Many people generally think of drowning as someone struggling underwater. But, drowning can still occur even when a person is already out of water, even hours later. Then, what does drowning mean? Medically, “drowning” refers to the condition where a person suffers from respiratory impairment caused by submersion in water. Drowning leads to cardiac arrest if not treated in time.
You rescue a person struggling in water and bring the situation under control after necessary emergency treatment. But life-threatening danger doesn’t go away there. These situations are described by dry drowning and secondary drowning conditions. In this blog, we will explore dry drowning and secondary drowning, including their symptoms, treatment options, and prevention measures.
What Is Dry Drowning?
Dry drowning occurs when water is inhaled but does not enter the lungs. Instead, even a small amount of water can cause the airway to spasm and tighten, making it difficult to breathe.
This drowning can happen from something as minor as a splash of water going down the wrong way while swimming, diving, or even during a bath. Even someone briefly choking on water may need attention. It mainly affects children, but it can occur in adults too. After inhaling water, a person may appear fine initially, but the airways can begin to swell, causing symptoms to develop shortly after the incident.
Here are the warning signs and symptoms of dry drowning:
1. Persistent Dry Cough
2. Shortness of Breath or Gasping
3. Discomfort in the chest
4. Unusual tiredness, vomiting, and nausea
5. Behavioral Changes
6. Pale or Bluish Skin (Cyanosis)
What Is Secondary Drowning?
Secondary Drowning, also known as “delayed drowning”, occurs when a small amount of water enters the lungs, but symptoms appear hours later. It causes irritation, inflammation, and additional fluid buildup (pulmonary edema) in the lungs.
As a result of a lack of oxygen delivery to the body, the victim suffers difficulty in breathing and other serious symptoms. The delayed onset of symptoms in secondary drowning makes it comparatively more dangerous than dry drowning.
We should closely watch out for the following secondary drowning symptoms and signs:
1. Difficulty breathing and persistent coughing
2. Chest pain or tightness
3. Fatigue or Lethargy
4. Vomiting, fever, and diarrhea
5. Behavioral changes
6. Pale or Bluish skin
Difference Between Dry Drowning and Secondary Drowning
Even though both dry drowning and secondary drowning can happen after inhaling just a small amount of water, and may show similar types of symptoms, they are not the same. We should understand the difference between the two so that we can know what signs to look for and when to take action.
Here are the key differences between dry drowning and secondary drowning:
| Feature | Dry Drowning | Secondary Drowning |
| Definition | Dry drowning is a post-immersion reaction that happens shortly after someone inhales water, where instead of water reaching the lungs, the airway closes up or spasms | Secondary drowning or delayed drowning is the response where lung inflammation is involved due to the water reaching the lungs and fluid build-up over time |
| Causes | The throat or airway tightens and eventually closes up after water goes in and causing irritation and breathing difficulty | Water gets into the lungs and causes fluid buildup up causing lung inflammation, sometimes aspiration pneumonia |
| Onset of symptoms | Right after getting out of the water or within an hour | Appears hours later, and sometimes even up to 48 hours later |
| Main Symptoms | Trouble breathing, coughing, chest tightness, tiredness | Coughing, breathing problems, tiredness, fever, and vomiting |
| Risk of infection | Low | High possibility of aspiration pneumonia if the water is dirty |
| Example | A child may accidentally swallow water while playing in the pool and then suddenly start coughing and struggling to breathe. This could be a sign of dry drowning | Imagine a young boy playing in the shallow end of a pool. He slips under briefly and comes up coughing. At first, he seems fine, but a few hours later, he becomes unusually tired and starts having trouble breathing. This could be a case of secondary drowning and needs immediate medical attention |
How Dry Drowning or Secondary Drowning Treated?
Both Dry Drowning and Secondary Drowning are extremely rare, but equally dangerous, if we don’t pay attention in time. The most important step to treat these post-immersion syndromes is to act quickly, even after the slightest doubt or warning sign of complication or trouble.
If someone shows signs such as difficulty breathing, persistent coughing, unusual fatigue, or confusion after a water-related incident, seek medical attention immediately. Early intervention can make a critical difference and help prevent more serious complications.
Follow this step-by-step guide to give treatment:
1. Ensure your safety
Always begin the rescue attempt by assessing the surroundings and ensuring your and the victim’s safety. If you hurry without proper caution, it can just cause another accident or further complications.
If you’re not a trained rescuer or strong swimmer, use available objects like a life ring, rope, or stick to reach the victim without putting yourself in danger. For additional help, call out for lifeguards or trained personnel nearby. Make sure to enter the water body for rescue only if you are confident enough and safe to do so.
