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Drowning happens quickly and it happens quietly

Learn how to keep your children safe

When you’re at the beach, waterpark, or backyard pool with your kids, drowning may not be the first thing on your mind. But, in addition to the sunscreen, towels, pool toys, and snacks, it is important to bring your water safety skills and drowning awareness with you.

Drowning is a leading cause of accidental death and is the second most common cause of death in children aged 1-4, second only to birth defects. Yet that is only part of the drowning picture.

There has been a lot of press of late regarding the phenomenon of “dry drowning” or “secondary drowning,” which occurs when a person who is experiencing a submersion injury then aspirates, or breathes water into his lungs. This is very rare, occurring in approximately 1 in 100 nonfatal submersion injuries. The person may initially appear well but the inflammatory reaction and/or laryngospasm (throat closing) that has been triggered may cause symptoms up to 24 hours after the incident, and can even lead to death. Thus, anyone who experiences a near-drowning incident, even if feeling fine, should not return to the water for at least 24 hours and should seek medical attention if experiencing any shortness of breath or coughing.

In addition to the secondary drowning phenomenon of lung injury, nonfatal (“near”) drowning incidents often involve significant hypoxia, or lack of oxygen to the brain, which may result in permanent brain damage, organ injury, lung infections, and other significant problems.

Drowning can happen quickly and quietly – even with adults nearby, and even with a lifeguard present. The best way to save children from drowning is to prevent them from getting into trouble in the first place.

Swimming pools must have a fence on all four sides and a locked gate at all times, so children cannot gain access to the pool without an adult’s awareness. Fences have been shown to reduce the risk of drowning by 83 percent compared with three-sided fencing. The fence should be at least 4 feet high with a self-closing and self-latching gate that is out of reach of children.

When children are in the pool, there should be at least one adult assigned as a designated watcher, who pays attention at all times and is within an arm’s reach of younger children (i.e. “touch supervision”). It is very easy to lose track of a child while engaging in other distracting activities such as reading a book, cooking on the grill, talking or texting on the phone.

Children should be taught how to swim. Formal swimming lessons have been shown to reduce the risk of drowning in children as young as 1-4 years. An adult should always be monitoring, however, regardless of the child’s abilities. Older children and adults should learn how to be safe in natural water environments (e.g. how to deal with rip currents) and understand the importance of using the buddy system.

When doing watersports or boating, adults and children should wear Coast Guard approved life jackets (swimmies and pool noodles are not life-saving devices!). No running near the pool, pushing others underwater, or other unsafe roughhousing. And, children should be taught never to hyperventilate before or attempt to hold their breath for a long time when going underwater, as this can cause them to black out and drown.

Finally, it is important to learn CPR. Seconds count in drowning, and knowing what to do before emergency medical services arrive can save a life.

What to do in an emergency:
If you find a child in the water, immediately pull him out of the water while calling loudly for help. Ask a bystander to call 911. If the child is not breathing, CPR should be started immediately. In drowning, unlike other situations, the first thing to do is to give two rescue breaths. If the victim does not respond to the two breaths, then start full standard CPR, including the use of an AED (automated external defibrillator), which if available, should immediately be started while awaiting further help. The Heimlich maneuver is not helpful in drowning. As for concerns about neck injuries, according to the current American Heart Association guidelines, immobilizing the victim’s neck is not a priority and should not be done as it may interfere with the administration of life-saving CPR.

Drowning is preventable. So, remember to have fun and enjoy splashing in the water, but remember to enjoy the water safely!

Stacey G. Fox, MD, FAAP, is a Board Certified Pediatrician with Beacon Pediatrics, which is affiliated with Beebe Healthcare. Beacon Pediatrics is now accepting new patients and is also available for scheduled urgent appointments for children who are visiting the area. The office is located at 18427 John J. Williams Highway, Suite 212, Rehoboth Beach, DE 19971. For more information, call (302) 645-8212 or go to

Dr. Fox comes from three years of private practice experience in Pennsylvania. She also worked and taught medical students and residents in the Emergency Department at St. Christopher's Children's Hospital in Philadelphia for four years.