Recognizing and Preventing Dry and Secondary Drowning

Following the tragic death of 4-year-old Frankie Delgado after he inhaled water at Houston’s Texas City Dike in 2017, his parents disclosed the details to news media. Almost a year later, Frankie’s story played a crucial role in saving another child’s life.

When Lacey Grace’s daughter, Elianna, inhaled pool water and exhibited unusual symptoms, Grace recalled Frankie’s story and suspected that Elianna might be suffering from the same condition, known as secondary drowning. She promptly took her daughter to the emergency room, where doctors administered antibiotics to combat the infections caused by water in Elianna’s lungs.

What is dry drowning?

In light of prominent cases involving near-fatalities and fatalities due to delayed drowning, swimming can feel like a perilous activity. What exactly is secondary drowning? How does it differ from dry drowning? Should you head to the emergency room every time your child accidentally ingests water?

The answer is likely no.

“Children often swallow water, and that usually doesn’t lead to aspiration issues,” said Dr. Kristin Stukus, an assistant professor of pediatrics in the emergency medicine division at Nationwide Children’s Hospital in Columbus, to TODAY. “My concern arises when there is a submersion event lasting longer than 30 seconds.”

Experts want the public to recognize that drowning remains a significant threat.

“Drowning is one of the leading causes of death for children, particularly among those under 12 years old, and more so in males,” Dr. James Callahan, associate medical director of the division of Emergency Medicine at Children’s Hospital of Philadelphia, emphasized to TODAY.

Regarding secondary drowning and dry drowning, both are rare but can be perilous.

“Approximately seven to ten deaths can be linked to delayed drowning,” Callahan stated. “These delayed instances are devastating, but they constitute less than 1% to 2% of all drowning injuries.”

Symptoms of dry drowning

While dry drowning and secondary drowning are often confused, they are distinct conditions.

“Both involve submersion injuries,” explained Callahan.

He advises parents to seek medical attention for their children following a water-related incident if they:

• Experience vomiting
• Cough persistently
• Struggle to breathe
• Show signs of lethargy

Understanding drowning, secondary drowning, and dry drowning

Dry drowning occurs when individuals inhale water, leading to spasms in the vocal cords that close off the airway, resulting in asphyxiation.

“When a significant amount of water is inhaled rapidly, the muscles at the top of the airway can close,” Callahan remarked.

In such cases, the person may appear to be choking and can turn blue.

The nature of secondary drowning

In secondary drowning scenarios, water enters the lungs but may not show immediate symptoms. Conditions can worsen over time, with parents observing rapid, labored breathing that develops within 24 hours.

“They may exhibit considerable, persistent coughing and exhibit rapid or labored breathing,” Callahan explained.

Affected children are often lethargic and may seem “off.”

“A child who appeared fine and active in the water but then suddenly appears tired may be struggling to get enough oxygen,” Callahan added.

Ensuring children’s safety in water

Teaching children to swim is one effective way to prevent drowning. Callahan also suggests that parents learn CPR, encourage the use of life vests, and restrict swimming to safe locations. Having a dedicated watcher can help ensure a child does not submerge unnoticed.

“Drowning is not always a loud, noticeable event—it can be as simple as a child slipping below the surface,” Stukus noted. “I can treat infections; however, I cannot address a lack of oxygen to the brain… always supervise your children closely.”

This article was first published in 2017 and has been updated.