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Parenting

A Wet End for Scott?

By Dr. Scott Hamilton
July 14, 2017

The Louisiana Health Department has made child drowning prevention a priority for 2017, since our state has the second highest rate in the nation.  Though I always cared deeply about this, it' now more important for me since I recently almost drowned off Grand Isle. On a beautiful day at the beach, our teenagers were congregating off shore on their inflatable "island."  They insisted on dragging it out to the second sandbar, requiring a swim to reach .  After quaffing a beer, I decided to swim out to visit them. Though I'm in pretty good shape, I'm not a strong swimmer ("suck" best describes my aquatic prowess).  As I paddled out the wind was blowing against me.  I rolled on my back to rest, but waves kept breaking over my face.  I was running out of gas and beginning to struggle and still wasn't near where I could touch bottom. Let's pause and examine what I did wrong.  Being in the water is fun, but for some their desire outmatches their abilities.  Some kids will jump into the water even if they can't swim.  Some, like me, overestimate their ability and go too far. Drinking and swimming is also a bad idea.  Alcohol impairs judgement, whether you're going for the swim, or if you're tasked with keeping the toddlers safe around a pool. Here's what I did right, postponing my funeral. Out on the party island was my friend Dayle.  Dayle grew up swimming on swim teams, and worked every summer as a life guard.  I knew that if I did have trouble, help was 30 yards away. So when I began to splutter and panic that the end was near, I yelled "Dayle, help!" and in seconds he was buoying me up and towing me to safety. The lessons are clear.  Know how to swim; get your kids lessons.  Swim within your abilities.  Don't drink and swim.  Make sure there's a lifeguard, though it doesn't have to be your best friend Dayle. More than I hate drowning myself, I hate it happening to kids.  When a child comes in in full arrest from drowning, we almost never get them back, and it's horrible to have to tell a family that their child's dead. When a child survives an episode, it's called "near-drowning." Last month I had this case of near-drowning:  The 4 year-old child was home in the pool with friends.  Later they came in the house to mom, yelling that the child had choked when his face went in the water.  Fortunately, he got out of the pool and seemed alright. But mom had heard about "secondary drowning," and brought the child to us. Secondary drowning is when a child almost drowns, but is plucked out, revived, and seems fine. However, the child gets a little bit of water down their windpipe (a teaspoon is enough), and goes awhile without oxygen. This combination can injure lung tissue, where fluid weeps into the airways, a process called pulmonary edema.  The patient begins to have trouble breathing through that fluid, needs oxygen support, and is admitted into the hospital for observation. I examined the child and thought: I could declare him fine, which he probably was, and send him home, but run the risk that he could get sicker.  I could admit him for observation, which was probably overkill, when the kid's fine and will just jump up and down on the hospital bed all night. I took a middle route.  After hearing no sounds of lung wetness with my stethoscope, I did a chest xray.  When there were no signs of pulmonary edema, I reviewed the risks. By report this kid didn't go without oxygen- never turned blue, didn't stop breathing. His mom was cool-headed, and could be trusted to come back if he worsened.  And pulmonary edema onset is slow- mom would have plenty of warning that the child needed to return to the hospital. Never let drowning happen to your kids.  Get them swimming lessons.  Don't have a pool or pond that toddlers could slip into unnoticed, or gate it if you do. Have someone remain sober at pool parties, whose only job is to watch the kids and not be distracted by conversation and beer.  And know CPR- near-drowning survivors are resuscitated at pool side.  Not in the ER.