What Is Dry Drowning? 5 Symptoms Parents Should Know

"Dry drowning" describes a series of delayed symptoms that someone may experience after a water-related incident. It's different from actual drowning because no water actually reaches the lungs. Technically speaking, the child has experienced a drowning incident and survived, but they can still experience complications later on as a result of being underwater.

Dry drowning (and "secondary drowning," which happens when a little water gets into the lungs) can be scary for everyone involved because although the child may appear fine at first, symptoms can appear as long as 24 hours after the initial incident. Dry drowning can lead to dangerous respiratory distress in kids, but it can be prevented with the proper precautions. Here's what you need to know before your next swimming session.

Dry drowning

Dry drowning is when someone takes in a small amount of water through their nose and/or mouth, and it causes a spasm that makes the airway close up. Dry drowning usually happens soon after exiting the water. Note, however, that medical experts simply refer to this as "drowning."

Secondary drowning

Secondary drowning, on the other hand, happens when a little bit of water gets into the lungs, resulting in inflammation or swelling. The body subsequently struggles to exchange air properly through the lungs, which can lead to a build-up of carbon dioxide and dangerously low levels of oxygen. With secondary drowning, there can be a delay of up to 24 hours before the person shows signs of distress.

Some experts reject the terms "dry drowning" and "secondary drowning" altogether, as they are not real medical terms. Rather, they refer to them as submersion injuries. Mark R. Zonfrillo, M.D., MSCE, a pediatric emergency medicine physician says they're equally dangerous, as both can cause trouble breathing and, in worst-case scenarios, death.

How Common Is Dry Drowning?

Rest assured: Submersion injuries, while incredibly scary, are rare. There aren't specific stats on how many kids die each year from dry drowning or secondary drowning, but it's very few, says Kathleen Berchelmann, M.D., a pediatrician at St. Louis Children's Hospital and Washington University School of Medicine.

In fact, in 12 years of practicing as a pediatrician, Dr. Berchelmann has only seen one patient who experienced drowning that happened long after getting out of the pool. Still, she says, it was a life-threatening scenario, and if you're going to be spending time at the pool, ocean, or lake this summer, it's smart to know the signs and symptoms.

Dry Drowning Symptoms

Dry drowning might sound terrifying, but there is some good news: It doesn't happen without clear signs you can spot early on. Look out for these dry drowning symptoms in toddlers, babies, and children.

• Shallow or labored breathing. Rapid and shallow breathing or nostril flaring means your child is working harder than normal to breathe—and so does seeing the space between the child's ribs or the gap above their collarbone when they breathe. If you notice these symptoms, you should seek medical help immediately.
• Coughing. Persistent coughing—or coughing associated with increased work of breathing—needs to be evaluated.
• Vomiting. "Vomiting is a sign of stress from the body as a result of the inflammation and sometimes a lack of oxygen, and also from persistent coughing and gagging," explains Dr. Berchelmann.
• Fatigue or excessive sleepiness. Was your kid just playing excitedly in the pool, and now they're acting fatigued? It could mean they aren't getting enough oxygen into their blood. Don't put them to bed until their health care provider gives you the go-ahead. A day of water fun can tucker kids out, but in this case, it's better to be extra cautious if any sort of water rescue was involved.
• Behavioral changes. If your child is acting more forgetful or just not acting like themselves, it could indicate there has been a change in their oxygen status. Similarly, a dip in oxygen level could make your child feel sick or woozy.

If your child is unable to speak or express themselves, it may be hard to know exactly how they feel. Monitor them closely to ensure they're breathing freely, and keep an eye out for any of the other aforementioned symptoms.

Dry Drowning Treatment

Treatment for a submersion injury depends on the severity of the symptoms. A health care provider will check your child's vital signs, oxygen level, and work of breathing. People with mild symptoms might simply need careful observation, while in more serious cases, the medical provider may perform a chest X-ray or give them oxygen.

In cases of respiratory failure, which happens when a child can no longer breathe on their own, extra support is required such as intubating them or putting them on a ventilator. The goal is to increase blood flow in the lungs and get the child breathing well again. (Thankfully, respiratory failure is rare with dry drowning.)

How to Prevent Dry Drowning

To prevent dry drowning and secondary drowning—as well as other water-related injuries—consider these expert-approved strategies:

• Enroll your child in swim lessons. Kids who have been taught to skillfully and safely navigate the water are less likely to struggle and more like to understand the rules of water safety.
• Supervise kids near water. Monitor kids closely whenever they're around water and make sure to enforce pool safety rules.
• Follow water safety measures. Children should wear floatation devices on boats, jet skis, canoes, and any other accessible watercraft; pools should have four-sided fencing around them or some other approved safety barrier; and you should never leave a child alone near standing water.

As long as you practice water safety, pay close attention to your kids after swimming, and get them checked out if you notice trouble breathing, you shouldn't stress about submersion injuries like dry drowning or secondary drowning. "I can't emphasize enough how rare they are," says Dr. Zonfrillo. And for any parent, we know that's welcome news.