*As promised, I’ve come back to edit and flesh out a bit. Enjoy!
Dry Drowning Is Not A Thing
OK, it’s a thing and a very bad thing but I’ve been encountering a lot of misunderstanding about what it is (and what it isn’t). Drowning claims the lives of WAY too many children every year and real prevention comes down to supervision when kids are in the water. Delayed mortality from drowning has hallmark symptoms and parents need to know what those look like as well (and also when not to worry). OK, let’s talk about dry drowning (which, by the way, is not an accepted medical term – drowning is drowning, with or without mortality, see links below for more details).
In short, your child is not going to go swimming, swallow some water, have no issues in the water whatsoever, and then suddenly die without warning 4 days later from “dry drowning”. I know the stories you’ve been reading, they’re all over my newsfeed too. I know how the thought of losing your child makes you have actual physical chest pain because it does that to me too. I don’t have a pool at my house and that is intentional. I don’t want to take the risk that my kid could end up in it unsupervised. But I don’t want the kids of the world never going near the water again because their parents were frightened by a poorly researched Facebook article.
Remember that there is a lot of fake news and misinformation on the internet. Many authors do not care about delivering accurate, useful information. They care about the sensational headline. My major issues with the stories I’ve been reading lately are these: first, their misuse of the word “swallowing” when they mean aspiration. Second, their lack of discussion about REAL symptoms of actual drowning that parents should be watching for. Far too many kids die from drowning every year and it would be wonderful if the press would talk to some medical experts and get better information about drowning prevention out there to parents. Most of the stories I’ve read, however, give parents the impression that kids who have drowning with morbidity (the accepted medical term, check out the links below) swallowed some water, were fine for a few days and then suddenly died. It doesn’t really work like that. Drowning is more dramatic.
Here’s the deal, in brief: a human may experience inflammation in the lungs (pneumonitis) with massive fluid production and death after aspirating water. This is not the same thing as swallowing water and many people don’t understand the difference. Swallowed water goes into the esophagus and down through the digestive tract. Swallowing chlorinated pool water may make you throw up but it will not make you die of flash pulmonary edema. ASPIRATION is when the water goes into the trachea and down into the lungs. In this case, the patient in question will have an episode of distress after they come out (or are pulled out) of the water. You will see it and you will KNOW they are not OK. They will take longer to recover than they would after choking on a little orange juice at the dinner table. They will cough and gasp and sputter. They may even require intervention like CPR. And I’m pretty sure everyone understands that a child who is down in the water, gets pulled out, and requires resuscitation needs immediate medical attention, even if they seem to recover. If your child has an episode like this and then later continues to have coughing, vomiting, wheezing, chest or belly pain, or seems abnormally tired, we have a problem. Get to the ED. If your child goes swimming and does not have an aspiration event and afterwards they are perfectly fine . . . they are perfectly fine. Go ahead and go to the beach this weekend, people.
The key to preventing drowning? Supervision. There needs to be a designated child watcher. Just because there are ten adults present doesn’t mean one of them is paying attention to the kids. Have a plan. If it’s a party where you don’t really know anyone, this is not the time to make new friends. Watch your kids. If you’re watching them and they have an aspiration event, you will see it and you will get them the medical attention they need. If your child is participating in swimming activities when they are not with you, be the annoying parent. Ask questions about who will be supervising. Ask if anyone present has had lifeguard training. If you don’t like the answers you get, don’t send your kid. Hosting a pool party yourself this summer? Consider hiring a lifeguard.
OK, good talk! Oh, and wear sunscreen.
Lucky for me, the emergency medicine docs of the world have already knocked this topic out of the park so go read their stuff. You’ll feel better.