There has been much attention paid over the past several weeks, in both
print and social media, to the concept of "dry drowning." This
seems to have been sparked by the story of a four year-old boy from Texas
who died nearly a week after going swimming with his family. Although
official autopsy results have not been released publicly, the symptoms
and circumstances that have been described in the media are, unfortunately,
misleading and causing needless alarm for parents and caregivers. To make
matters worse, physicians quoted in the media appear to be perpetuating
the use of this term "dry drowning." But what is this new issue,
and what should you do to protect your child?
While the death of any child is a terrible tragedy, the term "dry
drowning" does not actually exist in medicine. Drowning occurs when
there is respiratory or breathing impairment due to submersion or immersion
in a liquid. And while there are various outcomes to drowning that range
in severity, the terms “near drowning, secondary drowning or dry drowning” are not medically accepted, as they are terms that describe a situation,
not an actual physical condition. Drowning is a process that begins with
submersion or immersion, usually accompanied by coughing or choking or
even requiring CPR, but it does not simply appear out of nowhere.
There has simply never been a case reported in the medical literature of
a child or a patient who was without symptoms initially but then deteriorated
and died or "drowned" while in bed. In cases where “dry drowning” has been mentioned as a cause
of death, the child’s condition was more likely due to an underlying
or undiagnosed medical condition.
Drownings are a common cause of pediatric death, and parents should always
provide close supervision when children of any age are around water. But,
it’s also important that physicians share medically correct information
with the media and with our patients. By focusing on this non-existent
and misleading term, we are taking our collective eye off the ball for
the REAL dangers of swimming and drowning.
To prevent drowning, it’s important that parents focus on water safety.
This starts, in many cases, with direct supervision. Multiple studies
confirm that whether the incident involves a child and a lake, a river,
a pool or even a bathtub, in more than 90% of the cases there was lack
of direct supervision. These tragedies are largely preventable! The take-home
message is that following a submersion/immersion or drowning event, if
patients have warning signs like: continued breathing difficulty, excessive
coughing or foaming at the mouth, or not acting normally, they should
seek immediate medical attention. These patients need to be evaluated
by medical personnel and monitored. Patients who recover after a drowning
event but then develop symptoms more than 8 hours later should be evaluated
for problems or diagnoses
other than drowning. Symptoms may worsen over time but they do not appear out
of nowhere.
Protecting our children from all of life’s dangers can be harrowing
enough, so let’s work to keep our kids water safe and not worry
about things that don't exist.
Joel "The Fish" Lutterman, MD is Medical Director for the Pediatric
Hospitalist Program and Drew "I Can Hold My Breath for Six Minutes
Underwater" Matthews, MD is Medical Director for Apollo Physicians
at CaroMont Regional Medical Center.