Running Doc: Be aware of the signs and risks of dry drowning

Dear Running Doc:

We recently moved into a beautiful new home in Kings Point, N.Y., complete with a backyard in-ground pool. My daughter , who’s 3-years-old, loves to swim and we do keep careful watch all the time. Our new pool opens Memorial Day. Two years ago I remember seeing you on TV discussing the dangers of "dry" or secondary drowning. Can you please refresh our memorial about what this is and how to prevent it?

— Joel G. Kings Point, NY

Thanks for writing in as everyone should know of this and be aware of prior symptoms to get victims help before it is too late.

As a former water safety instructor and Nassau County lifeguard I am very familiar with this condition. Here is what I know and what all should be aware of:

Secondary drowning, aka "dry drowning," is rare and accounts for 1%-2% of all drownings. It can occur from one hour to 24 hours after a struggle in the water, where water was breathed into the lungs. This water causes an irritation to the muscles lining the airways and spasm of those muscles eventually occurs. The lungs then produce fluids over time, causing pulmonary edema. The person then drowns of their own fluids, not directly from the pool or ocean water. That is why it is called “dry drowning.”

It is important to understand this physiology, as well as symptoms, so you can get the victim medical care as soon as possible. Symptoms after swimming, even if a child does not report a struggle, include, increasing chest pain, shortness of breath or wheezing, extreme fatigue, and/or cough.

Immediate care will include oxygen, supportive measures in a hospital and diuretics to get some of the fluid (from pulmonary edema) off. Adults tend to survive easier because they recognize something is wrong where children tend to not complain, go to sleep, and it isn't until their parents hear abnormal breathing or bubbling fluid around the lips that they realize something is wrong.

Prevention is best done by good water safety, teaching children (and adults) to swim and be water safe, observation of those in the water to watch for and care for struggles, and proper fencing around pools so no one can get in without supervision.

I hope this information is useful to you Joel as well as everyone else.

Lewis G. Maharam, MD, FACSM is one of the world’s most extensively credentialed and well-known sports health experts. Better known as Running Doc™, Maharam is author of Running Doc’s Guide to Healthy Running and past medical director of the NYC Marathon and Rock ‘n’ Roll Marathon series. He is Medical Director of the Leukemia & Lymphoma Society’s Team in Training program. He is also past president of the New York Chapter of the American College of Sports Medicine. Learn more at runningdoc.com.