The terms “dry drowning” and “secondary drowning” have cropped up in the media in recent years. While “dry drowning” and “secondary drowning” have been used to describe very real, medical ailments associated with drowning, the medical community generally does not use this terminology. 

That's because all “drowning is drowning,” says Dr. Michael D. Patrick, Jr., MD, an associate professor of pediatrics at Ohio State University, and an emergency medicine physician at Nationwide Children’s Hospital. It doesn’t matter if you’ve experienced a drowning event in which your lungs were completely filled with water, or if symptoms of drowning took a little bit of time to manifest, generally doctors refer to it all as drowning. Here's what you need to understand about these different events and the signs associated with them.

What are the signs of drowning?

Drowning is a “significant injury from being immersed in water,” Patrick says. When your lungs function normally, you inhale oxygen, which then enters your bloodstream. As you exhale, carbon monoxide exits your bloodstream and is released back into the air. 

If water enters the lungs, “your body can't extract oxygen from the water,” causing your body’s vital breathing functions to become impaired. Without an adequate supply of oxygen, suffocation can occur, he explains.

Drowning happens extremely fast, and significant injury can occur within 20 to 60 seconds. There are clear signs of drowning — someone is likely to be silent, still, stiff-armed, with their head bobbing up and down in the water, according to WebMD. 

What is ‘dry drowning’?

With “dry drowning,” water never actually enters the lungs, per Detroit Medical Center. Rather, when water is inhaled through the nose or mouth, a laryngospasm can occur, causing the muscles around the vocal cords to contract, Patrick explains. Consequently, this contraction restricts airflow to your lungs, and can also make it difficult to fit a breathing tube in your throat. A misconception is that this event could occur hours after exposure to water, but more likely this would occur immediately after exposure to water, he notes.

What is ‘secondary drowning’?

“Secondary drowning” is another rare situation in which the symptoms of drowning don’t appear immediately. “Sometimes you can get a little bit of water down in the lungs, but it's not enough water to actually impede oxygen delivery,” Patrick says.

How is it possible to experience “delayed” symptoms of drowning? Deep in our lungs, there is “a soapy substance called surfactant, [which] keeps the little tiny air sacs open,” he says. If enough water enters the lungs, it can wash away the surfactant, causing the air sacs in your lungs to collapse. Subsequently, “the body responds to that by actually drawing fluid into the lungs,” medically known as a pulmonary edema, Patrick says. 

The biggest myth associated with “secondary drowning” is that it can occur days after an event in which someone has been submerged in water. “It does not — it still is within 24 hours,” he adds. During this period, it’s absolutely essential to “keep a really close eye [on your] kids or anyone who's had any sort of event in the water.” However, “if they're fine at the 24 hour mark, they're going to remain fine,” Patrick says.

However, while these terms are thrown around in the media to describe very real ailments associated with drowning, in the medical community, “we don't really like to say, ‘delayed drowning,’ or ‘secondary drowning,’ because it's just drowning,” Patrick reiterates. 

What to do when you see signs of drowning

In the event that you or a loved one are experiencing the symptoms of drowning, including “a persistent cough, wheezing, tightness in the chest, [or] any discomfort related to the chest or with breathing,” it is imperative that you seek out medical attention and call 911, Patrick says.

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