In the popular Showtime series “The Affair,” a lead character is haunted by the dry drowning death of her young son. Interest in so-called dry drowning has accelerated in recent years, thanks in part to a handful of high-profile cases and fictionalized accounts. While the phenomenon of dry drowning is real, the term is a colloquialism--not a medical diagnosis.
Because dry drowning can occur hours, or even days, after water exposure, first responders need to know and recognize the signs. Equally important is educating the general public about the dangers of dry drowning, and the simple steps parents can take to prevent dry drowning in kids.
What is Dry Drowning?
Dry “drowning” is a misnomer – in dry drowning episodes, water never reaches the lungs. Dry drowning occurs when inhaled water irritates and inflames the vocal cords, causing them to spasm. In severe cases, the vocal cords may completely close the throat, preventing breathing. Most dry drowning incidents happen four to eight hours after a person breathes in water.
Some other symptoms may be mistakenly labeled as dry drowning episodes. For instance, the tragic 2017 case cited above of a four-year-old who died a week after being submerged in water was mistakenly dubbed a secondary drowning. An autopsy revealed that the real cause of death was myocarditis--a heart infection that was not in any way related to drowning.
The Symptoms
Symptoms of dry drowning don’t appear out of nowhere. Instead, they follow inhalation of water, usually within a few hours. Some symptoms to monitor for include:
- Unexplained hoarseness
- Coughing or gagging
- The sensation that there is something in the throat
- Sudden loss of consciousness
- A child who is difficult to awaken
- A child or infant who is turning blue or white
- Feeling like you can’t catch your breath
Treating Dry Drowning
It’s important to conceive of drowning as a process, not something that happens immediately. As long as the process of drowning is interrupted between the initial inhalation of water and death, it’s possible to prevent morbidity and mortality. The right suction unit can remove water from the airway and prevent further inhalation of water.
Once stabilized, it’s important to transport the patient to a hospital for further monitoring. Inflammation to the airway, inhalation of contaminated water, and other common characteristics of drowning can be a source of morbidity secondary to drowning.
In the case of “dry drowning,” portable suction may help protect against aspiration pneumonia during a vocal cord spasm. Depending on the extent of the spasm, the patient may need to be intubated. They must always be transported to the hospital for further evaluation, even if they seem stable. Dry drowning victims may appear deceptively well, but deteriorate quickly if not treated.
Dry Drowning Prevention and Education
Among children ages 1-14, drowning is the second-leading cause of death. Parents are rightfully concerned about the dangers of water, but their fears of dry drowning may be misplaced. Concerns about dry drowning have led parents to seek emergency care for children who swallow water in bathtubs, or for kids who get congested a few days after swimming.
Dry drowning is a complication of drowning itself, so the key to dry drowning prevention is drowning prevention. Consider educating parents about strategies that can reduce the risk of all forms of drowning, including:
- Always wearing life vests when boating or engaged in other water sports.
- Never leave young children unsupervised in the bathtub.
- Teaching children basic swimming skills.
- Encouraging children to swim in groups, and never alone.
- Learning CPR.
- Reduce the risk of other water injuries by discouraging diving in shallow water.
Seconds matter during a drowning emergency. Proper suction can restore a patent airway and save the patient’s life. However, proper suction depends on having the right emergency suction device accessible and functioning. For help selecting the right device for your agency, download our free guide, The Ultimate Guide to Purchasing a Portable Emergency Suction Device.
Editor's Note: This blog was originally published in October 2018. It has been re-published with additional up-to-date content.
