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t m c » p u l s e | a u g u s t 2 0 1 7 10 The Truth About Dry Drowning Look for coughing, confusion or trouble breathing B y S h e a C o n n e l l y A s the temperature creeps above 90 degrees nearly every day, pools throughout the Houston area are filled with children seeking respite from the heat, shrieking with laughter as they play. While kids splash around without a care in the world, a recent news story has many parents watching the water anxiously, not just for signs of immedi- ate distress, but for more subtle hints of danger to come: a condition referred to as "dry drowning." In early June, 4-year-old Frankie Delgado died nearly a week after swimming with family in Texas City. Frankie's parents said they were told their son had fluid in his lungs and may have died from dry drowning. The Delgados' story made national head- lines as a cautionary tale about the phenomenon of dying from a swimming-related injury long after leaving the water. This is not the first time stories that mention dry drowning have gone viral. Every June for the past five years, the phrase has seen a spike in popularity as a search term, according to Google Trends, with the biggest spike happen- ing after Frankie's death. What most coverage fails to mention, however, is that "dry drowning" and "secondary drowning," terms often used inter- changeably, are not medically accepted conditions. Organizations including the Centers for Disease Control and Prevention and the World Health Organization caution against using those words, noting that "drowning" doesn't necessarily mean death. Instead they refer to drowning as a spectrum: nonfatal drowning, nonfatal drowning with injury and fatal drowning. Dry drowning stories have many parents imagining scenarios in which their children exhibit no signs of dis- tress during a day at the beach or pool, or even during a bath, and then die suddenly, hours or days after inhal- ing water. Corrie Chumpitazi, M.D., an emergency medicine physician at Texas Children's Hospital, said this is extremely unlikely. "There has never been a published case where a patient was initially asymptomatic and later deteriorated or died," Chumpitazi said. And while it is possible for a person to die from drowning after leaving the water, "most would be expected to have symptoms within four to six hours," she added, noting that patients have come to the emergency room days after swimming with concerns about dry drowning that have turned out to be a respiratory virus or cold. Additionally, parents would likely observe something out of the ordinary while their children are in the water. "The way I would think about it is, if your child was in the pool and had to be pulled out because maybe they had a little trouble. They have some amount of coughing or problems breathing after, those are some of the scenarios," said Robert Lapus, M.D., an emergency medicine physician with Children's Memorial Hermann Hospital and The University of Texas Health Science Center at Houston (UTHealth). "Definitely more than someone shooting them with a water gun or just playing in the bathtub." Parents who notice a scenario like the one Lapus described should keep an eye on their child for the next several hours, looking out for symptoms like coughing, confusion or trouble breath- ing, with indicators like chest retrac- tions and flaring nostrils. There has never been a published case where a patient was initially asymptomatic and later deteriorated or died. — CORRIE CHUMPITAZI, M.D. Emergency medicine physician at Texas Children's Hospital