A Pediatrician Debunks The Hype About “Dry Drowning”

Young boy in pool

Tragic drowning deaths like that of a Texas child in summer 2017, put the term “dry drowning” in the spotlight. The story went viral on social media as frightened parents read about the little boy’s death—seemingly out of the blue—that occurred after swimming several days prior.

Unfortunately, a lot of misinformation has been shared on social media, causing confusion. Let’s unravel the hype, starting with two facts that may surprise you:

1: There is no such thing as dry drowning

2: You can drown and not die

What Is Drowning?

The medical definition of drowning is “the process of experiencing respiratory impairment from submersion/immersion in liquid.” The results range from nothing at all to lung/breathing problems to death.

In the worst cases, breathing stops after the person is submerged in water. These drowning victims require CPR to survive. However, respiratory impairment can also mean significant gagging, choking, sputtering, intense coughing, and/or gasping that lasts much longer than the 3 or 4 coughs a child would have if a sip of water “went down the wrong pipe.” A few coughs in an otherwise unbothered child don’t count. Drowning causes significant distress, during which time your child (and you) will be alarmed and probably panicked.

Swallowing Water Without Coughing Is Not Drowning

Many articles about the drowning death of the Texas child described him as “swallowing” water during his swim, which has caused confusion.

All kids swallow a swig or two of water when splashing around. Water goes down the esophagus (“food pipe”) into the stomach, just as any other food or drink would. The swallowed water completely bypasses the trachea (“wind pipe”) and the lungs and therefore cannot cause lung damage. So, don’t worry if your child accidentally takes a couple gulps of water but has no associated coughing–that swallowed water is nowhere near the lungs.

However, if your child experiences significant coughing after ingesting water, that means water entered the trachea and is making its way toward the lungs. The medical term for this latter process is aspiration and aspirated water can cause lung damage.

It is impossible to “nearly aspirate” water–it either enters the airway or it doesn’t. Thus, it is impossible to “nearly drown.” Every significant event in a body of water is a drowning. Drowning means there was a time where the top of the airway was under water and water entered the airway, causing symptoms.

Will Drowning Lead to Death?

Here’s where the so-called “dry drowning” comes in. If there was a drowning event—either the child was pulled out from under the surface of the water and resuscitated or had a significant coughing and gagging spell after being in the water—the water has crossed the threshold into the airway and could continue to cause damage to the lungs.

Sometimes this causes spasm of the vocal cords, making it hard to breathe air in. Other times it causes inflammation of the lung tissue itself, preventing the transfer of oxygen to the blood. This process can smolder in the lungs of a person who seems to recover after their drowning event, slowly escalating to an emergent situation in which the lungs cannot function.

Can this happen after the swimmer goes home? Yes. Is this dry drowning? No. This is a latent effect of the initial (wet) drowning that happened in the water.

Since we can’t predict how severe lung damage will be after a drowning event, ALL victims of drowning should be evaluated in an emergency room without delay to ensure the aspirated water does not continue to cause lung damage.

Other Warning Signs

Other post-swim warning signs of drowning include vomiting, shortness of breath, wheezing, and chest pain. If your child experiences these symptoms after a swim where there may have been an event, take them to the emergency room.

The Best Defense Against Drowning

While it is important to know the signs of drowning so you can be proactive in getting treatment, the best defense against drowning is prevention via supervision.

As a rule of thumb, any child playing in water should have a set of eyes (you, another caregiver, a trained lifeguard) watching them at all times without distraction. Adults in the vicinity do not count as adequate observation. No supervision = no swimming. Period.

author name

Joan B. Thode, MD

Joan B. Thode, MD, FAAP, is a pediatrician with LG Health Physicians Roseville Pediatrics.

Education: Undergraduate—Franklin & Marshall College; Medical School—George Washington University School of Medicine and Health Sciences, Residency—NYU Langone Medical Center.

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