MOST types of drowning aren’t as obvious as the hands-flailing-in-the-air, “Help-I’m-drowning” scenes we see in the movies.

    In reality, most types of drowning are subtle, quick, and silent. One can happen hours after one has gotten out of the pool, ocean or bathtub. And the most mysterious type of drowning does not even require water in the windpipe. Here’s what drowning can mean, and how it looks across cases.

    Wet

    Wet drowning is the classic case you imagine in your mind when someone mentions drowning. “If you think of what happens when you’re caught underwater and holding your breath, the body eventually inhales liquid,” says emergency medicine physician Darria Long Gillespie, an assistant professor at Emory University School of Medicine. “The liquid floods the lungs, harms the lining and you can’t take in oxygen. This is the most common type.”

    Dry

    In roughly 10 to 15 percent of deaths by drowning, victims are found with no water in the lungs. “The throat reflexively closed before they hit water, and they died,” says Gillespie. “For a while, though, doctors wondered, does it really exist?”

    There was no obvious explanation for dry drowning, although experts have come up with a couple of theories. One is that the initial flood of water causes the throat to close up, and victims die by asphyxiation. The other is that victims go into shock upon hitting cold water, the heart stops suddenly, and they go into cardiac arrest.

    Silent

    Drowning in the movies is a wild event. Arms are flailing, water splashes, and the victim is calling for help. In reality, drowning is often a very quiet moment. There is no warning, and no sounds. The victim often just slips away and is found later on. Drowning is something Hollywood gets wrong.

    Active

    That said, there are rare times when a drowning victim is fighting. Active drowning refers to the state of the victim when they’re found in the water. The person is likely upright, they are treading water, trying to keep themselves above it, and their hands are flailing. They are also likely trying to grasp for the rescuer.

    This whir of motion is actually dangerous for the person attempting to make the save, and they must use extra caution in the water. The drowning victim may latch onto a rescuer, and potentially drag them underwater.

    Passive

    When a victim is unconscious, usually in the later stages of a drowning episode, it’s referred to as passive drowning upon rescue. They are generally facedown in the water instead of upright. Sometimes they aren’t on top of the water, but floating a bit under the surface, and they are unresponsive.

    Secondary

    Most people aren’t aware of secondary drowning, but it can be frightening. “Someone was submerged, they did not die, came out of the water and initially seemed fine — and that’s what is so dangerous,” says Gillespie.

    While under the water, the secondary drowning victims inhale a small amount of water, which damages the lining of the lungs and causes inflammation. “If the lung lining is damaged, it can’t transmit oxygen, and the body is also leaking fluid into the lungs as a result of the inflammation.” This fluid accumulates in the hours following an episode, and the victim can slowly and silently drown after the fact.

    Especially with children, parents should watch for the signs of secondary drowning for around 24 hours after a drowning episode. “When an adult is drowning, they can keep their head above water,” Gillespie says. “When it’s a child, they can’t always keep their head above the water.”

    If your child experiences a near-drowning, or is sucked under the surface and inhales water, look for the signs. These include excessive fatigue, constant coughing, breathing abnormally, and vomiting — the latter of which is important, and occurs in about 60 percent of secondary drowning cases, according to Gillespie. Other changes in behavior, like acting out of character or soiling themselves, should also be noted.

    Dangers by setting

    In addition to presentation, Gillespie says drowning also carries dangers that are setting-specific. A lake drowning episode usually involves different factors than a hot tub incident.

    Any place with pooling water can present danger, especially for children. In swimming pools, hot tubs and spas, beware especially of suctions that can trap hair, and overcrowding, where struggling kids can slip underwater without notice.(SD-Agencies)