A Q&A with water safety and medical expert Dr. Linda Quan
Most of us who spend time in the water are familiar with the risks of drowning, but what have we heard about “dry drowning?” This lesser known and somewhat confusing term has come up in recent reports, so we sat down with water safety and medical expert Dr. Linda Quan to get the facts straight.
What is a drowning?
Dr. Quan: The medical definition of drowning is “the process of experiencing respiratory impairment from submersion/immersion in liquid.” This means that drowning happened only when there was some trouble breathing right after the submersion. If a person was in the water and had no breathing troubles after being rescued, then regardless of what happens later, the person did not drown.
To the average person, “near-drowning,” “dry drowning,” “secondary drowning” or “delayed drowning” sound pretty scary, but there are no medically accepted conditions that use these terms. Why?
Dr. Quan: The use of these terms is discouraged by many organizations, including The World Health Organization, the U.S. Centers for Disease Control and Prevention (CDC) and the American Red Cross.
Here are why these conditions don’t make sense and are not approved:
- Near-drowning: Imagine using terms like “near burns,” “near cardiac arrest,” or “near car collisions.” To be clear about whether the victim died or lived after a drowning event, the terms that should be used are fatal drowning (died) or non-fatal drowning (lived).
- Dry drowning: The terms dry and wet drowning were abandoned decades ago when the real culprit in drowning injury was not understood and was mistakenly thought to be about the amount of water entering the lungs. Drowning injury is actually caused by lack of oxygen.
The amount of injury from drowning is due to how long the victim is without oxygen.
- Secondary drowning (also known as “delayed drowning”): The terminology was also used before drowning injury was understood, and before prehospital care and emergency departments could evaluate breathing with the sophistication they do now.
What should we watch for after a person was submerged and then rescued?
Dr. Quan: There are three possible scenarios you’ll want to keep an eye on.
- A child who, after exiting the water, is completely normal, with no symptoms, did not drown. If the child develops a cough, breathing difficulty, confusion or other concerning symptoms at any time, seek immediate medical attention.
- A child who has minimal symptoms (think sputtering and coughing after swallowing water down the wrong pipe at the dinner table) after being rescued that resolve quickly AND returns immediately to normal with no breathing difficulty, can be observed by an attentive caretaker. The child will typically either get better or worse within 2 to 3 hours. If the child develops coughing, breathing difficulties, sleepiness, or confusion, seek immediate medical attention.
- If after a water rescue, a child has an excessive or prolonged cough, fast or hard breathing, is not breathing normally, or is not “acting right,” seek immediate medical attention.
Drowning deaths do not occur due to unexpected deterioration of a person’s condition days or weeks later with no preceding symptoms. Brand new symptoms that develop days later are extremely unlikely to be related to the drowning episode. Importantly, the child should be evaluated for other conditions that might have caused the deterioration.
Bottom line: If your child has been in the water, and was breathing, walking and talking normally and then later gets worrisomely sick, the child needs be seen by a health-care provider immediately. But it is not drowning.
The most important way to “treat” drowning is to prevent drowning. What works are swim lessons, adequate supervision for children and adolescents, life jacket usage, 4-sided pool fencing, and swimming in areas where there is a lifeguard. Parents and those supervising others in the water should know water safety, be sure to adequately supervise children, be able to perform a safe rescue and learn CPR.
Those wanting additional information may reference the American Red Cross Scientific Advisory Council’s Q&A: Debunking the Existence of Dry or Delayed/Secondary Drowning.
To learn more about how to prevent drowning, visit redcross.org/watersafety and download the American Red Cross Circle of Drowning Prevention. For steps on how to respond to someone in trouble in the water, download the Chain of Drowning Survival.