If you are the caregiver or parent to a little one, water safety is likely often on your mind, especially once summer rolls around. While many of us recognize the importance of drowning prevention, recognizing the signs of dry drowning, or delayed drowning, can be more confusing.
While “dry drowning” isn’t an official medical term, it has been used frequently in the media to describe an instance where a child experiences a non-fatal drowning incident. The child may seem fine afterwards but later experiences concerning respiratory symptoms.
It’s vital for caregivers to recognize the signs of delayed drowning, says Dr. CharlRe´ Slaughter-Atiemo, pediatrician and co-owner of PM Kidz. “By understanding the dangers and recognizing the symptoms, parents and caregivers can take necessary steps to ensure children’s safety around water.” Here, we’ll take a close look at dry drowning, including dry drowning symptoms and what to do if a child is experiencing any signs of dry drowning.
What is dry drowning?
All of the experts we spoke to emphasized the fact that dry drowning isn’t a term used in the medical world. “It is a term that lay people use to describe respiratory failure occurring several hours after a near drowning incident,” says Dr. Molly O’Shea, official pediatrician for Goldfish Swim School.
“[Dry drowning] is a term that lay people use to describe respiratory failure occurring several hours after a near drowning incident.”
—Dr. Molly O’Shea, official pediatrician for Goldfish Swim School.
Typically, what we refer to as dry drowning is injury to the lungs that occurs when water is aspirated. “When water enters the airway and settles deeper in the lungs, it can trigger a response from the body that leads to the body’s own fluids pouring into the lungs as well causing breathing problems,” O’Shea explains.
In other words, dry drowning describes an instance where symptoms of drowning come on more gradually. “Unlike with true drowning, where respiratory distress is immediate, dry drowning symptoms can develop minutes to hours after water exposure,” Slaughter-Atiemo describes.
How common is dry drowning?
According to O’Shea, dry drowning is actually not that common. “This is very rare and would not occur from the common situations where kids spend a moment or two underwater, coughing a little bit afterward,” O’Shea says. “Rather, these situations occur when a child is rescued from a near drowning episode, appears to be doing well and several hours later is experiencing severe breathing issues.”
“While awareness of dry drowning is important, the primary focus should always be on preventing water accidents in the first place.”
—Dr. CharlRe´ Slaughter-Atiemo, pediatrician and co-owner of PM Kidz
While there are no statistics on dry drowning vs. other types of drowning, it’s important to understand that overall, drowning is tragically common among children, especially young children. Drowning is the leading cause of death among kids aged 1 to 4, and it’s the second leading cause of death among kids aged 5-14, according to the Centers for Disease Control and Prevention (CDC).
It is vital to practice water safety and take precautions to prevent all water accidents, not just dry drowning.
Recognizing dry drowning symptoms
The main difference between dry drowning symptoms and other drowning symptoms is the speed at which they present. “The key here is that inflammation and subsequent damage may evolve over a period of time — hours or possibly days — and what you may see is either delayed respiratory symptoms and/or slowly evolving respiratory symptoms,” says Dr. Todd Zimmerman, pediatric emergency medicine physician and medical director at Pediatrix Medical Group in Las Vegas.
Slaughter-Atiemo says the most prominent symptom of dry drowning is trouble breathing. “This often appears as rapid, shallow breaths, labored breathing or wheezing,” she explains. According to Zimmerman and Slaughter-Atiemo, dry drowning symptoms may also include:
- Dry hacking cough.
- Shortness of breath.
- Heavy breathing.
- Chest pain.
- Fast breathing.
- Fatigue.
- Excessive sleepiness.
- Appearing listless and weak.
- Fussiness or irritability in young children.
- Loss of appetite.
- Headache.
- Vomiting.
While many of these can be symptoms of other conditions, if they happen soon after swimming or after any concerning incident in the water, you should have your child be seen by a physician. “The key to knowing when it’s happening is prior water exposure and timing,” says Slaughter-Atiemo. “In some cases, the water exposure might be minor or go unnoticed, making it important to be aware of the potential signs,” she adds.
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When to seek medical attention for dry drowning
Dry drowning symptoms are hard to recognize, and you may not be 100% sure about whether you should seek medical attention. But experts agree that you shouldn’t wait to reach out to a physician if you have any concerns whatsoever. It’s always better to be safe than sorry.
“Any time there is a non-fatal drowning incident, one should have a very low threshold to seek medical attention,” Zimmerman says. This means that if a child was submerged in water or rescued from almost drowning, for any period of time, it’s best to reach out to their pediatrician for next steps. If there are any immediate concerns, or if the child is acting or looking ill, Zimmerman suggests calling 911 right away.
“Due to the potential severity of breathing difficulties, it’s crucial to seek immediate care at an emergency room equipped to handle respiratory emergencies,” says Slaughter-Atiemo. “By being vigilant and knowing the potential signs, even the subtle ones, parents and caregivers can act quickly and potentially save lives.”
Safety tips to prevent drowning accidents
When it comes to water safety, prevention is key. “While awareness of dry drowning is important, the primary focus should always be on preventing water accidents in the first place,” Slaughter-Atiemo emphasizes.
Here are her tips for preventing any type of drowning:
- Parents and caregivers should always supervise children closely around any body of water (pools, oceans, bathtubs and lakes), even if they seem shallow.
- Don’t leave children unattended for even a few seconds, because even that can be enough time to trigger a drowning episode.
- If you are attending an event with multiple kids, consider designating a responsible adult as a “watcher,” who focuses only on water safety (i.e., not chatting with other parents or looking at their phone).
- Use life jackets when appropriate.
- Use pool gates and keep other bodies of water secure.
- Learn infant and child CPR.
- Invest in swim lessons for children as early as possible (experts suggest anytime after age 1).
Drowning typically happens in swimming pools, but it can happen anytime kids are close to water, including in bathtubs, toilets or even unattended buckets of water. In fact, the majority of infant drowning deaths occur in bathtubs and large buckets. The American Academy of Pediatrics (AAP) recommends these additional tips for keeping kids safe at home:
- Be aware that bath seats can tip over and should not be a substitute for supervision.
- Never leave a small child unattended in a bathroom.
- Consider toilet locks.
- Always empty buckets and pails after using them.
- Don’t leave a child alone near a filled bucket or other water receptacle.
The bottom line
No one wants to think about the possibility of a child drowning, but it’s a real and present danger that all parents and caregivers of young kids need to be aware of. Preventing drowning accidents of all kinds should be parents’ and caregivers’ first priority. Knowing what dry drowning symptoms to look for is also key, because the sooner you get medical help for a child, the better the outcome will be.
If a child you are caring for shows symptoms of respiratory distress — including coughing, trouble breathing, fatigue and weakness — within a few hours of a non-fatal drowning incident, don’t hesitate to reach out for medical care. When it comes to water safety, it is always better to be cautious. “Awareness and early intervention are crucial,” Slaughter-Atiemo concludes.
