'Dry Drowning' and 'Secondary Drowning': What Parents Need to Know

"Dry drowning" and "secondary drowning" are not real medical conditions. The American Red Cross says there are no medically accepted conditions (opens in a new tab) called "near drowning", "dry drowning", "secondary drowning" or "delayed drowning". What is real is that a person who had trouble breathing in the water can get worse over the next few hours, which is why anyone with symptoms after a water incident should be watched closely and, if symptoms continue, checked by a medical professional.

Stories online have frightened many parents. Here is what the evidence says, and what to actually watch for.

Why doctors don't use these terms

The Red Cross explains that the World Health Organization, the International Liaison Committee on Resuscitation, the Wilderness Medical Society, the CDC and others all discourage these terms, and that a scientific review of the medical literature showed no evidence (opens in a new tab) to support them.

• What drowning is. The CDC defines drowning as the process of experiencing respiratory impairment from submersion or immersion in liquid (opens in a new tab). In plain words: breathing problems from being in or under water. It is not always fatal.
• "Near drowning." The Red Cross says people who drown either die or survive. The right terms are fatal drowning and nonfatal drowning.
• "Dry" and "wet" drowning. These were abandoned decades ago. Drowning injury is caused by lack of oxygen, not by how much water gets into the lungs.
• "Secondary" or "delayed" drowning. The Red Cross says this has no accepted medical definition. It came from a time before doctors understood that drowning victims can sometimes get worse after rescue.

Water Safety USA, a group of national water safety organizations, is just as clear: these so-called conditions are social media myths (opens in a new tab).

What really happens after a drowning incident

Water Safety USA explains that the signs of drowning happen immediately: trouble breathing, excessive coughing, or foam in the mouth (opens in a new tab). After that:

• For some people, breathing trouble clears quickly.
• For others, breathing trouble can get worse over the next few hours, up to 5 to 8 hours after the incident.
• No one who has drowned will be completely fine for several hours or days and then suddenly develop drowning symptoms. Symptoms don't go away and then return.

The Red Cross adds that there are no known reported cases of a death from drowning after a person had returned to being completely normal.

5-8 hours

Symptoms that need medical care

Water Safety USA says anyone who has any of the following after a drowning episode should be evaluated by medical professionals (opens in a new tab):

• coughing that doesn't stop;
• loss of consciousness, even for a moment;
• needing rescue breathing or other breathing support;
• needing CPR;
• chest pain or shortness of breath that continues despite rest and treatment;
• confusion, being really tired, or not acting or behaving normally.

The Red Cross describes three groups of children after a water incident:

This page explains what the experts say. It can't tell you what is wrong with your child. If you are worried, call your child's doctor, and call 911 in an emergency.

When not to worry, and what to do instead

A child who swallows a mouthful of water, coughs for a moment and then plays happily is a very common sight at any pool. If they recover quickly and stay normal, the Red Cross says that is not drowning.

If a child who was breathing, walking and talking normally gets sick days later, the Red Cross says they need to be seen by a health-care provider right away, but it is not drowning. Brand-new symptoms days later are extremely unlikely to be related to swimming, and the doctor should look for other causes.

The Red Cross ends its article with the most important point: the most important way to "treat" drowning is to prevent drowning (opens in a new tab). It lists what works: swim lessons, adequate supervision, life jackets, four-sided pool fencing and swimming where there is a lifeguard.

Why getting this right matters

Fear of "dry drowning" can send families to the emergency room for a child who is fine, while the real dangers, like a toddler slipping silently into a pool, get less attention. The Red Cross says emergency departments are seeing families bring in children for evaluation of "dry drowning."

Nonfatal drowning is common and can be serious. The CDC estimates about 8,000 nonfatal drownings a year (opens in a new tab) in the United States (2012-2021 average), with outcomes ranging from no injury to brain damage or permanent disability. Knowing the real symptoms helps you get care when it is needed, quickly.

What you can do today

• Save the symptom list above in your phone, or print it for your pool bag.
• If your child had a scare in the water recently and has none of these symptoms, you can let go of the worry.
• If they did have symptoms, follow up with their doctor.
• Learn the quiet signs of drowning and the first steps in an emergency.
• Test yourself with the Drowning myths quiz, then read drowning myths vs. facts.
• If your child is still frightened, read helping a child after a scary moment in the water.