2. Remove the Victim from Water
The next step is to remove the drowning victim from the water with care. It is crucial to safely carry the victim from a drowning emergency. While carrying them, support their head, neck, and spine and place them on a flat, dry surface to avoid further stress, such as hypothermia. You shouldn’t shake or move them roughly, as this could worsen internal injuries or cause panic.
If the person is conscious but struggling, you should try your best to keep them calm. If the victim is unconscious, lay them flat on their back and immediately check responsiveness, breathing, and pulse.
3. Call Emergency Medical Service
Even if the victim seems stable after some time, you should call EMS as soon as possible. Only EMS professionals are trained to assess the possible complications. Any delayed care after water accidents may lead to respiratory failure. So it is better to seek a lifeguard and EMT for prevention and make sure to give details of the incident accurately to them once they arrive.
Whereas if the victim is unconscious and is gasping to breathe or not breathing at all after the rescue from water, immediately call for help and perform hands-only CPR without any delay.
4. Perform CPR
While you wait for the EMS to arrive, you can begin to perform high-quality CPR. If you are not trained, then ask for help from life lifeguard or perform hands-only CPR. Start with 30 chest compressions at the rate of 100-120 compressions, followed by 2 rescue breaths, and repeat the cycle. Make sure the compression depth is 2 inches for adults and 1.5 inches for children to achieve a high compression fraction.
If possible, call for someone nearby for help. It is important to switch the rescuers’ positions to ensure high-quality compressions. Even after the 30 chest compressions, if the victim is still not breathing, the next step is to provide rescue breaths to manually provide supply oxygen to the person.
5. Provide Rescue Breathing if Breathing but Unconscious
After 30 chest compressions, once again assess the condition of the victim. If there is a pulse but no signs of breathing, you should immediately provide rescue breathing. Make sure to maintain the 30:2 ratio, that is, 30 chest compressions followed by 2 rescue breaths. You should ensure airway management using the head-tilt-chin-lift method before giving rescue breaths. If you are a trained rescuer and a BMV mask is available, you should use it for proper ventilation.
Though it may seem similar, the rescuer should monitor the victim cautiously to know when to perform CPR and rescue breaths. If an AED is available, you should use it by following the built-in prompts to restart the person’s heartbeat. A combination of CPR with rescue breaths and AED usage significantly increases the survival chances of the victim.
6. Monitor for Delayed Symptoms (Dry/Secondary Drowning)
The victim may respond with brief coughing and then may start responding normally some time after coming out of the water. But there may occur cases like dry drowning and secondary drowning, which involve delayed responses, like hours later.
It is essential to keep close monitoring of the victim to recognize the warning signs of such post-immersion syndrome. Quick action is possible only if we can watch out for warning signs early. Call emergency medical service soon after rescuing the victim from water. While you wait for help, keep the person warm, calm with reassured, and in close monitoring.
7. Seek Medical Help
Even after the victim regains consciousness or starts showing normal responses, medical assistance from a professional is still crucial. Keep constant monitoring of the victim’s condition. Always seek emergency medical services or take the person to the nearest hospital for a thorough check-up.
With a timely medical check-up, a medical professional can monitor the victim’s oxygen levels, listen to their lungs, and decide if further care and observation are needed. It is always best to consider even the small signs of the problem and address them immediately to prevent further complications.
How To Prevent Dry Drowning and Secondary Drowning?
Dry Drowning and Secondary Drowning are delayed reactions to water inhalation. Though these cases are rare, being informed and prepared on how to prevent them gives you peace of mind. With a few simple precautions, you can significantly reduce the risk of drowning and keep water activities safe and fun.
Here are the preventive measures of Dry Drowning and Secondary Drowning:
1) Always supervise children closely in and around water.
2) Learn CPR techniques to handle drowning emergencies.
3) Use proper flotation devices for kids and non-swimmers.
4) Learn water safety and swimming skills.
5) Only allow swimming in the presence of lifeguards.
6) Avoid rough play in water.
7) Closely monitor the victim of a water accident.
Conclusion
Dry drowning and Secondary drowning may seem like unusual conditions, but people die from them. These types of drowning are especially dangerous because they can happen unexpectedly, when you least suspect it. Even if you rescue someone on time, they may start to show symptoms of discomfort soon after coming out of the water. Then, know that it’s a possible indication of dry drowning or secondary drowning, and you should be prepared to provide high-quality CPR to such a victim. If you are well-trained in emergency skills like performing CPR, you can quickly act and handle such emergencies confidently.
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