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LI KIDS: Behind a Âdry drowning’

A boy’s death is alarming, but doctors say such events are rare and can be avoided

Beth Whitehouse | Parental Guidance

June 22, 2008

Oh, great. Another thing for parents to worry about.

On Long Island, the land of backyard swimming pools, some parents are freaked out after hearing the story of the 10-year-old boy in South Carolina who "dry drowned" earlier this month more than an hour after getting out of the pool.

After all, he walked home, talked to his mom and went to take a nap after a day in the sun.

Then his mom discovered him dead in his bed.

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Initial news reports said that 10 to 15 percent of drownings are such so-called "dry drownings." That's more than one in 10. Too many to ignore.

However, area doctors interviewed about the "dry drowning" phenomenon said parents, for the most part, can calm down.

"This is not a question of, 'My kid was in the pool today and went swimming, and now that he came out I have to worry about what could possibly happen,'" says Dr. Christopher Anselmi, a pulmonologist - that's a lung doctor - at Huntington Hospital.

The news stories were misleading in that they made parents think every "dry drowning" is one that occurs after a delay, says Dr. Michael Stratemeier, associate chief of emergency medicine at Huntington Hospital. "It doesn't mean that you're fine and then you have trouble after the fact," he says. It's a classification of the way the body was deprived of oxygen. "I don't think that dry drowning is more likely to be a delayed event than wet drowning."

What dry drowning usually means is that the victim has a spasm in the throat called a laryngospasm, Anselmi says. The spasm is the body's attempt to stop water from getting into the lungs. Unfortunately, it also stops air from getting into the lungs, he says.

And, it can cause normal bodily fluid to collect in the lungs, says Dr. Alan Mensch, chief of pulmonology at Plainview and Syosset hospitals and past president of the Nassau-Suffolk Chapter of the American Lung Association. "The fluid is not from the water. It is fluid that comes from inside the body," he says.

Because the body is still trying to breathe but the air passage is blocked by the continuing laryngospasm, it causes a vacuum in the lungs and fluid is sucked out of the blood that is circulating around the lungs and would normally pick up oxygen and deliver it to the body, Mensch says.

So dry drowning becomes the cause of death instead of the usual "wet" drowning, Stratemeier says. He has never seen one in his emergency room career, he says.

Dry drowning can happen anytime up to 24 hours after swimming. But not every one of those cases of dry drowning is delayed. Most happen soon after swimming, and the incidence of dry drowning tapers off as hours pass, Mensch says.

In the vast majority of dry drowning cases, some incident in the pool precipitated the event, such as being stuck underwater or swallowing a lot of water or losing one's breath, so parents should have some indication that something was wrong, the doctors interviewed say. The boy in South Carolina soiled himself after swimming, and was lethargic. It was his first time swimming, according to news reports.

"It's not that he was just happily playing in the pool and afterward he drowned," Stratemeier says. "I think it's unlikely if your child doesn't have an event similar to that that he's going to have respiratory distress afterward."

What to look for to prevent a tragedy

In cases of dry drowning, usually the child will have experienced some distressing incident in the pool during the swimming session, says Dr. Christopher Anselmi, a pulmonologist at Huntington Hospital. Symptoms of dry drowning can appear immediately or be delayed, he says. Symptoms include persistent coughing, chest pains or lethargy, he says.

"If they come out of the pool coughing, they should be watched," Anselmi says. "In those situations, it would be prudent to keep an eye on them."

That's another reason children should never be allowed to swim without adults present; parents should know whether something unusual occurred in the water. "The key thing is you never should leave kids unattended in the pool," Anselmi says.

If something like that happens at day camp, for instance, the camp would hopefully notify the parents, Anselmi says.

What's important is that parents should know about the symptoms of dry drowning, and the potential for dry drowning, so they can be vigilant if they do suspect something is wrong. In that case, parents can take the child to the hospital.

"If there's any questions where you think your child might have any of these signs or symptoms, you should bring him to an emergency room," Anselmi says. "It's always better to go to the emergency room and get sent home than to stay home and have a disaster."

- BETH WHITEHOUSE