The Myth of Dry Drowning

Tue, 07/11/2017 - 4:24pm
Author: 
Chad Simpkins, MD
Editor: 
Richard Byrne, MD

 

First, there is no such thing as "dry drowning." The use of terms without a medical definition has allowed for the confusion regarding this problem.

 

 

Definitions:

Drowning is submersion in water resulting in respiratory difficulty or cardiac arrest

  • Drowning does not mean death

  • Similarly, there is no medical diagnosis for near, delayed, dry or secondary drowning

  • There are THREE possible outcomes of a submersion:

    • nonfatal drowning without injury or illness

    • nonfatal drowning with injury or illness

    • fatal drowning

 

 

 

It may be best to explain non-fatal downing as spectrum, similar to strokes, ranging from mild to severe neurologic impairment as a result.

 

 

 

What to do when a child arrives for which the parent is concerned about dry drowning:

 

 

 

  • If there were any symptoms worse than the typical coughing after drinking water “down the wrong pipe” at the dinner table, the child should remain in the ED for observation. This is particularly true if there is amnesia to the event, loss of consciousness or any observed period of apnea.

  • An observation period of 4-6 hours is appropriate, with serial pulmonary exams and trending of oxygen saturation.

  • If deterioration is going to occur, it will likely do so within this time period.

  • Reminder: the vast majority of patients who arrive alert with stable vitals survive with minimal disability. It is rare for a minimally symptomatic patient to progress to death

 

 

 

Take Home Messages for Parents:

 

  • If a child continues to have symptoms after being pulled out of the water, further medical attention is required.

 

  • The majority of pediatric drowning deaths are due to lack of supervision. Prevention is the key

 

 

 

 

 

Hawkins, S. C. Drowning in a sea of misinformation: Dry drowning and secondary drowning. Kevin MD. July 6, 2017. http://www.kevinmd.com/blog/2017/07/drowning-sea-misinformation-dry-drowning-secondary-drowning.html

 

 

 

Lumba-Brown, A. Mythbusting Dry Drowning. PEM Network Blog. June 11, 2015. http://www.pemfellows.com/blog/mythbusting-dry-drowning/

 

 

 

Sempsrott, J. Dry and Secondary Drowning. Wilderness Medicine Magazine. 2014. http://wildernessmedicinemagazine.com/1114/Drowning-Dry-and-Secondary

 

 

 

Tintinalli, J. E. (2011). Emergency Medicine: a comprehensive study guide. New York: McGraw-Hill. 1395-1397.