What is dry drowning?

Drowning is one of the most common forms of accidental deaths among children. It is one of the leading causes of unintentional injury or death among children. According to the Arizona Child Fatality Review, children of age 1-4 years are at highest risk of drowning, accounting for 60% of deaths related to drowning. The two types of drowning we are looking at are:

• Dry drowning: It occurs when the water enters through the nose or mouth resulting in the closure of the airway leading to difficulty in breathing. It is calleda "dry drowning" because water does not enter the lungs due to the closure of vocal cords. Death occurs as vocal cordsdo not open which prevents air from entering the lungs.
• Secondary drowning: It occurs when water enters directly into the lungs leading to swelling or edema of the lungs. It takes hours or 1-2 days to develop edema or swelling after initial contact. Death occurs due to lack of oxygen entering the bloodstream.

Clinical Features:

1. Difficulty breathing
2. Persistent coughing
3. Frothy or bloody respiratory secretions
4. Choking
5. Lethargy or sleepiness
6. Irritability
7. Vomiting

Preventive measures:

1. Monitor kids around water at all times
2. Never let your child swim alone
3. Have a designated lifeguard
4. Allow the children to enjoy pool time only after they learn how to swim
5. Have a four-sided barrier around your pool with a self-latching gate

Treatment:

Treatment depends on the extent of the problem. Emergency services should be called right away for resuscitation and oxygen administration. The affected individual should be taken out of the water and placed on a flat surface. When the victim passes out or loses consciousness, the first step is to assess the airway. Make sure there are no foreign objects in the mouth or the throat. Next step is to assess if the victim is breathing or not. Their pulses should also be checked. If the victim is not breathing or pulses are absent, CPR (Cardio Pulmonary Resuscitation) or chest compressions should be initiated. As per the new American Heart Association guidelines released in 2015, chest compressions only may be performed by untrained bystanders. Trained personnel can provide two breaths for every 30 chest compressions. Chest compressions should be performedat 100-120/minute. If an advanced airway is available, the victim should be intubated and transferred to a hospital.

Even if the victims are conscious, they should still be takento the emergency room for further care. They may need a chest x-ray to determine the extent of the injury. Further procedures like a bronchoscopy may be neededas per pulmonology recommendations.