Dry Drowning?

[BJJVP]

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What to know about 'dry drowning' after 4-year-old's incident

This article got my attention because:

1) I didn't think it was entirely accurate.

2) It is only going to make the general public panic unnecessarily. From the comments section:
"Terrifying. This is also why nobody should ever refuse to get checked out out in the ER after being rescued from the water if they got any in their lungs."

3) I was ready to blow it off as bad reporting by non-medical news people until I saw it was written by an EM physician.

 

[deleted109597]

It doesn't exist. I wish the lay public would get it through their heads.

 

[deleted109597]

"Dry Drowning" is not an accepted medical term as it is a disease entity that does not exist. For more information visit http://goo.gl/PQ3dxB or contact @904Schmidt

 

[Psai]

There is a strong genetic predisposition in those with parents that have fibromyalgia

 

[gro2001]

Yeah, a little upsetting that he would use a term that is no longer encouraged. Just to clarify: we don't use terms like dry drowning or secondary drowning any more. Drowning refers to any respiratory distress experienced after being submerged in or exposed to liquid. Although I agree that the article is far from accurate, I think the take away by a typical layman would be that children can have breathing problems after being exposed to water and you should take them seriously, which is not a terrible takeaway IMHO.

 

[Birdstrike]

Pulmonary edema certainly exists. And no, it's not a surprise a portion of people might get it after inhaling a bunch of nasty chlorine water full of quaternary ammonium compounds, muriatic and cyanuric acid, or salty ocean water mixed with sand, dead seaweed particles & fish poop. I don't need a poorly written fake news article going viral on Facebook to tell me that.

But "pulmonary edema" doesn't sound cool, like "dry drowning" does.

You gotta let people have it. It's like their "spider bites," "mold toxicity," the "Arthur Itis" that comes with the rain, their flu shot that "gives them the flu" and their "seat belt that makes them more likely to die in an accident."

Oh, and don't forget, "Grandpa lived till he was 99 and he smoked unfiltered Pall Malls since he was 13 and drank a pint of Everclear every night before bed. So if I stop doing that stuff, I'll die."

You just gotta let 'em have it.

 

[RustedFox]

Worsening post-traumatic arthritis during (and just before) a rainstorm is a very real thing. Wife broke wrist last year, and before every "afternoon Florida thunderstorm" she has that compression brace on and the ibuprofen bottle finds its way to the kitchen countertop.

 

[GonnaBeADoc2222]

I'll "let em have it" but I'm not making clinical decisions based on it. No chance I'm admitting a kid with rock solid vitals who's bouncing off the walls eating doritos.

 

[Birdstrike]

Worsening post-traumatic arthritis during (and just before) a rainstorm is a very real thing. Wife broke wrist last year, and before every "afternoon Florida thunderstorm" she has that compression brace on and the ibuprofen bottle finds its way to the kitchen countertop.

About 2/3-3/4 of my patients complain about this phenomenon every time the weather gets cold or rainy.

 

[Birdstrike]

I'll "let em have it" but I'm not making clinical decisions based on it. No chance I'm admitting a kid with rock solid vitals who's bouncing off the walls eating doritos.

There’s no reason to admit. Orange artificial-cheese power on the finger tips and around the oral opening is 100% predictive of a positive outcome.

 

[RustedFox]

About 2/3-3/4 of my patients complain about this phenomenon every time the weather gets cold or rainy.

Straight out of Mrs.RustedFox's mouth: "I used to think people were crazy when they said things like that. Now, I can tell when the storm is coming. The wrist throbs and I can't hold the chef's knife as tight when making dinner."

 

[deleted109597]

Yeah, a little upsetting that he would use a term that is no longer encouraged. Just to clarify: we don't use terms like dry drowning or secondary drowning any more. Drowning refers to any respiratory distress experienced after being submerged in or exposed to liquid. Although I agree that the article is far from accurate, I think the take away by a typical layman would be that children can have breathing problems after being exposed to water and you should take them seriously, which is not a terrible takeaway IMHO.

Yeah, but it's stupid. She's crediting an article about myocarditis as saving her child from dying of aspiration pneumonia.
Jesus tapdancing Christ that's stupid. The takehome should be "if your kid is sick get them evaluated", not "this imaginary disease that we blamed for killing one kid even though it was unrelated MIGHT KILL YOURS TOO".
The fact that ABC is using a ***** for a resident to proof their medical papers is even worse. ACEP is going on the air today to fight this nonsense.

 

[Apollyon]

About 2/3-3/4 of my patients complain about this phenomenon every time the weather gets cold or rainy.

And you think it's all made up/not there? Thunderstorms, lower air pressure, joint capsule expands, pain. Ortho has known about this for, literally, as long as there have been orthopedic surgeons.

 

[Birdstrike]

And you think it's all made up/not there? Thunderstorms, lower air pressure, joint capsule expands, pain. Ortho has known about this for, literally, as long as there have been orthopedic surgeons.

