Water Safety

I would like to carve out a few minutes to splash some attention on water safety! I am passionate about water safety both from a Pediatric perspective and from having completed medical school in Florida and subsequent training in Residency and Fellowship in Hawai'i, two states where water is a part of everyday life. In reality, water sources are everywhere inside and outside the home all over the world, in every state and country.

As a Mother, I am acutely aware of the draw of the water and my mermaid daughter’s at times overconfident love for getting in any body of water possible including “da drink” as we at times affectionately refer to the ocean here in Hawai’i.

I am extremely passionate about this topic having worked with numerous families with my background both in Pediatrics &Sports Medicine and in Mental Health Counseling &Hospital Social Work prior to entering my career as a Physician. I have been part of the care of many children who have recovered from submersion events, and I have also been present in the acute grief and devastation that I will carry with me forever in the presence of family’s who have lost otherwise healthy young children to drowning.

Important Points for Parents Regarding Keeping Children Safe Around Water During the Summertime (And Year Round)

Parents and caregivers need know that water vigilance and having a safety plan is imperative to keeping their children safe around water this summer and year round. Water safety issues typically stem not from a lack of good parenting, but from momentary lapses in the inevitable colorful chaos of everyday life while curious young children navigate themselves to a water source, or a temporary interruption which deflects the caregivers attention elsewhere.

There is no substitute for children possessing the skills to be safe in the water should they fall in or become submerged in some capacity. The safest solution when a young child will be around a pool or water source such as the ocean is to have enrolled the child in infant or child swim classes so that the infant or child acquires life sustaining water safety skills. Learning to turn onto their back and float and potentially make their way to the side of the pool can mean the difference between life and death, helping to provide the parent/caregiver time when they realize the child is missing.

If possible for a home pool or exposure to a pool, ensure it is fenced on all four sides with a lock/latch mechanism in place. Swimming around lifeguards when possible is also recommended, although not a substitute for parental supervision.

There is also inherent danger in water sources and young children when in crowds or at family/social gatherings. In these settings, parents/caregivers can be lulled into a sense of security that someone is watching due to the amount of people around. This is a potentially very dangerous scenario in that the guard for constant vigilance can be down and the young child can lure themselves close to whatever water source is in proximity. Healthcare professionals care for many children for drowning and near drowning events that present from crowded pools or beach settings.

It does not take deep water for drowning to occur. Never leave children unsupervised in bathtubs or around any source of water in or out of the home.

At least one parent/caregiver should be designated to devote their undivided attention to the infant or child when near or in the water at all times. This person should plan to refrain from the use of cellular devices and alcohol in order to be maximally present and enhance awareness. Popular floats and “swimmies” do not prevent drowning and should not be regarded as a reason to allow an infant to be in any water source unsupervised for even a very short period of time. Wearing life jackets or other flotation devices is recommended for those that cannot yet swim independently.

Possible Signs of Distress Parents/Caregivers Can Monitor for After Water Exposure

If parents are concerned about water exposure, potential signs of distress that children may display typically are related to respiratory symptoms: persistent coughing, choking, vomiting, working harder to breathe, or changes in mood such as fatigue or irritability. Any chest pain or discomfort may be a child attempting to articulate underlying breathing issues. Any signs of cyanosis or a bluish tinge to the perioral area (mouth or area around the lips) should be noted and the child should be triaged at a local ED as soon as possible. Additionally, fatigue beyond that which is expected after swimming can indicate a lack of oxygenation to the brain from underlying lung pathology and should be further evaluated.

Important to note is that many children will cough at some point during swimming due to swallowing water. In the vast majority of cases, this is a normal response and does not indicate any distress as long as it is a short bout of coughing with complete recovery.

Safety Tips At & Around the Pool

Safety at the pool both in the water and on the pool deck can be accomplished by having proper fencing to keep younger infants and toddlers away from the pool when not being monitored. Memories made in and around the pool can be joyful times for children, so enhancing fun while accomplishing safety by mandating supervision whether swimming or not, is imperative.

Safety Tips At the Beach & On the Shore

Safety at the beach and on the shore is similar to to pool safety although also keeping in mind never turning your back to the water or waves and trying to stay in an area with a lifeguard when possible to be warned about potential hazardous conditions at the beach and for the access to lifeguard expertise if required.

Defining Terms - What is Dry Drowning? What is Secondary Drowning?

There is a need to distinguish between the terms Dry Drowning vs. Secondary Drowning, terms which have gained a lot of exposure in the public eye.

Dry drowning is rare and can occur after a submersion event in which the child inhales water through their nose or mouth causing difficulty breathing typically manifesting as an airway spasm. The term "dry drowning" refers to the fact that the water does not gain entrance to the lungs as the spasm closes off the vocal cords and access to the lungs beyond. This can be a serious condition however if the vocal cords do not relax as air can not pass through its normal inspired channel into the lungs, and can possibly be fatal if medical attention is not sought. This condition is typically notable to parents and caregivers. Secondary Drowning does involve inhalation of water into the child's lungs and an evolving inflammatory cascade of events causing edema or swelling to the airway and lung tissue. Typically, children will show signs of respiratory distress in the immediate aftermath, but at times symptoms can be subtle and present in a delayed fashion hours after the water exposure and subsequent inhalation event. The physiology behind secondary drowning involves a condition called pulmonary edema where water will irritate the lining of the lungs and cause a fluid buildup.

It is important that children are taken and triaged at a nearby Emergency Department where their vital signs and oxygen saturation levels can be monitored. Typically, a chest x-ray is taken to evaluate the health of the child's lungs and look for any presence of pulmonary edema. The child may be admitted to the hospital for observation of oxygen saturation levels and to ensure they make a full recovery under supportive care.

These complications are rare and the usual course is self resolution. However, parents should feel empowered in knowing their own children, and if they have any concerns about their child, or their child exhibits any signs of breathing trouble after exiting the water, taking them into a local ED to be seen and evaluated is a prudent course of action.

What To Teach Your Children About Water Safety

Water safety is among the most imperative safety topics for parents and caregivers to be aware of year round and to instill into their children as they grow. With planned excursions to water sources increasing in the summer months, attention to safety precautions and vigilance must be emphasized. Parents should teach their children to respect water and the most important way to enhance safety is by giving children the chance to develop water safety skills via swim lessons and exposure in a controlled setting.

Wishing everyone aloha and happy & safe times in the water ahead!