Like a lot of people, I assumed that dry/secondary drowning was an actual thing due to news reports like this 2017 CNN story about a 4-year-old Texas child who supposedly died from the condition:
Frankie Delgado was playing in knee-deep water during a Memorial Day weekend trip to Texas City Dike when a wave from a distant ship knocked him over and his head went under, said his father, Francisco Delgado Jr. A family friend picked him up, and Frankie said he was OK.
“He had fun the rest of the day,” Delgado said. “I never thought nothing of it.”
The next night, Frankie began to vomit and have diarrhea. Delgado and his wife had taken the boy to the doctor for similar symptoms before and were told it was a stomach bug, so they decided to treat him at home. Doctors now suspect these symptoms were the result of the water he had inhaled the day before.
This story went viral, but Delgado didn’t die from drowning. According to Emergency Medicine News,
As it turns out, and as we expected, the results of the autopsy revealed Frankie’s cause of death was recurrent myocarditis. Few mainstream media outlets reported that, which stresses how important it is to continue the discussion and understand ED treatment and disposition for drowning.
Other outlets reported that Delgado’s myocarditis was caused by a virus, utterly unrelated to his brief submersion in water. Similar cases of “dry drowning” reported in the media appear to be caused by underlying medical conditions unrelated to exposure to water.
The Red Cross has a nice summary debunking the claims of dry drowning:
The terms dry and wet drowning were abandoned decades ago when the real culprit in drowning injury was understood. Drowning injury is caused by lack of oxygen; it is not about water entering the lungs. In the past, these terms were used to try to explain that some fatal drowning victims had very little water in their lungs at autopsy. Now it is understood that little water enters the lungs during drowning. Moreover, when water enters the lungs, it is rapidly absorbed when breathing starts again. The amount of water that enters the lung does not determine the amount of injury or determine the treatment of drowning. The amount of injury from drowning is due to how long the victim is without oxygen.15 Thus, not being able to breathe for longer than a few minutes leads to death or survival with severe damage. Not getting breathing restored after rescue also leads to death. The care of the drowning victim is the same regardless of whether water is present in the airways and lungs. The treatment of drowning is restoring breathing and oxygenation.
The Cleveland Clinic Journal of Medicine notes that the term secondary drowning is also not accurate or helpful:
Secondary drowning, sometimes called delayed drowning, is another term that is not medically accepted. The historical use of this term reflects the reality that some patients may worsen due to pulmonary edema after aspirating small amounts of water.
Drowning starts with aspiration, and few or only mild symptoms may be present as soon as the person is removed from the water. Either the small amount of water in the lungs is absorbed and causes no complications or, rarely, the patient’s condition becomes progressively worse over the next few hours as the alveoli become inflamed and the alveolar-capillary membrane is disrupted. But people do not unexpectedly die of drowning days or weeks later with no preceding symptoms. The lungs and heart do not “fill up with water,” and water does not need to be pumped out of the lungs.
There has never been a case published in the medical literature of a patient who underwent clinical evaluation, was initially without symptoms, and later deteriorated and died more than 8 hours after the incident.6,10,21 People who have drowned and have minimal symptoms get better (usually) or worse (rare ly) within 4 to 8 hours. In a study of more than 41,000 lifeguard rescues, only 0.5% of symptomatic patients died.