No, I don't think it's made up. I believe people are telling me the truth in regards to pain and weather. However, we don't have a complete or adequate scientific explanation for it. Many things in this universe that are entirely real, don't have complete or adequate scientific explanations. "Joint capsule expansion" doesn't explain how perceived weather changes affect pain unrelated to joint conditions, which I see daily, also. Pain exacerbations from temperature changes (without pressure changes) don't explain it, either (body temperature doesn't change with slight air temperature changes). Regardless, it's irrelevant to me whether I can fully explain this or not, because I can't change people's report of past pain levels, and I can't change the weather. So I accept them for what they are. Only how I react to them, is within my control.

 

[RustedFox]

Its not a perceived weather change; its a measurable weather change. Check out what the change in atmostpheric pressure did to this plastic bottle.

Atmospheric pressure - Wikipedia

 

[Birdstrike]

Its not a perceived weather change; its a measurable weather change. Check out what the change in atmostpheric pressure did to this plastic bottle.

Atmospheric pressure - Wikipedia

I'll keep that in mind the next time one of my plastic bottles complains of 10/10 pain.

 

[Apollyon]

No, I don't think it's made up. I believe people are telling me the truth in regards to pain and weather. However, we don't have a complete or adequate scientific explanation for it. Many things in this universe that are entirely real, don't have complete or adequate scientific explanations. "Joint capsule expansion" doesn't explain how perceived weather changes affect pain unrelated to joint conditions, which I see daily, also. Pain exacerbations from temperature changes (without pressure changes) don't explain it, either (body temperature doesn't change with slight air temperature changes). Regardless, it's irrelevant to me whether I can fully explain this or not, because I can't change people's report of past pain levels, and I can't change the weather. So I accept them for what they are. Only how I react to them, is within my control.

Dude, why do you have to be so pugnacious? Joint capsule violated, low pressure, pain. Now, if your patients c/o "10/10" pain, that's a different kettle of fish. However, they come to you, a pain doc (it's right there in the name), and that's what they say. You equate that with the more spurious "spider bites" and "mold toxicity", the first of which are abscesses, and the second are crazy. But, the joint pain is real. What do I tell them? Me, as a NOT fellowship trained doc? Ice, ACE, elevation, NSAIDs, maybe a burst of steroids, and wait for sunny days to come.

But, as I said, you don't have to be so snarky and pugnacious.

 

[KGflyboy]

Hmm... I'm not denying g weather affects joint pain, but I don't think these explanations fully explain why it happens. Can someone clarify how ambient pressure changes affect internal organs (joint caosules)? There has to be more to this than simply stating air pressure changes the joint capsule. And about the temperature link... Does anyone have any data to show that ambient temperature changes of a few degrees, heck even 15-20 degrees, have a measurable impact on joint capsule temperature. If not, there has to be some missing link to this phenomenon beyond the usual explanations about pressure and temperature changes.

 

[Birdstrike]

Dude, why do you have to be so pugnacious? ...

I don't know. I wasn't trying to be.

Wait, though. Why are you pretending that what I say on here, matters?

 

[Birdstrike]

But, the joint pain is real. What do I tell them? Me, as a NOT fellowship trained doc? Ice, ACE, elevation, NSAIDs, maybe a burst of steroids, and wait for sunny days to come.

1 cc of 40mg/ml Kenalog with 3 cc of 1% lidocaine in a 5 cc syringe directly into the knee joint and you'll get a much better result than with an oral burst of steroids, which will deliver <1% of the steroid to the end target, with less systemic side effects. Identical technique as aspiration, just load the syringe with meds first. Well within your skills and scope as a residency trained EP. Then bill 20610 (for major joint aspiration/injection) along with your E&M code, for an extra $60 or so. Takes an extra 60 seconds, and everyone's happy: The patient, you, your group, Press Ganey, the hospital and the knee.

 

[RustedFox]

I'll keep that in mind the next time one of my plastic bottles complains of 10/10 pain.

Dude, why do you have to be so pugnacious?

I think its because he's not actually as happy as he says he is all the time on here. Just beginning to think that. Reaction formation?

My wife is not a "OMG 10/10" pain gal. I actually took care of her the night of the fracture and set her wrist myself. She gave a reasonable numerical answer (I think she said a "6" or "7") to what was an obvious Colles' fracture. When the pressure drops and the rain falls, its not "I need two percocet 10/325s", its ace wrap and 600mg ibuprofen.

 

[Birdstrike]

I think its because he's not actually as happy as he says he is all the time on here. Just beginning to think that. Reaction formation?

This has got to be a first time in the history of SDN that I'm being accused of appearing overly happy.

 

[deleted109597]

Its not a perceived weather change; its a measurable weather change. Check out what the change in atmostpheric pressure did to this plastic bottle.

Atmospheric pressure - Wikipedia

It turns out that knowing science might actually help us be better doctors.
But this anecdotal stuff is all BS.
The influence of weather on the risk of pain exacerbation in patients with knee osteoarthritis - a case-crossover study. - PubMed - NCBI
Acute Low Back Pain? Do Not Blame the Weather—A Case-Crossover Study | Pain Medicine | Oxford Academic

People extoll the virtues of acupuncture and essential oils. There are people out there that believe they have the power to turn off sensor lights. You know what it is? Recall bias.