Friday, July 24, 2015

Dry and secondary drowning

When the weather gets hot kids and their parents flock to the water, beating the heat by splashing around in oceans, lakes and pools.

The last place parents want to be flocking to during the summer is the emergency room, yet every year dozens of children end up there for drowning. This particular drowning doesn't occur while swimming though. It happens hours after the child has left the water, CBS New York station WCBS reports.

Sports medicine specialist Dr. Lewis Maharam explains to WCBS it is a condition known as "dry drowning" and it is landing a lot of kids in the hospital hours after swimming in the pool. He said it takes just a few teaspoons of water to go down the wrong way and into the lungs that causes this condition.

"Dry drowning" happens when children playing around in the pool or lake accidentally inhale water. They may cough, but then they seem fine. But, sometimes, they are not fine.

"They had a normal day and then they go to bed and they're coughing or they're wheezing or their parents see bubbling from the mouth," Dr. Maharam explained.

Dr. Maharam said the lungs are irritated and start to secrete fluid -- and as a result children can actually drown in their body's own fluid.

WCBS spoke to parents at a Long Island pool and asked what they knew about the condition. One parent said she was shocked, and especially shocked it can occur nearly a day after leaving the water.

"This is why it's so important to get the word out," Dr. Maharam said.

The symptoms can include lethargy, irritability and trouble breathing.

Jim Hazen with the swim school Safe-T-Swim advises caregivers to go straight to the emergency room, not the pediatrician, after noticing a problem after their child has been in the water.
Hazen says most cases are treatable and preventable.

"The prevention is obviously adult supervision, number one, learn to swim, number two," Hazen said.
WCBS reports that research shows not all children are susceptible to "dry drowning." And while it can also happen in adults -- it's rare.

http://www.cbsnews.com/news/kids-can-drown-hours-after-swimming-experts-say/

If you're like most parents, you probably figure once your child is done swimming or playing in the water, his risk of drowning is over. But "dry" and "secondary" drowning can happen hours after he's toweled off and moved on to other things. There are steps you can take to keep your child safe.
These types of drowning can happen when your child breathes water into his lungs. Sometimes that happens when he's struggling while swimming. But it can be a result of something as simple as getting water in his mouth or getting dunked.

It can happen to adults, but it's more common in kids because of their small size, says Raymond Pitetti, MD, associate medical director of the emergency department at Children's Hospital of Pittsburgh.
 
With dry drowning, water never reaches the lungs. Instead, breathing in water causes your child's vocal chords to spasm and close up after he's already left the pool, ocean, or lake. That shuts off his airways, making it hard to breathe.
 
Secondary drowning happens a little bit differently. Your child's airways open up, letting water into his lungs where it builds up, causing a condition called pulmonary edema. The end result is the same: trouble breathing.
 
Symptoms of dry drowning usually happen right after any incident in the water. Secondary drowning generally starts later, within 1-24 hours of the incident, Pitetti says.
 
Both events are very rare. They make up only 1%-2% of all drowning incidents, says James Orlowski, MD, chief of pediatrics at Florida Hospital Tampa.
 
Symptoms
Dry drowning and secondary drowning have the same symptoms. They include:
  • Coughing
  • Chest pain
  • Trouble breathing
  • Feeling extremely tired
Your child may also have changes in behavior such as such as irritability or a drop in energy levels, which could mean the brain isn't getting enough oxygen.
What to Do
If your child has any signs of dry drowning and secondary drowning, get medical help. Although in most cases the symptoms will go away on their own, it's important to get him checked out.
 
"The most likely course is that the symptoms are relatively mild and improve over time," says Mark Reiter, MD, president of the American Academy of Emergency Medicine.
 
Any problems that do develop are usually treatable if you get medical help right away. Your job is to keep a close eye on your child for the 24 hours after he or she has had any problems in the water.
 
If the symptoms don’t go away or get worse, take your child to the emergency room, not your pediatrician's office.
 
"Your child will need a chest X-ray, an IV, and be admitted for observation," Pitetti says. "That can't be done in an office."
 
Because there are no drugs for dry or secondary drowning, your child will probably get "supportive care" at the hospital. This means checking that his airways are clear and monitoring his oxygen level. If he's having severe trouble breathing, he may need to temporarily use a breathing tube.
 

5 comments:

  1. Whitner Milner was a sport spear fisherman who was training in his family's backyard pool to hold his breath for longer periods when something went wrong. That's when Rhonda Milner found her son at the bottom of the Atlanta pool on April 17, 2011.

    “And then I, you know, tried to stir him and didn't realize I couldn't,” she said.

    Whitner Milner, 25, had passed out and drowned. An avid spear fisherman and accomplished free diver, he’d fallen victim to shallow water blackout, in which people who are trying to hold their breaths for an extended period essentially pass out underwater because of oxygen deprivation to the brain...

    “We usually say 30 seconds is about the limit. Certainly we don’t want people holding their breath for more than a minute because a child can drown within 90 seconds," Griffiths said.

    Several shallow water blackouts have been caught on underwater surveillance video. In one video, a 13-year-old boy struggles to stay conscious, then slowly sinks to the bottom of the pool. Helps comes just in time. In another video, an experienced 18-year-old swimmer can be seen sinking seconds before being rescued.

