How swim safety saves kids’ lives

On June 7, I spoke to a family medicine physician, Dr. Lauren Quan, at Dignity Health to discuss swim safety, including potential health outcomes and risks. Unlike the rhetoric of the media dramatizing the seconds in drowning to be loud with yelling and arms splashing, “Drowning can happen in an instant, often without any noise or noticeable signs,” Dr. Quan said.

In the span of two minutes, children who are saved from drowning do not suffer brain damage, but as submersion time increases, so do health consequences. “It can range from breathing problems to permanent neurological disability,” Dr. Quan said. It takes 10 minutes for drowning to result in severe cognitive impairment and motor deficits. In moments where a child is saved from drowning and is seemingly “OK,” they must be seen by a health provider regardless.

Some of the most common warning signs after drowning can be worsening or excessive cough, fast or hard breathing, difficulty breathing, vomiting, sleepiness or confusion. Symptoms can last up to eight hours after a drowning incident and require immediate medical attention. Shockingly, symptoms can sometimes occur four to six hours later.

Oxygen deprivation (asphyxiation) from drowning is known to cause brain damage, cardiac arrest and death. Oftentimes, people mistake drowning to be caused by water entering the lungs, but in reality, oxygen deprivation is the root issue.

Physiologically, drowning occurs in stages. First, water will enter the airway, leading to the body instinctively holding its breath. When oxygen levels drop, the shock and panic can lead to inhalation of water. The oxygen supply to the bloodstream decreases due to water filling the lungs. In the matter of minutes, organs begin to fail and hypoxia leads to drowning. Prolonged oxygen deprivation will cause the heart to stop beating, leading to cardiac arrest.

In these timely moments, CPR should be done immediately. Apart from completing a first aid certification to be qualified in performing CPR, there are more preventive measures to ensure water safety among children. Ninety percent of drowning cases are preventable, and they start with education.

Enrolling children in swimming lessons, wearing life jackets approved by the U.S. Coast Guard and having secure fences at least 4 feet high in residential pools are all great steps. Inside of homes, families should have bathroom doors closed and toilet locks to increase the physical barriers for accessibility. For those who are enjoying the summer heat at pool parties or lakes, remember to control alcohol intake when children and water are involved. Having a dedicated “water watcher” who is undistracted and sober is key.

As much as someone may recoil at the thought of infants being in a pool having to turn themselves over, putting them in swimming lessons can decrease the occurrence of drowning. This does not make it justifiable to leave an infant or child unsupervised, but “the idea is having multiple layers of protection,” Dr. Quan said. When it comes to water, one could never be “too safe.”

One large risk factor that is uncontrollable in comparison to others lies in children with preexisting diseases or disabilities such as autism or epilepsy. Autistic children gravitate toward “elopement,” meaning they try to escape from a place, activity or person. The lack of swimming proficiency and attraction toward water is a dangerous combination, requiring attentive water watchers during time spent in or around water.

As summer continues to bring warm days (hopefully at a courteous 75 degrees), remember children could always use multiple layers of protection as Dr. Quan said. July is a peak month when it comes to annual drowning fatalities in the U.S., but again, having the education and attention for water safety among children is a great place to start. Panicking in water ultimately leads to frightening outcomes in all ages, but lives can still be saved and individuals should feel empowered to take action under crisis.

Thank you to Dr. Quan and the Dignity Health team for reminding families to stay safe when it comes to water safety.

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