Morgan Shirley, 7, leaps into Mabel Davis Pool. Shelby Tauber / AMERICAN-STATESMAN

The story of the 4-year-old boy who died in Houston from “dry drowning” has parents everywhere wondering what is “dry drowning” and do I  need to be worried about it?

“Dry drowning” is an outdated term, says Dr. Eric Higginbotham, medical director of the emergency department at Dell Children’s Medical Center of Central Texas. Instead doctors think about about it as just drowning. It’s the drowning that happens after you’re out of the water.

What happens?

A kid goes under water and comes up coughing. He probably inhaled water that hits the vocal chords, or he inhaled water that gets under the vocal chords and gets into the lungs.

A minimal amount of fluid can cause the surfactant in the lungs to become inactive. Surfactant is a a fluid secreted by the alveoli (the tiny air sacs in the lungs) that prevents the alveoli from collapsing.

When the surfactant becomes inactive, the alveoli become sticky and collapse instead of lubricated and open. As more and more of them collapse, atelectasis happens. It becomes hard to breathe and a kid goes into respiratory distress.

When do you know if you need to go to the emergency room?

People go swimming all the time, swallow water and come up coughing. In fact, it happened to Higginbotham recently at Deep Eddy Pool. He wasn’t worried because he was able to clear the water and go on with his day.

When you should worry is when a kid looks like he is in distress, feels uncomfortable in his chest, continues to cough or wheeze, or has an unusual amount of fatigue. That’s when you need to go to the emergency room. If you’re worried, go ahead and go.

Most of the time, this drowning will develop over the period of six hours and continue to get worse.


What do doctors do for kids who are drowning in this way?

They make sure that they secure the airway. They could need oxygen or a breathing tube. They could just need monitoring to make sure they don’t get any worse. There is some artificial surfactant that can be given as well.

How worried should I be about this kind of drowning?

Higginbotham says it is very rare. He’s much more worried about the kid who goes under the water and doesn’t come back up, that happens about 10 times a day in the United States. He reminds that drowning, especially in kids, doesn’t look like it looks like in “Jaws.” You don’t see them sputtering around on the top of the water. Instead, it is silent, and it happens quickly. They just disappear under water.

Brigitte Decato, a swim instructor with the Swim Safe program at the YMCA, works with Octavio Ruiz, 5, (center) on the backstroke. 2007 Laura Skelding AMERICAN-STATESMAN

What can I do to prevent drowning?

When a kid comes into the emergency room in cardiac arrest after a day at the pool, and you don’t get them back. “It’s a completely avoidable death. It’s something that does break your heart,” Higginbotham says.

He recommends:

Always have kids at arm’s length, where you can reach out and touch them. When they are in the water, you have to really watch them. Put kids in swimming lessons early, and swimming lessons that teach kids what to do if they fall into a pool: how to flip over, get to the edge and pull themselves out. They need to practice it so they don’t panic. Learn CPR. “Early bystander CPR really, really saves lives,” he says. Put kids in the right size, U.S. Coast Guard-approved life jackets.



Austin-based Colin’s Hope offers these water-safety tips:

Inside the house:

Never leave small children alone near any container of water. Keep bathroom doors closed and secure toilet lids with lid locks. Never leave a baby alone in a bath for any reason. Get what you need before running water, and take the child with you if you must leave the room. Warn babysitters or caregivers about the dangers of water and emphasize the need to constantly supervise young children. Make sure small children cannot leave the house through pet doors or unlocked doors to reach pools or hot tubs.

Outside the house:

Never leave children alone around water whether it is in a pool, wading pool, drainage ditch, creek, pond, or lake. Constantly watch children who are swimming or playing in water. They need an adult or certified lifeguard watching and within reach. Secure access to swimming pools with fences, self-closing and latching gates, and water surface alarms. Completely remove the pool cover when the pool is in use. Store and secure water toys away from the water when not in use, so they don’t attract a small child. Don’t assume young children will use good judgment around water. Be ready for emergencies. Keep emergency telephone numbers handy and learn CPR. Find out if your child’s friends or neighbors have pools.