In this Contemporary Pediatrics interview, James Barry, MD, a pediatric emergency fellow in Rochester, New York, explained how drowning takes place and reminds providers of some common but practical safety tips to discuss with parents.

Transcript (edited for clarity):

Contemporary Pediatrics:

From your position in emergency medicine, what about drowning is important to understand as summer is in full swing?

James Barry, MD:

It is something that happens quickly, it happens usually insidiously, and it's really difficult to unwind the damage from drowning as time goes by. The best way to explain drowning to anybody honestly is when you're submerged in water, you have this kind of panic response and you start flailing and at some point, you take a breath. A breath leads to an aspiration or breathing in of the water, and that can disrupt the way that your body transitions oxygen and carbon dioxide across the lung and it actually disrupts the surface tension of the lungs so you experience a lot of collapse of the lung. That leads to hypoxemia, or low blood oxygen, which can lead to loss of consciousness or apnea. That leads to bradycardia, which leads to arrest and then you have a lot of pulmonary edema, you can have neurovascular compromise. There really are a lot of terrible sequelae of drowning if it's not treated quickly and not treated robustly. It's really important for any pediatrician, any provider, in the first 8 hours if the patient is showing pulmonary symptoms, could be a sign of a lead to pulmonary compromised. So it's really important for those children to get evaluated if they are having those pulmonary symptoms in the first 8 hours, even if you feel like it wasn't a real submersion.

Contemporary Pediatrics:

Can you highlight some common water safety practices that providers can discuss with families?

Barry:

The [American Academy of Pediatrics] (AAP) has really good guidelines they always put out for stuff like this, especially during injury prevention season. It's very important to have a fence around a pool. Very important to have your kids get swimming lessons, if at all possible whether or not you have a pool. [Wearing a] life jacket at all times in any kind of watercraft. A lot of pediatricians do a really good job of this, but it's always important to remind families with intellectually or cognitively delayed or impaired children, they should have a lifejacket on regardless of what body of water they're in. Regardless of who's with them. It's extremely important for those patients. I say this to every pediatrician as an emergency doctor, if you have a concern about the child after submersion incident, send them into the emergency department (ED). It's always important to just get that screened chest X ray to see if there's any kind of pulmonary injury to prevent a lot of that compromise later.

Read more:

Though some drowning prevention strategies seem common or routine, data demonstrate drowning deaths among children have risen in recent years, which should prompt conversations with families on refreshers and new prevention initiatives.

Click here for CDC data related to a rise in drownings in the United States in recent years, more tips, and further discussion with James Barry, MD.

Click here to explore the digital version of the July issue of Contemporary Pediatrics.