Dry Drowning in Children : Is Your child at risk ?

Recently a four-year-old boy from Texas, USA died from “dry drowning” almost a week after his family went swimming. This has resulted in a lot panic and unrest among parents globally about how did this happen and what they could do to prevent it from happening to their children.

What is Drowning? Are there various types of drowning?

Drowning is a form of asphyxia (a condition where body is deprived of oxygen) due to fluid (water or any other liquid) in air passages of lungs.

Traditionally,  Drowning was categorized in 4 types:

1. Wet Drowning : In this , water is inhaled into lungs.
2. Dry Drowning : In this type of drowning, water does not enter lungs due to immediate spasm of airways , causing it to close up and make breathing difficult.
3. Secondary Drowning / Near Drowning/ Post-immersion Syndrome : In this type , death occurs from within half an hour to several days after resuscitation from a near-drowning experience or inhaling large amounts of water. Water enters lung and builds up over time (pulmonary edema), eventually causing breathing difficulties.
4. Immersion Syndrome : Death resulting from cardiac arrest due to cold water stimulating nerve endings of the surface of the body. Falling or diving in water feet first, or diving involving horizontal entry into water with a consequent blow to abdomen or swimming under the influence of alcohol can lead to Immersion sydrome.

 

What You Should Do in a Drowning Emergency:

• Get your child out of the water immediately, then check to see if she is breathing on her own. If she is not, begin CPR immediately.
• If someone else is present, send him or her to call for emergency medical help, but don’t spend precious moments looking for someone, and don’t waste time trying to drain water from your child’s lungs.
• Concentrate instead on giving her rescue breathing and CPR until she is breathing on her own. Vomiting of swallowed water is very likely during CPR.
• Only when the child’s breathing has resumed should you stop and seek emergency help.

In case of a Near Drowning experience or Inhalation of water :

Any child who has come close to drowning should be given a complete medical examination, even if she seems all right. If she stopped breathing, inhaled water, or lost consciousness, she should remain under medical observation for at least twenty-four hours to be sure there is no damage to her respiratory or nervous system.

Is it dry or secondary drowning  ? Signs to watch out for at home:

• Trouble breathing

• Coughing

• Sleepiness or a drop in energy level

• Irritability

• Chest pain

• Vomiting

  Be attentive to sudden changes in behavior; if child appears fatigued, do not presume it is from a long day of swimming, it may be a sign of dry or secondary drowning. While symptoms are often mild and improve over time, it is still important to have your child examined as a precautionary measure.

  Go to the hospital and let your physician determine if airways are blocked, water is in the lungs, or oxygen levels are low. Once diagnosed, a physician will be able to provide the best treatment to restore your health.

Signs that signal that a child is in danger of drowning :

• Head low in the water, mouth at water level / Head tilted back with mouth open
• Eyes glassy and empty, unable to focus / Eyes closed
• Hair over forehead or eyes
• Not using legs — vertical
• Hyperventilating or gasping
• Trying to swim in a direction but not making headway /Trying to roll over on the back
• Appear to be climbing an invisible ladder

How to prevent drowning?

• For newborn infants and children through four years of age,

1. Parents and caregivers should never—even for a moment—leave children alone or in the care of another child, while in or near bathtubs, pools, spas, or wading pools, or near irrigation ditches or other open bodies of water.
2. With children of this age, practice “touch supervision”; that means that a supervising adult should be within an arm’s length of the child with full attention focused on the child at all times when she is in or near water.
3. The supervising adult should not be engaged in distracting activities, such as talking on a telephone, socializing, or tending to household chores.

4.   Parents, caregivers and pool owners should learn CPR.

5. Bath seats cannot substitute for adult supervision.
6. Empty water from buckets and other containers immediately after use.
7. To prevent drowning in toilets, young children should not be left alone in the bathroom.

AAP supports swimming lessons for most children 4 years and older. Classes may reduce the risk of drowning in younger children as well, but because children develop at different rates, not all children will be ready to swim at the same age.

• With older children 

1. An adult should be focused on the child and not distracted by other activities.
2. With weak swimmers, an adult should be within an arm’s length.
3. Parents should know the depth of the water and any underwater hazards before allowing children to jump in. The first time you enter the water, use poolside steps , don’t dive.
4. When choosing an open body of water for children to swim in, select a site with lifeguards.
5. Counsel teenagers about the increased risk of drowning when alcohol is involved.
6. All children should wear a life jacket when riding in a boat. Small children and nonswimmers should also wear one at water’s edge, such as on a river bank or pier.
7. Youngsters with an intellectual disability, and children with seizure disorders are particularly vulnerable to drowning.
8. Do not use air-filled swimming aids (such as inflatable arm bands) in place of life jackets. They can deflate and are not designed to keep swimmers safe.

Children > 4 years and above need to learn to swim but Swimming lessons should not be considered as a way to “drown-proof” your child. 

•   If you have a pool, install a four-sided fence that is at least 4 feet high to limit access to the pool. The fence should be hard to climb (not chain-link) and have a self-latching, self-closing gate. Families may consider pool alarms and rigid pool covers as additional layers of protection, but neither can take the place of a fence.

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Sources:

• http://www.forensicpathologyonline.com/E-Book/asphyxia/drowning
• https://www.aap.org/en-us/about-the-aap/aap-press-room/pages/AAP-Gives-Updated-Advice-on-Drowning-Prevention.aspx
• http://www.osteopathic.org/osteopathic-health/about-your-health/health-conditions-library/childrens-health/Pages/secondary-drowning.aspx
• https://www.healthychildren.org/English/health-issues/injuries-emergencies/Pages/Drowning.aspx