Dry Drowning

[Richard B the EMT]

OK, I just skimmed the article, but note that they do not address "Salt Water" versus "Fresh Water" drownings. Those are the only ones I have been familiar with, via my training, over my career. "Laryngospasm" was kind of a sub-topic, and then the instructor starts in with "Mammalian Diving Reflex".

[ERDoc]

Maybe I'm just being simple, but how do you have death without morbidity?

Or why categorize something as with morbidity when that should mean death, right?

Nope. You are confusion morbidity and mortality. Mortality is death. Morbidity is basically injury.

[firedoc5]

To cover an actual drowning, the lungs do not fill up with water. The epiglottis is still functioning cause the water to go into the stomach. Death is due to suffocation. Water in the lungs is secondary, not until a short period of death.

Between my father who had been on over 75 drownings/ recoveries in less than two years, and my experience sitting on the Coroners Inquest board. You'd be surprised what you can learn by doing that.

With what they explaining with the "dry drowning" is exactly what happens when water does get into the lungs, later causing asphyxiation secondary to laryngospasm and pulmonary edema in severe cases. At one time it was sort of explained to me it's like the gag reflex over reacts causing even more respitory problems.

[Flasurfbum]

I think that it would be safe to deduce, from what was gathered from the article, that this would be a fresh water drowning. I really can not think of any places that (still) have salt water pools.

Being in the Sunshine State, one of the nations leaders in drownings, especially in children, I will forward this to my instructor, the Chief of the Beach Patrol, and my classmates. Thanks for the story!

[ERDoc]

Here is an interesting little article to go with an old topic. Enjoy.

[Michael]

Here

Where?

[ERDoc]

Where?

Here

Do you want everything handed to you? I expected better from you Michael.

[Michael]

Do you want everything handed to you?

Only when I'm drowning, Doc, only when I'm drowning.

[NREMT-Basic]

This dry-drowning business is something that I had not heard of until recently. In EMT school, I was taught about drowning and near drowning...that is to say death from drowning and death from near drowning with death from drowning being immediate and death from near drowning being a death from complications secondary to the inhalation of water and occurring 24 to 48 hours after the actual event. When I spoke about this with a medical examiner friend, she stated that they will list manner and cause of death variously for water related deaths. It can be listed as "Manner: Accidental---Cause:Drowning" or "Manner: Accidental---Cause: Injuries or Illness Secondary to Near Drowning Incident" or as specific as "Manner: Accidental---Cause:Complications Secondary to Aspiration Pneumonia."

Oddly for some reason, my medic school syllabus has us studying environmental MOIs early on in the course so I will be interested to hear what the lifeguards from the Chicago area beaches that will be teaching us about drowning and water related MOIs will have to say in terms of how these are defined and differentiated.

I had also heard that aspiration of "clear" water and aspiration of salt water caused different MOIs if anyone can speak to this. What I have been told is that the clear water fills up the lungs, broncioles, etc and air simply cannot enter the lungs and salt water essentially corodes these structures causing them to fail and is generally the cause of what was defined above (read as I was taught....) as near drowning. As I live in IL, I'm not likely to deal with salt water aspiration any time soon, but I wonder if chlorine in pool water can have similar reactions with the structures of the lungs causing similar complications.

I also see that there has been some discussion in this thread about "swallowing" water and "inhaling" it. While I have heard the terms used interchangeabley ( as in when we used to vacation in the Land of 10,000 Lakes, we would hear that someone had "swallowed a lung-full of water). But to me the term "swallowing" anatomically speaking has to do with the act of taking something into the stomach and inhaling is taking something into the lungs. Obviously, if there is an epiglottal "malfunction" something can go where it isnt supposed to go. I also learned during a recent AHA CPR refresher that there seems to be a lot of confusion surrounding the term "choking" not in terms of how the AHA or other medical bodies define it (gonna run and look it up in Taber's) but in terms of people's (both lay and emergency responder) understanding of the exact mechanics of choking. Personally I was surprised at how many folks looked surprised in that recent class when the instructor said "if your patient is coughing or gasping, they are NOT choking." Everyone sort of looked like stunned dear on that one but it made perfect sense to me. I guess the best way to determine if it is actually happening is still to ask your patient "are you choking" cause Im thinking that pretty universally, if youre choking, you know it.

I look forward to the emergency docs among us pontificating on this since, as a new medic student, I have had to become much more involved with all matters cardio-pulmonary than I ever did as a Basic.

[Richard B the EMT]

NREMT-Basic, I can join in your confusion. Swallowing, to me, is going into the stomach, and aspiration is taking something what shouldn't be there into the lungs. Add a bit to the confusion, how many times have we heard of someone "Gulping for air" after being badly frightened, or after an unexpected heavy muscle usage?

As for the "Freshwater" versus "Saltwater" drownings, per the article cited, the salt content has nothing to do with anything, which means I have to unlearn something I've "known" for over 30 years.