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<< Pediatric Submersion Injuries: New Definitions And Protocols

Preventive Strategies

Like all diseases, it is much easier to prevent a drowning, than it is to treat one.41 Many of the major factors that contribute to a drowning are preventable, such as an inability to swim, failure to wear proper protective gear, consumption of drugs or alcohol, and stunts. Because the greatest proportion of drownings occur in non-swimmers, the protection afforded by swimming lessons is easy to support and has been known for ages. Children require special preventative measures. It is interesting to note that a Virginia study of toddler pools found that the children who had some form of swimming lessons by 18 months of age were only half as likely to require retrieval from a pool.128 A child with "water wings," or in a floating support, without adequate supervision immediately available, is a fatality waiting to happen. Overestimation of swimming skills and trauma associated with horseplay may contribute to a child's demise. Most parents believe their child is not susceptible to injury.135

Fences around pools markedly reduce the incidence of submersion injuries in those areas where it is required.129-132 Because fencing requires no training or action on the part of the child or the parent; it deserves a very high priority in prevention efforts. The fencing should be at least 4 feet high and include self-locking gates. Immersion alarm systems for unattended pools will further decrease deaths, but should not be used as a primary means of drowning prevention.

The adult who is intoxicated not only cannot supervise a child; he or she cannot supervise personal actions. To reach the "legally drunk" 100 mg/dl level, the average 70-kg person needs to consume only 4 beers or two mixed drinks in the space of an hour. Any steps that reduce intoxication among swimmers will reduce the frequency of injury and death.

Patients with seizure disorders or other handicaps must be properly supervised, as their risk is higher.133 For these patients, buddy swimming and proper supervision is mandatory. For parents of these children, cardiopulmonary resuscitation training should be strongly advocated.41