What Is Dry Drowning? 5 Symptoms Parents Should Know

While "dry drowning" is not a recognized medical term, the symptoms—and potential complications—are real. Read on to learn more about dry drowning.

Medically reviewed by Monika Goyal, M.D.

The phrase "dry drowning" refers to a series of delayed symptoms that a person may experience after a water-related incident or submersion injury. While the phrase describes real complications that may require medical treatment, it is important to note that dry drowning is not a recognized medical condition or scientific term.

Instead, the medical and scientific communities use the terms drowning, fatal drowning, non-fatal drowning, and rescue to describe the different types of drowning. While a health care provider won't use the term "dry drowning," it's still important to understand and be able to recognize the symptoms it refers to, so you can seek medical attention when needed.

The symptoms of dry drowning can be scary for everyone involved and can lead to dangerous respiratory distress in kids. But dry drowning can be prevented with the proper precautions. Here's what you need to know before your next swimming session.

What Is Dry Drowning?

Drowning is the process of experiencing respiratory impairment (essentially trouble breathing) due to water in the airway and lungs. "Dry drowning," on the other hand, refers to complications that can arise after a person takes in water through their nose and/or mouth, but not into their lungs, causing a spasm that closes the airway.

Dry drowning usually happens soon after exiting the water. Research has shown that "dry drowning" has been observed during autopsy in 10% to 15% of drowning cases where people died after experiencing laryngospasm, which is when water touches the upper airways and triggers spasms leading to cardiac arrest.

"Secondary drowning" is another term you might hear. Secondary drowning happens when a little bit of water gets into the lungs, resulting in inflammation or swelling. The body struggles to exchange air properly through the lungs, which can lead to a build-up of carbon dioxide and dangerously low levels of oxygen. With secondary drowning, there can be a delay of up to 24 hours before the person shows signs of distress.

Some experts reject the terms "dry drowning" and "secondary drowning" altogether and instead refer to these situations as submersion injuries. Mark R. Zonfrillo, MD, MSCE, a pediatric emergency medicine physician, says they're equally dangerous, as both can cause trouble breathing and, in worst-case scenarios, death.

Related: 4 First-Aid Steps That Can Save a Child From Drowning

Signs and Symptoms of Dry Drowning

Dry drowning might sound terrifying, but there is some good news: It doesn't happen without clear signs you can spot early on. If your child experienced an incident that required a water rescue, they could be at risk for dry drowning.

Look out for these dry drowning symptoms in toddlers, babies, and children after time in the water:

• Shallow or labored breathing: Rapid and shallow breathing, nostril flaring, or seeing the space between the child's ribs or the gap above their collarbone when they breathe means your child is working harder than normal to breathe. If you notice these symptoms, you should seek medical help immediately.

• Coughing: Persistent coughing—or coughing associated with increased work of breathing—needs to be evaluated.

• Vomiting: "Vomiting is a sign of stress from the body as a result of the inflammation and sometimes a lack of oxygen, and also from persistent coughing and gagging," explains Kathleen Berchelmann, MD, a pediatrician at St. Louis Children's Hospital and Washington University School of Medicine in St. Louis.

• Fatigue or excessive sleepiness: Was your kid just playing excitedly in the pool, and now they're acting fatigued? It could mean they aren't getting enough oxygen into their blood. Don't put them to bed until a health care provider gives you the go-ahead. A day of water fun can tucker kids out, but it's better to be extra cautious if any sort of water rescue was involved.

• Behavioral changes: If your child is acting more forgetful or just not acting like themselves, it could indicate there has been a change in their oxygen status. Similarly, a dip in oxygen level could make your child feel sick or woozy.

If your child is unable to speak or express themselves, it may be hard to know exactly how they feel. Monitor them closely to ensure they're breathing freely, and keep an eye out for any of the other aforementioned symptoms.

When to Seek Medical Attention

If you think your child might have a submersion injury, whether you're in your backyard pool or on a beach vacation, call a health care provider immediately. They should talk you through symptoms, says Dr. Berchelmann, and might advise you to visit the ER, a primary care doctor, or an urgent care center.

If your child is really struggling to breathe, though, call 9-1-1 or head to the emergency room right away. "Necessary treatment may not be available in settings other than the ER," says Dr. Zonfrillo.

How Common Is Dry Drowning?

Rest assured: Submersion injuries, while incredibly scary, are rare. There aren't specific stats on how many kids die each year from dry drowning or secondary drowning, but it's very few, Dr. Berchelmann.

In fact, in 12 years of practicing as a pediatrician, Dr. Berchelmann has only seen one patient who experienced drowning that happened long after getting out of the pool. Still, she says, it was a life-threatening scenario, and if you're going to be spending time at the pool, ocean, or lake with kids, it's smart to know the signs and symptoms.

How Dry Drowning Is Treated

Treatment for a submersion injury depends on the severity of the symptoms. A health care provider will check your child's vital signs, oxygen level, and work of breathing. People with mild symptoms might simply need careful observation, while in more serious cases, the medical provider may perform a chest X-ray or give them oxygen.

In cases of respiratory failure, which happens when a child can no longer breathe on their own, extra support is required, such as intubating them or putting them on a ventilator. The goal is to increase blood flow in the lungs and get the child breathing well again. (Thankfully, respiratory failure is rare with dry drowning.)

How To Prevent Dry Drowning

According to the American Academy of Pediatrics (AAP), drowning is one of the leading causes of death among kids ages 1 to 4. Although incidences of drowning have gone down since the 1980s thanks in part to public outreach campaigns that include pediatricians discussing risks with parents and caregivers, one death is too many.

To prevent dry drowning and secondary drowning—as well as other water-related injuries—consider these expert-approved strategies:

• Enroll your child in swim lessons. Kids who have been taught how to skillfully and safely navigate the water are less likely to struggle and more likely to understand the rules of water safety.

• Supervise kids near water. Monitor kids closely when they're around water, and enforce pool safety rules.

• Follow water safety measures. Children should wear floatation devices on boats, jet skis, canoes, and any other accessible watercraft; pools should have four-sided fencing around them or some other approved safety barrier; and you should never leave a child alone near bodies of water.

As long as you practice water safety, pay close attention to your kids after swimming, and get them checked out if you notice trouble breathing, you shouldn't stress about submersion injuries like dry drowning or secondary drowning. "I can't emphasize enough how rare they are," says Dr. Zonfrillo. And for any parent, we know that's welcome news.

Related: Pool Safety Tips All Parents Should Know

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