Parents know to be on the lookout for signs of drowning at the pool this summer. It is, after all, the fifth leading cause of unintentional injury death in the United States, and about one in five people who die of drowning are 14 and under.
Parents may also know that drowning doesn’t always look like it does in the movies—it’s often silent, with minimal movement.
What parents may not know is that in rare cases—about two percent— death by drowning may actually occur hours after getting out of the water.
This type of atypical drowning recently made the news after a four-year-old boy from Texas, Frankie Delgado, died days after being knocked over by a wave. When knocked under, unknown to his parents, he had aspirated water. While Frankie was fine for the rest of the day, in the evening he began showing symptoms of a stomach bug—diarrhea and vomiting. Later, his shoulder began to hurt. Although the parents resolved to take him to the hospital in the morning, he died during the night, days after the incident occurred.
The family has named “dry drowning” as the likely cause of death, although autopsy results are pending.
The term drowning itself is often misused. Dr. Kevin Yan, a doctor of internal medicine who works at Mount Sinai Beth Israel in New York, explained to Second Nexus that “drowning” merely means that “a person experiences respiratory distress due to immersion in a fluid. It does not imply that a person has died from this event, and therefore initial survivors are classified as having experienced ‘nonfatal drowning.’” However, he continued, initial survivors “can then die soon afterward from the consequences of the initial drowning event.”
When an individual experiences distress from drowning minutes or hours after the initial drowning event, it has been colloquially referred to as “dry nonfatal drowning” and “secondary” or “wet nonfatal drowning.” Doctors do not like to use these phrases, and the World Congress has rejected the terms, but they are still used as shorthand to describe these atypical drowning events.
Yan explained that in what is colloquially termed dry nonfatal drowning, the muscles in the larynx spasm as a reaction to water entering and irritating the airway. This can prevent aspirating water, but also cuts off needed oxygen to the body. If the spasm persists, immediate death can occur. If the larynx relaxes, a person can begin to breathe again. However, during the spasm, the lungs can undergo significant trauma, which can subsequently cause inflammation and impairment of airflow and oxygenation.
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