Summer Terror

This week’s guest columnist is Dr. Jordan Conway, a Family Practice resident at the University Hospital and Clinics here in Lafayette.  

It started as a beautiful summer day- blue sky, hot grill, everyone visiting.  The kids were having a ball too, playing and swimming.  Then someone screamed- a toddler was at the bottom of the pool.  One party-goer jumped in to fetch the boy, another started CPR when he was lain on the concrete.  After some rescue breaths, the boy began to breathe, and was waking up when the ambulance arrived.  In the Emergency Department we admitted him for observation and he did fine, though the parents couldn’t quit crying.

“Submersion injury” comes in many severities.  Some kids fall in and are snatched out so quickly they barely know what happened.  Other kids are discovered too late and die.  In between are children who are resuscitated just in time, like our boy above, or survive but suffer some degree of brain injury.  How can these tragedies be avoided?

First, at pool parties you should designate an adult whose only job is to stay sober and monitor the kids.  It’s easy to become engrossed in conversation, help with the food, accept a cold beer, and lose track.  It doesn’t take long for toddlers to get out of sight either!  Losing track is even more problematic by lakes and rivers where the water is murky, and seeing lost children at the bottom and thus getting them out in time is pretty much impossible.  If they disappear, they’re gone.

The best way to avoid child drownings is not to have a pool.  Second best, the pool should be fenced on all 4 sides, meaning no patio door access.  The fence should be unclimbable, with a kid-proof lock.  If you’re by a large body of water, bring a playpen or other enclosure for the tots.  Knowing CPR is important to prevent drowning death after the patient has been submerged.  Most 12 year-olds are capable of learning and performing CPR.  Finally, although swimming lessons improve swimming ability, there’s no data that swimming lessons actually decrease the risk of drowning.  The American Academy of Pediatrics doesn’t recommend them for drowning prevention,

Kids can have wacky ideas about what’s hilarious, which parents DON’T AT ALL find amusing.  One day I thought it’d be funny to float face down in the pool and not respond when my mother called me.  She yelled and yelled, and when a family friend went to retrieve me. I picked my head up and smiled like nothing was wrong.  She was too freaked out to punish me, and only now as a parent do I realize how cruel that joke was.  I have since apologized.

Child drowning is often even more subtle than my ill-advised joke.  In particular, infants and toddlers, not knowing the danger when falling into a pool, sink to the bottom without making a sound.  They don’t thrash or scream.  Older kids too, when swimming and run out of gas, can slip under before they can call for help.  Therefore, as we said above, a sober adult dedicated to watching the kids helps prevent tragedy.  Also as we said above, the water in lakes, rivers, and oceans is murky, and hides drowning children.  You won’t see them after they sink, and thus they’ll be gone for good.

If a child is submerged, parents and bystanders need to be prepared to save a life.  One study showed that 14 out of 18 victims resuscitated by bystanders survived the event. This means knowing CPR.  It’s also clear that waiting for EMS to arrive without starting CPR seriously degrades the chance of survival.  If the child’s heart and breathing aren’t restarted by the time of arrival at the Emergency Department, the game is up.

So learn CPR.  Find a course near your at the American Heart Association website.  There’s almost weekly courses in the Lafayette area.  Every year around March the local AHA puts on the Be A Heart Starter event at the Cajundome, where over a thousand people learn CPR in one day, for free.  Children as young as 12 can learn the skills of CPR, using an AED (Automated External Defibrillator), and the Heimlich maneuver.

Drowning is preventable.  Through use of dedicated supervision, fences and other barriers, throwable floatation devices, and CPR, you may avoid losing a loved one this summer.