr. Marquardt. It is also very rare to experience dry drowning without having been submerged in water.

Cases of dry drowning typically happen within 6-12 hours of the water incident. If it’s a day or more later and the child is fine, there’s likely no reason to worry.

Cases of dry drowning typically happen within 6-12 hours of the water incident.

While toddlers and young children tend to be more susceptible to dry drowning, it’s only because they are more likely to be submerged under water. The inflammatory reaction in the lungs can happen to anyone.

Dry drowning can sound very scary but it’s important to know that with supervision and proper pool safety, it’s preventable, and that the symptoms can help you get help if needed. “If you’re really concerned it’s never a terrible idea to call your doctor or go to Urgent Care,” reminded Dr. Marquardt.

And don’t let fear keep you from enjoying the pool. “Swimming is a great physical activity,” said Dr. Marquardt. “Getting your kids introduced to water early is a great way to build a lifelong interest in swimming. It’s not something to avoid; just do it as safely as you can.”

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