Dispelling Myths about Dry Drowning

Nothing sounds better on a hot summer day than hopping in a cool pool. But, if you have kids, pool time might cause you a bit of anxiety and fear. Amy Groen, DO, UnityPoint Health, works in pediatric emergency medicine and often gets questions around dry drowning. She explains the difference between drowning and dry drowning, concerning symptoms to look for in your child, and five of the best ways to prevent drowning.

What is Drowning?

“Drowning is the process of experiencing respiratory problems from submersion or immersion in water,” Dr. Groen says. “In other words, to have a drowning event, the child has to go under water. You don't drown by just swallowing water or playing in it.”

Dr. Groen says there are three terms used by medical professionals.

• Fatal drowning. Death related to drowning or its complications.
• Nonfatal drowning with injury. Someone who has injuries or complications that don't lead to death.
• Nonfatal drowning without injury. A drowning episode that doesn't cause injury or death.

“These three terms were agreed upon at a 2002 World Congress on Drowning and are accepted by the Centers for Disease Control and Prevention (CDC), the American Heart Association, the American Red Cross and many, many others. We don't use the terms near drowning, dry drowning or secondary drowning. These are terms that have been coined by the media and are often sensationalized,” Dr. Groen says.

What is Dry Drowning?

“Dry drowning is not an actual medical condition. It's a term that's been used and sensationalized by the media to describe when lungs of drowning victims contain no water in about 10-20 percent of autopsies. The reason for this is because of laryngospasm, which is when the body forcefully closes the airways. This can happen when water is attempting to enter the lungs,” Dr. Groen says.

In fact, Dr. Groen says many drownings are actually dry, in the sense that very little water actually enters the lungs. The main problem during a drowning event is lack of oxygen to the brain.

“If a person is rescued before the brain runs out of oxygen, then the small amount of water in the lungs is absorbed and causes no problems. Or, it can cause excessive coughing that gets better or worse over the next few hours. The treatment is the same, regardless of whether small amounts of water (wet) are present or not (dry),” Dr. Groen says.

She says the cases of dry drowning reported by the media in the past few years weren't due to drowning, but rather, other medical issues. Children don't show any symptoms for multiple hours or days and then just die from dry drowning.

“There was a reported death in 2017, but the child was found to have a heart infection, and the death wasn’t related at all to the fact he was swimming. The child that died in 2018 from a reported dry drowning was actually suffering from aspiration pneumonia, because she had water blown into her lungs while playing in the pool. Two days later, the fluid developed an infection,” Dr. Groen says.

Dry Drowning Symptoms

“While there's a lot of concern for dry drowning, remember, to have a drowning event the child has to go underwater or be immersed in water. So, their face must be in water or they have to go under water. That’s when you can be concerned. You don't need to worry if a child swallows some water or plays in water. You don’t drown by that,” Dr. Groen says. 

• Fatigue. Children are usually tired after swimming. If there's been no drowning event, and the child didn’t go underwater, they're simply worn out from a lot of exercise.
• Vomiting. Kids might naturally vomit if they swallow a bunch of water. This is not a sign of drowning.
• Coughing. Kids who have water “go down the wrong pipe” will have several minutes of coughing and some shortness of breath. If this resolves within a few minutes with no other persistent symptoms, the risk is near zero and you can relax. Any symptoms of coughing that weren’t present prior to swimming and are still present immediately after or a couple hours after a drowning event, should be evaluated by a doctor.
• Fast Breath. Children who’ve gone underwater during a drowning event might develop fast breathing immediately after or even several hours following the incident. You need to go to urgent care or the emergency department immediately.

“If there's a known submersion and the child is fine after the event, they'll either stay fine or develop symptoms within two to three hours. Drowning deaths don’t occur days or weeks later,” Dr. Groen says.

5 Ways to Prevent Drowning

Dr. Groen says there is an average of about 3,500 fatal drownings every year in the United States, which is about 10 per day. She says one in five are children under the age of 14. Here’s her list of the top five ways to prevent drowning.

• Adult supervision. This is the number one way to prevent drowning. If you’re at a party, designate one adult who is not drinking any alcoholic beverages to focus on the children. For toddlers and preschoolers, use touch supervision, which means an adult is close enough to reach the child, always.
• Swim lessons. Multiple studies show swim lessons prevent drowning.
• Life jacket use. Put life jackets on the kids, even in a pool.
• Learn CPR. Every second counts and CPR can help in an emergency.
• Barriers around in-home pools. This includes gates, door alarms and/or covers over the pool.