Be safe: Keep our children and youth from drowning

Drowning is a preventable public health issue.Since the beginning of the year, young people have died due to drowning in rivers, beaches, pools and stored water. It’s summer, and the beaches and rivers are being reopened after restrictions, so the risk of drowning may increase.

According to the World Health Organization, drowning is the third leading cause of unintentional death worldwide, accounting for seven per cent of all injury-related deaths. Children ages one to four, and five to nine years, are at the most significant risk, usually after a lapse in supervision.

Children age one to four years are mobile and can fall into open or water bodies (even a bucket of water), which they can’t get out of. Children who live near open water sources, such as rivers, pools or unsecured water storage containers, are additionally at risk.

Young people, especially males, are also at risk due to unsafe behaviour such as swimming alone or alcohol consumption before swimming.

WHAT DOES DROWNING LOOK LIKE?

Parents mistakenly believe that they will hear splashing or crying if their child was in trouble in the water. Young children who fall into water often make no noise and can be hard to see below the water surface. Drowning is QUICK and SILENT.

WHO IS RESPONSIBLE FOR SUPERVISION?

A lifeguard is not the primary person responsible for supervising a child. It is dangerous to leave a child entirely unsupervised in water.

A designated adult must be assigned as ‘water watchers.’ Their responsibility is constant supervision without engaging in any distracting activities.They should be constantly attentive, in close proximity (i.e., within arm’s reach), and be prepared to intervene.

For group outings with young people at a beach, river, or pool, have a buddy system if someone develops difficulties in the water.

In addition, supervisors need to know what a distressed swimmer looks like and how to intervene safely, if required .

ADDITIONAL MEASURES TO PREVENT DROWNING

• Never leave toddlers or small children unattended in the bath.

• Control access to water hazards by using barriers such as playpens, doorway barriers, pool fencing, pool covering, drain covering and tank covering. Pool gate alarms are useful.

• Remove or secure water hazards such as water drums.

• Use life jackets for weak swimmers, non-swimmers who are near or wading in water.

• Ensure safe boating policies, including life jacket use while boating.

• Prevent alcohol consumption during recreational water activities.

• Provide safe places away from nearby water sources, with supervised childcare.

TEACH CHILDREN TO SWIM

• Teach school-age children basic swimming and water safety – preferably a formal programme taught by trained instructors. In a low-income country such as Bangladesh, a Swim Safe programme was developed using community instructors to teach children to swim and rescue others.

• Children learning to swim should be screened for risk (e.g., for epilepsy, asthma, disabilities) and taught in clean, clear, shallow water with highly visible boundaries.

• Include parents in the water safety training, including how to rescue a drowning child safely.

• Train bystanders in safe rescue and resuscitation. Untrained people tend to help others in danger and can place themselves at risk of drowning. Training allows people to act more safely when performing a rescue.

THE ‘DROWNING CHAIN OF SURVIVAL’

The drowning chain of survival refers to a series of five steps that, when enacted, attempts to reduce deaths associated with drowning and attempted water rescue.The steps of the chain are:

Prevent drowning;

Recognise distress;

Provide flotation;

Remove water from water;

Provide care as needed.

The steps of the drowning chain of survival are unique because of the water environment. Flotation is necessary to keep the victim’s airway out of the water and facilitates getting them to land.

TIMELY INTERVENTION IS KEY

Death, or survival with moderate or severe neurological injury, appears to be increased with submersion duration of six minutes or longer, with the worst outcome after 10 minutes of submersion. The chance of survival with no brain injury increases if the child is submerged for less than six minutes and emergency response time is less than 10 minutes. The early rescue and initiation of bystander CPR facilitate improved outcomes.

The prevention of drowning is key. Pay close attention to the measures as outlined in this article.

Be safe! Observe all COVID protocols, and keep our children and youth safe from drowning this summer.

Dr Tracy Evans Gilbert is a consultant on paediatrics, tropical medicine and public health at the Cornwall Regional Hospital and senior associate lecturer at The University of the West Indies. This article is endorsed by the Paediatric Association of Jamaica.