Secondary or Dry Drowning: What You Need to Know

Recently there was an article that circulated from an American mother who wanted to raise awareness as a result of her own experience with “secondary” drowning. Her 2-year-old son had an incident at a party, where he fell into a spa (right next to her). The mother quickly got him out of the spa though he was “bobbing” up and down a few times before she was successful. No CPR (cardiopulmonary resuscitation) was required as the little boy was conscious and breathing after the ordeal.

At home the mother noticed that her little boy was uncharacteristically tired and “not himself”. She called her paediatrician who told her to get him to Emergency immediately, which fortunately she did, as the steps that followed saved her little boys life.

Before this ordeal, the mother had never heard of “secondary drowning” otherwise known as “dry drowning”. In addition, had she ignored her instincts and let him rest instead of seeking immediate medical attention, the end of this story would have been very different.

The article was extremely informative and very well written so I shared it on social media and was pleased to hear that many parents had read it, which is great because many of them had also never heard of “dry drowning” before. What I didn’t expect was the anxiety it seemed to feed.

Could this happen to me?

I would love to say that dry drowning is not a real risk but unfortunately that’s not true. It’s a reality we just must face, just like traffic hazards or choking – they’re real concerns. That doesn’t mean we avoid cars or food, instead we educate ourselves so we avoid potential risks and know what to do should things go wrong. The same applies for little ones around water.

If you’ve taken your baby to swimming lessons you’ll notice that it’s normal to pass baby to the swim instructor, underwater. This is safe to do because babies have a great knack for knowing when to hold their breath. Other times splashes of water reach baby’s face, they may cough, but they’ll be okay. Nevertheless, if in doubt – get it checked out!

What is drowning?

Drowning is where the lungs are so full of water that they’re unable to “breathe air.”

Lungs filled with water result in the patient not breathing and losing consciousness. CPR is a life-saving skill for a drowning patient. The sooner the CPR is started for a patient that’s unconscious and not breathing, the better the outcome for the patient.

CPR helps circulate the oxygen that is already in the blood to vital organs such as the brain. In some cases pumping the heart can actually “pump” a lot of this water out of the lungs as well.

What’s the difference between drowning and dry drowning?

In simple terms:

Drowning – lungs filled with water, cannot breathe at all.

Dry drowning – lungs can breathe air, but the alveoli are filled with water, preventing the exchange of oxygen and carbon dioxide, which can still be fatal.

The human body has two lungs that are like sponges. They breathe in air (oxygen) and breathe out air (carbon dioxide).

There are tiny little sacks at the end of the holes of our lungs called alveoli. These alveoli are responsible for the exchange of gasses in our body – taking in oxygen and disposing of carbon dioxide.

In the case of dry drowning, the lungs breathe in and out air but the alveoli in the lungs still have water in them, stopping adequate exchange of gasses in the body (oxygen/carbon dioxide). In other words, the patient can breathe, but they’re not receiving sufficient oxygen, or eradicating toxic carbon dioxide. This can be fatal.

The above article mentioned that the little boy was “bobbing up and down” in the spa for a few moments, which would indicate he was breathing in at the wrong time, unlike the example of baby at swimming lessons. Therefore water was able to reach the alveoli, even if not enough to cause fatal drowning.

Are there any complications of dry drowning?

The main complication is “Chemical Pneumonitis”. If the dry drowning incident has been because of a pool or spa, the extra complication includes the chemicals in the water such as chlorine reaching the alveoli with the water.

What are the symptoms of dry drowning?

Imagine you can breathe but your body is not receiving enough oxygen, nor is it getting rid of carbon dioxide. This will make you grumpy, irritable and very, very tired.

There may also be coughing that may or may not include gurgling sounds. Getting the right chemical balance in the body is exhausting so coughing will often look like it’s a major effort such as stiffening of the entire body.

Help! Now I’m too scared to bathe my baby!

Please don’t be. Teeny little splashes are quite safe. It’s important to not be afraid, though please be diligent around all kinds of water. It’s all about balance. “Millions of babies are bathed regularly without any drowning occurrence.”

How can I prevent any kind of drowning?

For small babies, they should be in your arms at all times, where you can see their face. Many drowning incidents occur when the caregiver turns their back “just for a second”.

Older babies may be able to sit up or even stand but can fall over easily so never take your eyes off them. On the other hand, splashing is fun so let them!

For toddlers, provide constant supervision and where possible, be in the water with them as you would be with a baby. Things can go wrong very quickly!

Be careful of not-so-obvious water dangers such as pet bowls or puddles.

For school-aged children that are good swimmers, this doesn’t mean we no longer supervise them. Older children in pools can also get carried away when playing, and can be a risk to little ones. Older children also move objects that little ones can climb over such as bikes or chairs, or even keep gate doors open without adults knowing.

Older children have also drowned by sitting in a bath when unwell, passing out and slipping under water. If your child is unwell, a sponge bath is recommended instead.

And finally, never assume someone else is watching. This is often a fatal mistake made around swimming pools at social gatherings.

Final Tips:

• Dry drowning “alarm bells” include extreme and sudden fatigue (tiredness).
• If your little one has been around water and seems unusually tired, call triple-zero (000).
• Dry drowning is also characterised by a change in behaviour.
• Listen to your instincts! If it feels like something’s not right, it probably isn’t. You have nothing to lose by getting checked out.
• Never concern yourself with “what if I’m over-reacting?”
• Likewise, never concern yourself with “I don’t want to waste the ambulance’s time if it turns out to be nothing.” You have enough going on right in front of you; it’s not your job to prioritise ambulances. When you call 000 they will ask as series of questions to help decide if you child is in danger, so stay calm and answer as accurately as possible.
• Swimming lessons as young as possible are an awesome idea. Of course they won’t automatically “drown-proof” your little one, only constant supervision can do that but it’s a great start.

About the Author:

Michelle Fiddian is a mother of two and a First Aid educator specialising in babies and children. With over 14 years combined experience as a 000 ambulance operator, ambulance operator trainer, First Aid educator (and her personal experience as a mother), Michelle is passionate about teaching parents how to stay calm and apply First Aid in times when their children need them most.