The Truth About Drowning

Little girl splashing in the pool

The thought of one of our children dying is terrifying.  And although it is true that we all are born and we all will die, noone is ever prepared for that to happen.  Especially when it is accidental and preventable.  For years now, stories surface about the dangers of dry drowning sharing heart wrenching stories about perfectly normal children who died after having innocent fun in the pool.

As if the thought of drowning wasn’t scary enough, now we hear about kids who were completely fine and then just die due to the water.  In reality, this is not something that really happens.  So let’s go thru all the types and descriptions of drowning so that we know what to keep our eye open for.

Wet Drowning

This is what we typically thing of as drowning.  The child inhales water and  water floods into the lungs.  This completely messes up breathing and the transfer of oxygen from the lungs to the body and brain does not work.  Circulation shuts down.

Dry Drowning

Theoretically, this can happen if really cold water starts to forcibly enter your airway (such as you fall mouth open into a lake in January).  This is quite a shock to your body and your airway involuntarily spasms totally blocking off your airway.  This is a very rapid event and you would be unlikely to resurface, let alone be fine for hours, days, or a week.  Thankfully, this is actually something that would be exceedingly rare to happen.

Near Drowning

In near drowning, water is inhaled and there is generally plenty of coughing and sputtering.  This is usually not a small event.  You may have to fish them out.  They may look bluish or grey.  But in this case, water DOES get into the lungs.   Once water is where it’s not supposed to be, it irritates the airways and can cause worsening symptoms.

After the moment has passed, they may seem ok.  But over the next hour or so they may not be quite right.  They may seem sleepy or confused.  They may complain of their chest hurting or start to cough more.   Symptoms usually begin within 4-6 of the water event.  THESE are the kids who need evaluation in the ER so that trained staff can monitor for worsening symptoms and supportive care.  If this child is at home and continues to worsen, they can get in trouble.

Young child swimming in a pool

The Reality

I trained in New Orleans, LA.  Very hot, very humid, and completely miserable in the summer.  I watched several “near drownings” during my rotations thru the PICU.  They are always devastating.  Pools, lakes, rivers, bathtubs, even little plastic kiddie pools can lead to problems.  Sometimes a youngster can manage to unlock a door they’ve never opened giving access to a pond or pool.  Sometimes it is an unfenced pool that belongs to a neighbor.  Other times a parent leaves for “just a minute” to answer the phone and returns to the unthinkable.

Children who die from near drowning events are never completely normal and then die.  They may have mild trouble that is easily overlooked and that worsens and progresses.  But they are not fine for days or a week and then die.

This is good news for us parents.  Because if we know what to look out for, we don’t have to stress over every single cough that happens in the water.

How to know if your child’s sputtering at the pool is something that may be more serious and need to get checked out

  • They require assistance to get over their choking at the pool.  Maybe they were under and you had to pull them out, maybe they had trouble catching their breath and had to sit out for a bit to recover.  Just because they needed help does NOT mean that they WILL have an issue.  But it DOES mean we should keep a watchful eye on them for a few hours and make sure they don’t start anything fishy.
  • Sometime after they’ve choked in the water, they start getting sleepy and don’t seem as responsive as usual.  They may keep falling asleep or zoning out.  Or they may seem confused.
  • They start coughing more as time goes on.  Maybe even complain of chest pain or trouble breathing.  Their chest may look funny with breathing (retractions) and if you look, you may see their nostrils flaring out with breaths.
  • Any of these issues start within 4-6 hours of their swimming event.

Keep your eyes open and be safe.  For more information on how to recognize when a swimmer is in trouble, you can check out my post on Water Fun here.

Also, you can check out the CDC’s handout on drowning prevention here.

Hopefully this will help to alleviate some of the fears that circulate this time of year.  There are so many ways we can help keep our kids safe.  As always, never hesitate to discuss concerns with your doctor.  I promise we don’t mind 🙂

Author: Dr. Jenny Seawell

Dr. Jennifer Seawell is a board certified pediatrician currently practicing in Tennessee. She is married with 2 daughters aged 7 and 13.

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