Drowning can occur even hours after leaving water

During the summer months, when recreational swimming is at its peak among children, many parents are concerned about the danger of drowning.

But health care professionals say parents also must be concerned about dry drowning, a little known phenomenon that can happen hours after a child leaves the water.

Dr. Carl Chelen, a pediatric intensivist at the McLeod Children’s Hospital, said dry drowning is an event brought on by natural reflexes triggered by water at the back of the throat.

“It’s something that usually happens after some type of immersion into water. There are natural reflexes in the body that cause the opening to the airway to shut off. It’s a reflex to keep fluid and things out of the lungs,” he said. “When that shuts off and the person is still trying to breathe, the diaphragm is still moving and it creates a lot of negative pressure inside the lungs. What that does is damage the air sacks and the alveoli and the capillaries in the lungs.”

A dry drowning can occur even if a person is removed from the water and never gets any water in his or her lungs, Chelen said.

The “damage that occurred from that serious negative pressure allows fluid (from the bloodstream) to leak out of the capillaries and into the lungs and that happens over several hours,” he said, “... and that’s what causes the oxygen problem and the quote ‘drownings.’”

Many South Carolina residents first learned about dry drowning after a 10-year-old boy in Goose Creek died of it in July. It’s an uncommon occurrence, Chelen said.

It’s difficult to determine how many dry drownings happen each year because the Centers for Disease Control and Prevention doesn’t distinguish dry drowning from other types of drownings in its records, according to the agency’s Web site.

The term “dry drowning” is not the most accurate term for the condition because death doesn’t necessary occur because of inhaled water, Chelen said.

“Dry drowning is actually a bad name for it,” he said. “Just breathing in a little water (and) having a choking episode, lots of people have done that. The body usually absorbs that water rather quickly.”

It is water, however, that is ingested while swimming that can trigger a natural reflex. This can cause the airway to close off, which leads to the negative pressure in the lungs, he said.

Dry drowning deaths can be prevented if adults are on the lookout for symptoms, said Erin Faile, Safe Kids Florence education coordinator.

Coughing, followed by excessive sleepiness, confusion or anxiety are tell-tale signs of the condition, Chelen said.

“There are things that parents would associate with playing in the water all day,” Faile said. “Once a child has been in the water all day and the heat, you expect them to be tired.”

Caregivers and parents also need to set limits for children while swimming and encourage them to take least two 15-minute breaks every two hours, she said.

After swimming, children should be encouraged to cough every 15 to 20 minutes for at least three hours after they leave the water, Faile said.