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How a Shot Glass of Water Can Cause Deadly Dry Drowning

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Drowning may seem like a distant concern, but it’s more prevalent than many realize. It can occur not only during summer water activities but also during everyday routines like showering or bathing. Small children are particularly vulnerable; even a small amount of water—equivalent to a shot glass—can cause respiratory distress and potentially lead to death. 

Understanding Dry Drowning

While traditional drowning occurs in water when fluid enters the airway, dry drowning happens outside of water. Our lungs contain air sacs called alveoli, which facilitate air exchange during breathing. Water entering the lungs instead of air can gradually damage the alveoli, leading to inflammation and constriction that obstruct breathing. Consequently, even a tiny amount of improperly inhaled water can result in drowning.

Even a Small Amount of Water Can Be Dangerous

Alveoli can become critically compromised when just 2 to 3 cc (0.07-0.1 fl oz) of water enters the airways for every kilogram (2.2 lbs) of body weight. This amount is roughly equivalent to a single shot glass of liquid for small children. Such a small quantity can cause severe respiratory distress and, within minutes, could lead to death.

Situations Where It Can Occur

Dry drowning can occur when a child who isn’t a strong swimmer unexpectedly jumps into the water or is pushed in, leading to involuntary water intake that can block the airway. It can also happen during everyday activities, such as when children drink water too quickly or accidentally swallow water while showering.

Difficult to Detect Early

Identifying dry drowning early can be challenging, as initial symptoms may not manifest if the amount of inhaled water is just below the dangerous threshold. Symptoms such as respiratory distress may suddenly appear hours later, resembling traditional drowning symptoms despite occurring outside of water. 

Causes: Excessive Laryngeal Spasm

One primary cause of dry drowning is excessive laryngeal spasm. This reflexive response occurs to prevent water from entering the lungs. However, if the larynx is overly sensitive, even a small amount of water can trigger a strong contraction, preventing it from reopening and leading to difficulty breathing.

Complications from Pulmonary Edema

Another cause involves complications from pulmonary edema. A small amount of water can lead to secondary complications such as pulmonary edema or pneumonia, which results in respiratory distress. In these cases, warning signs like coughing, chest pain, and decreased consciousness may appear, potentially even up to eight hours after water has entered the lungs.

Common Symptoms to Watch For

Dry drowning should be suspected if coughing, chest pain, difficulty breathing, fatigue, or unusual behavior occurs within 48 hours of water exposure. The most common symptom is coughing. If a child coughs excessively or struggles to breathe after water activities, seeking medical attention is advisable. In severe cases, symptoms may escalate to decreased respiration, lowered pulse, and cyanosis (bluish skin discoloration). 

Most Vulnerable: Children Under 5

Children, especially those under the age of five, require heightened vigilance regarding the risk of dry drowning. Due to their smaller body size, even a minor amount of water poses a greater risk. Additionally, young children may have difficulty communicating their distress, and their underdeveloped airways make it easier for water to enter. Close observation is essential during water play, bathing, or even drinking, as small amounts of water can easily lead to airway complications.

What to Do If Dry Drowning Is Suspected

If dry drowning is suspected, it’s crucial to administer the same cardiopulmonary resuscitation (CPR) measures as you would for drowning. Start by checking for breathing and pulse, prioritizing the oxygen supply to the lungs, as most individuals can recover well with prompt intervention. Avoid applying excessive pressure on the abdomen to expel any water, as this could cause stomach contents to regurgitate and block the airway or potentially harm internal organs.

Always Wear a Life Jacket, No Matter How Shallow the Water

Wearing a life jacket, regardless of the water depth, is essential when engaging in water activities. Watch for signs of someone swallowing water or needing rescue assistance. For children, it’s crucial to monitor their condition even after water activities have concluded.

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