    Shallow water blackout-related deaths can be hard to track, but at least seven cases have been documented across the country, according to figures from the New York City Department of Health. Griffiths told “GMA” that most shallow water blackouts happen in water that’s between three and four feet deep, not at the deep end of the pool.

    Milner founded Shallow Water Blackout Prevention to raise awareness about the hazard that claimed the life of her son.

    “I had never heard of shallow water blackout before our son died,” she said a YouTube video in which she tells her son’s story.

    http://abcnews.go.com/US/shallow-water-blackout-warning-issued-breath-holding-pool/story?id=31457519

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  2. Shallow Water Blackout Prevention - The Whitner Milner Story
    https://www.youtube.com/watch?v=miG8J2-u_JI

    www.shallowwaterblackoutprevention.org/

    How does the body get tricked into thinking it has plenty of oxygen?

    Usually, we let our bodies take control of breathing - we don't have to think about when to take a breath, it's done automatically. This way the body can best regulate the levels of oxygen and carbon dioxide. Of course, sometimes we take control of breathing for ourselves and we need to know if we are taking enough breaths. The way we know this is by the sensation we get when our carbon dioxide level gets high - an overwhelming desire to breathe. For some reason we don't have the same feeling when our oxygen level gets low. If we hyperventilate, or possibly if we breath-hold after prolonged vigorous exercise, our oxygen levels can go critically low whilst our carbon dioxide level isn't high enough to make us uncomfortable. By doing these things - breath-holding and hyperventilation – we are going outside the body's "design limits" which is hazardous. It is worth remembering that hyperventilating won't actually get any more oxygen into your body - it just gets rid of carbon dioxide.

    http://www.shallowwaterblackout.org.uk/faqs

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  3. While spending a muggy, summer afternoon with friends swimming, Ezra, 3, who doesn't know how to swim, jumped in the pool and went under for a snap second until an adult pulled him up. His mom, Darcy McQueeny, thought that was the full episode, but hours later, she rushed him to the ER for a dry drowning episode.

    Ezra usually swims with floaties on his arms, but when he jumped in the pool, he wasn't wearing them. An adult in the pool pulled him out of the water in seconds.

    "Ezra was never unconscious," Darcy told Yahoo Parenting. “He coughed up a lot of water and said that his chest hurt, but he was talking the whole time.”

    However, mom noticed he was falling asleep at dinner and coughing. Wasting no time, she rushed her child to the ER.

    "Everybody looked at us like, ‘He seems fine,’” she said. But at 10 p.m., the preschooler's mom says his eyes glazed over, describing him as "there, but not really there.” He was dry drowning. Thankfully, he was at the hospital, and doctors were able to revive him.

    Darcy posted a photo to her Facebook page, hoping to educate other parents.

    “Please take a good look at this photo,” she wrote a day after the accident. “He only went under for less than 30 seconds."

    http://www.parenting.com/news-break/mom-shares-sons-dry-drowning-photo-warn-parents

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  4. The death of an elite college swimmer has drawn attention to a dangerous condition called "shallow water blackout," which can threaten even the most skilled swimmers.

    Tate Ramsden, 21, died this week while doing laps at a YMCA in Sarasota, Florida, according to a police report. Despite being a member of the Dartmouth swim team, Ramsden had to be pulled from the pool by lifeguards who attempted to save his life.

    The student had already swum 4,000 yards when he attempted to swim four additional laps without taking a single breath, police said. Competitive swimmers train to take a minimal number of breaths in order to swim faster.

    But such training without breathing can lead to a dangerous condition called "shallow water blackout."

    It can occur when swimmers hold their breath until they blackout, after which the body forces a breath and inhales water. The severe lack of oxygen can lead people to blackout "without warning" so they don't surface for air before becoming incapacitated, according to the Shallow Water Blackout Prevention Organization.

    Dr. Rhonda Milner, a retired radiologist and founder of the organization, said it's key for advanced swimmers to understand that extreme training can be dangerous without proper supervision.

    "It's another tragic event; it's completely preventable," Milner told ABC News today. "One of my current concerns, he was an excellent swimmer; he didn't understand that he was putting himself at risk."

    Milner pointed out that if swimmers hyperventilate before breathing, their bodies may not build up the carbon dioxide that signals the body to take a breath, meaning they can pass out before they realize there's a problem.

    The same problem can occur if a swimmer works out with few breaths, leading to insufficient oxygen levels.

    "You can ignore your urge to breathe; you get endorphins," like a runner's high, Milner said. "You're set up for really putting yourself at risk."

    Milner, who started the foundation after her son died from a shallow water blackout-related drowning, said coaches must warn swimmers to be careful about trying to hold their breath for extended periods of time and not rely on lifeguards, who may not be used to seeing such cases.

    "It should only be done in practice where they're really closely watched," Milner said.

    http://abcnews.go.com/Health/elite-swimmer-tate-ramsdens-death-spotlights-dangers-shallow/story?id=35991838

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  5. Health Alert for Parents: Secondary Drowning

    http://abcnews.go.com/GMA/video/health-alert-parents-secondary-drowning-31229656

    ReplyDelete