Prevention of Drowning

Abstract

Drowning is a leading cause of injury-related death in children. In 2017, drowning claimed the lives of almost 1000 US children younger than 20 years. A number of strategies are available to prevent these tragedies. As educators and advocates, pediatricians can play an important role in the prevention of drowning. BACKGROUND Drowning is the leading cause of injury death in US children 1 to 4 years of age and the third leading cause of unintentional injury death among US children and adolescents 5 to 19 years of age. 1 In 2017, drowning claimed the lives of almost 1000 US children. Fortunately, childhood unintentional drowning fatality rates have decreased steadily from 2.68 per 100 000 in 1985 to 1.11 per 100 000 in 2017. Rates of drowning death vary with age, sex, and race and/or ethnicity, with toddlers and male adolescents at highest risk. After 1 year of age, male children of all ages are at greater risk of drowning than female children. Overall, African American children have the highest drowning fatality rates, followed in order by American Indian and/or Alaskan native, white, Asian American and/or Pacific Islander, and Hispanic children. For the period 2013-2017, the highest drowning death rates were seen in white male children 0 to 4 years of age (3.44 per 100 000), American Indian and/or Alaskan native children 0 through 4 years (3.58), and African American male adolescents 15 to 19 years of age (4.06 per 100 000). 1 Drowning is also a significant source of morbidity for children. In 2017, an estimated 8700 children younger than 20 years of age visited a hospital emergency department for a drowning event, and 25% of those children were hospitalized or transferred for further care. 1 Most victims of nonfatal drowning recover fully with no neurologic deficits, but severe long-term neurologic deficits are seen with extended submersion times (.6 minutes), prolonged resuscitation efforts, and lack of early bystander-initiated cardiopulmonary resuscitation (CPR). 2-4 The American Academy of Pediatrics issues this revised policy statement because of new information and research regarding (1) populations at

Anthropometric and Motor Competence Classifiers of Swimming Ability in Preschool Children—A Pilot Study

“…POOR (TNR = 32.2%) and EXCELLENT SAG (TNR = 19.4%) tend to have lower probabilities of false alarm as compared to GOOD SAG (Table 7). According to Press's Q statistic, the predictive model of SAG membership based on MQ total exceeds the classification accuracy expected by chance at a statistically significant level (Press's Q = 42.09 > critical value for χ 2 (1) = 6.63). Model cross-validation indicates an accuracy of 64.1%.…”

“…Swimming ability, as a narrower term of aquatic competence [1], has been acknowledged a life-saving skill [2,3], since drowning is one of the most common causes of unintentional injury deaths throughout the world [4]. As the self-propulsion of a person through water, swimming is a physical activity used in sports performance, recreation, and therapy.…”

Selected Injuries

“…Children are at the highest risk of drowning and should be the focus of prevention. Pools should be isolated with fencing (four sided and at least 4 ft. tall), and children should be supervised by an adult that is within arm's reach [8,9]. Infants and toddlers have heads that are heavy relative to their bodies and should not have access to water in buckets or toilets because they cannot self-extricate if they fall into these head first [9].…”

“…Pools should be isolated with fencing (four sided and at least 4 ft. tall), and children should be supervised by an adult that is within arm's reach [8,9]. Infants and toddlers have heads that are heavy relative to their bodies and should not have access to water in buckets or toilets because they cannot self-extricate if they fall into these head first [9]. Safety around the water should be taught at a young age, and swimming lessons are encouraged when age appropriate, potentially as early as 1 year old according to the American Academy of Pediatrics (AAP) [9].…”

“…Infants and toddlers have heads that are heavy relative to their bodies and should not have access to water in buckets or toilets because they cannot self-extricate if they fall into these head first [9]. Safety around the water should be taught at a young age, and swimming lessons are encouraged when age appropriate, potentially as early as 1 year old according to the American Academy of Pediatrics (AAP) [9]. Alcohol and drug use should be discouraged when around water as this contributes to the increased risk-taking behavior and increase in drowning fatalities seen in young men.…”