Dry Drowning: What to Know After You Leave the Water

Health Professional, Medical Reviewer
Medically Reviewed

Drowning is the third most common cause of accidental death in the United States. We all know about the threat of drowning that being in the water poses. But what about after we’re out? Is the threat completely over?

Consider a danger called dry drowning, also known as secondary or delayed drowning. Though rare, it can happen up to 24 hours after a person has left the water.

It occurs after a person inhales water through the nose or mouth. Water enters the lungs, triggering a muscle spasm in the airway, which causes it to close. Symptoms include trouble breathing, coughing, sleepiness or a drop in energy level, irritability, chest pain, and vomiting.

Large amounts of water need not enter the lungs for this phenomenon to occur. If it’s recognized and treated early, and the person was in fresh water, the prognosis is quite good. But if he or she was in water that had salt content, treatment is often not as successful.

Why symptoms are delayed

Once any amount of water enters the lungs it has the potential to cause significant damage. Just a small amount of water can affect the substance, called surfactant, that lines the many alveoli protecting the surface of the airways.

Inflammation then spreads over a period of time, which is why symptoms may not be evident right away. Ultimately, the airway will become narrowed and the flow of air restricted. This is especially possible in the small airways of children. Those cases are rare, fortunately, but they do deserve awareness and attention.

Risk factors include:

  • Infants left unsupervised or alone with another child in water
  • Use of alcohol before or while being in the water
  • Having a medical condition like epilepsy, which means you could have a seizure in water
  • Tourists unfamiliar with the ocean water conditions at their vacation destination.

The American College of Emergency Physicians, the American Heart Association, and other organizations discourage the use of the term “dry drowning” or “delayed drowning.” Those groups believe that prevention measures should be taken to reduce the risk of any form of drowning, whether it’s in the bathtub, wading pool, or any body of water.

How to protect yourself

Here are some tips from the International Journal of Aquatic Rescue Education:

  • Learn swimming and water safety survival skills
  • Always swim with others
  • Never go in the water after drinking alcohol
  • Avoid inflatable swimming aids such as floaters and know how and when to use a life jacket
  • Know the weather and water conditions before going into water
  • Always enter shallow or unfamiliar water feet first
  • Do not overestimate swimming capability
  • Learn safe ways of rescuing others without putting yourself in danger.

In areas where lifeguards are present, less than 6 percent of all rescued persons needed medical attention, and just 0.5 percent needed cardiopulmonary rescusitation (CPR).

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