Sarah Denny, MD, FAAP
July 6, 2016
Every year, my extended family goes on vacation to a small lake in Maine, and every year, I get anxious about my kids sneaking out and drowning in the lake. We talk to them endlessly about boat and water safety, but kids are kids. I know words alone aren't always enough.
As a pediatric emergency department physician – and as a parent --I know that idyllic summer days can turn terrifying, or tragic. Last year, my boys were playing hide-and-seek with their cousins while the adults sat on the deck watching and finishing dinner. After a short time, all the kids had been found but my 5-year-old niece. Panic set it in – my sister and I immediately ran to the water screaming her name.
Thankfully, she was found a few minutes later, but those few terrifying moments served as a good reminder about the importance of constant supervision around water. More than 3,500 people die from drowning each year, according to the Centers for Disease Control and Prevention, and drowning is the leading cause of unintentional-injury related death among children between ages 1 and 4.
It is important for pediatricians to discuss drowning risk and prevention at well child visits, and in order to do that well, they need to know the risks based on the child's age and geographic location. Even more importantly, we need to educate families that swimming is a life skill, just like learning to cross the street, tie shoes or ride a bike. All kids should know enough swimming and water safety so that if they fall off a dock, out of a boat or get pushed in a pool by some fun-loving friends, they have the skills to get themselves to safety. In some cases, parents may not expose their children to water because they themselves are not comfortable around the water – what a great opportunity to learn as a family!
We know that children under age 1 are most likely to drown in the home – bath tubs, toilets, even buckets of water. Children between ages 1 and 4 are most likely to drown in a pool, and adolescents have a slightly higher risk of drowning in natural bodies of water. Like many other injury mechanisms, there is racial disparity in drowning rates, with African American and Native American children drowning at much higher rates than Asian and Caucasian children.
When we talk to parents about water safety, let's get back to the basics:
- Supervision – Talking to kids about water safety is essential, but it doesn't replace the need for constant supervision near water. Young children are impulsive and don't always remember everything we tell them. Drowning can happen in minutes – just short lapses in supervision can lead to a lifetime of heartbreak. Supervision around water is a job, and the person watching should not be distracted – no phones, no alcohol, no magazines. Inexperienced swimmers should be within arm's reach of a responsible adult.
- Life jackets – inexperienced swimmers should wear Coast Guard approved life jackets in and around water. Everyone should wear them on boats and personal watercrafts, and parents need to remember that they are role models. Studies show that children are more likely to wear life jackets when they see their parents wear them too.
- Cardiopulmonary resuscitation (CPR) – early CPR often is the difference between life and death, serious neurologic injury and good outcomes. Just this week, I took care of a child who had been submerged for 3 to 5 minutes, pulled from the water pulseless and blue. Thankfully, people at the scene started immediate CPR and by the time EMS arrived, he had a pulse and was breathing. By the time he got to me he was walking and talking, showing no neurologic deficits. All pool and boat owners should learn CPR, as well as families who spend a lot of time near the water.
Summer should be a time filled with happy memories. We need to make sure that as pediatricians, we are doing our part to keep children safe in and around water.
Sarah Denny, MD, FAAP, serves on the Executive Committee for the Council on Injury, Violence and Poison Prevention for the American Academy of Pediatrics (AAP) and the Board of Directors for the academy's Ohio Chapter. She works as an attending physician in the Section of Emergency Medicine at Nationwide Children's Hospital and as an Associate Clinical Professor of Pediatrics at The Ohio State University School of Medicine.