Dry / Secondary Drowning
Disclaimer: It is my hope that this blog content acts to inform and empower you! My goal is not to add any additional stress or fears when it comes to your children’s safety and well being. There are already 100 other things we worry about, so here are some facts to provide you with more peace of mind.
The word drowning sparks alarm in all of us, and there have been various additional terms coined to further specify drowning such as near-drowning, secondary drowning, and dry drowning. The World Health Organization’s definition of drowning is broad ranged, but it is important to note that it does not imply death, or even the necessity for medical treatment. They define drowning as:
"The process of experiencing respiratory impairment from submersion/immersion in liquid" - WHO
So then drowning DRY? How can this happen? Well, let's dive in...
This occurs when, water enters the lungs after having been submerged in water. A person's vocal cords and airway experience a spasm reaction and may close or tighten, in turn making it difficult to breathe. When this happens, intense deep coughing occurs and our body's response is to send fluid to the lungs to try to re-open up the airway/vocal cords. However, the danger here is that this can lead to an abundance of extra fluid accumulating within the lungs; a medical condition known as pulmonary edema
This is caused by water inhalation that has diluted or washed out the lungs' surfactant (a slippery lubricating substance that's needed to prevent our tiny lung sacs from sticking together and collapsing). Without surfactant, the lung sacs start to stick together, and the body can't properly exchange carbon dioxide and oxygen at a cellular level. This causes the same response as dry drowning — the body sending fluid to the lungs — resulting again in pulmonary edema.
Signs and Symptoms of Dry or Secondary drowning usually start within an hour, but can occur up to 24 hrs after a person has been submerged in water or has aspirated (inhaled) water into their lungs.
So, let's relieve the panic now by reviewing
10 common signs and symptoms of water inhalation
1. High pitched breathing on inhale (stridor)
2. Gasping breaths
3. Wet sounding cough
4. Upright posturing in an attempt to get more oxygen
5. Blue or grayish skin colour
6. Unusually sleepy or lethargic (due to decreased oxygen levels in the body)
7. Swelling of the tummy
8. Chest pain (causes by collapsing of lung sacs)
If you witness any of these signs of distress after your child has inhaled water, seek medical attention or contact Health Link 811 to advise you further.
- Dry/Secondary drowning affects less than 4% of kids who have inhaled water
- Children younger than 5 are at a higher risk due to the immaturity of their lungs
- Inhaling pool water can also cause chemical pneumonitis, or inflammation/infections in the lungs due to harmful chemicals and bacteria
- Swallowing and Aspiration are not the same thing! When kids swallow water, water goes down the esophagus and into the stomach. Swallowing pool water may make you throw up, but it will not cause dry drowning.
- Fresh water inactivates surfactant, leading to alveolar collapse and pulmonary dysfunction.
- Salt water dilutes surfactant, leading to alveolar collapse and pulmonary dysfunction.
BLOG TERMINOLOGY GUIDE:
Surfactant - the slippery lubricating substance that's needed to prevent our tiny lung sacs from sticking together and collapsing
Alveolar / Alveoli - the said tiny sacs located in the lungs responsible for oxygen and carbon dioxide exchange
Aspiration- occurs when the water goes down the trachea (wind pipe) and into the lungs
Stridor - the word used to describe the sound of high pitched breathing on inhalation
Pulmonary / Respiratory- refers to all things lungs and breathing
Edema - swelling of tissues usually due to an excess of fluid accumulating
Interested in learning more about Child and Infant specific health considerations?
Check out our: Child & Infant Health + CPR course
Call 403-851-2265 for registration information.
Or Check out our "Host at Home" course program.
- Mary W. Lieh-Lai, ... Ashok P. Sarnaik, in Pediatric Critical Care (Fourth Edition)
- Mark A. Hostetler MD, MPH, in Pediatric Clinical Advisor (Second Edition), 2007