Drowning Prevention: An Inside Look at the Leading Cause of Accidental Death in Children

It's summer, the kids are home, and you need to get them out of the house and keep them entertained. A popular option is the local pool where the family can be outside in the sun, the kids are active and letting out excess energy, and it can be made into an entire day affair. My fondest memories growing up revolve around my mom taking my sisters and me to our local pool almost every afternoon in the summer, weather-permitting of course (I live in Chicago and the summers were either insanely humid and hot, or cold and rainy...and that could all be within 24 hours of each other). Our routine was to wake up in the mornings, get our errands done, come home, eat lunch, go to the pool, come home to shower, eat dinner, and go to bed. I'm fairly certain that every summer of my childhood until age 16 was spent at our local pool, and even just thinking about it now is nostalgia-inducing. But friends, we need to get insanely real for a second. And I'm talking about getting real about the one thing no one wants to talk about when talking about going to the pool: drowning.

Drowning is the number one cause of injury-related deaths in children 1-5 years old, and the second leading cause of death for children 1-14 years old (Source: National Drowning Prevention Alliance). Drowning doesn't happen as portrayed in the movies; there is no arm-flailing or calling for help...it's an silent and quick event. To the untrained eye, one wouldn't even be able to discern a drowning child from one who's just playing around, and a child can drown in the amount of time it takes for their parent/guardian to turn away and check social media or reply to a text message. In 30 seconds, a child's brain begins to shut down due to lack of oxygen. That 30 seconds is the difference between life or death in the most literal way I can express. Just because the water is "shallow" to you doesn't mean that it doesn't pose a risk to children -- "shallow" is a relative term that depends on the height of the water versus the height of the swimmer. If I'm 5'6'' obviously 3' of water is shallow for me, but a swimmer who is only 3' tall won't be able to keep their face above water in that depth. All it takes to drown is for one's mouth and nose to be covered by water...you can drown in a bucket full of water, as long as the water obstructs your ability to get air into your lungs.

The Five Stages of Drowning
1. Surprise the swimmer realizes they are out of their depth and are having a difficult time keeping their mouth and nose above the water. Their arms and legs are not able to propel them upwards, and they have bugged-out, fearful eyes (in the industry we call them the "oh shit!" eyes).

2. Involuntary Breath Holding the swimmer will be bobbing above and below the water's surface, trying to gasp for air, but will be unsuccessful. Their arms and legs are fatigued, so they won't be able to move in a forward direction and will slowly start to lose the battle in keeping their face above water.

3. Unconsciousness the swimmer's brain has gone without oxygen for so long that they are now unresponsive and their brain is in the process of shutting down.

4. Hypoxic Convulsions the swimmer has now begun inhaling water, which when mixed with the chemicals in their lungs, produce reflexive convulsions. The swimmer also begins foaming at the mouth and their face and body become blue and bloated due to lack of oxygen.

5. Clinical Death The swimmer is now clinically braindead, and their other organs are starting to shut down as well. The chances of reviving them at this point are slim to none.

I've been a lifeguard for 10 years now, and have been a lifeguard trainer and facility manager for 7 of those 10 years (I run the facility, supervise the lifeguards, slide attendants, swim instructors, concessions and admissions staff, keep the emergency equipment rescue-ready, resolve patron issues, and respond to emergencies as they arise). In those 10 years I have come to learn that water safety is not a subject that is to be taken as lightly as the majority of the public would like it to be. The rules and regulations that people love to argue about and complain they are inconvenienced by are put into place for one reason and one reason only: to keep patrons safe. Drowning PREVENTION is the name of the game in the world of aquatics risk management, and every day my staff and I clock into work, we are faced with the looming possibility that today could be the day that someone dies at our facility. I have to put my trust into the high school and college-aged lifeguards that my fellow managers and I have spent hours upon hours training and trust that they have come to work in the right state of mind, are rescue-ready and will be able to identify, prevent, and respond quickly to emergencies that can arise out of the blue during their shift. I'm going to share with you what we as lifeguards and facility managers wish you as the patrons knew...reasons behind rules, commons misconceptions, and the fact that we all have the same goal in mind: keeping you and your children safe.

Misconception #1: I don't need to be in the water with my kids, the lifeguards are watching them. Lifeguards are on duty to enforce the rules and respond to aquatic emergencies...they are not babysitters. The lifeguards are in the chairs systematically searching the water (also known as "scanning") for signs of lifelessness, distress, and behaviors that can turn into dangerous situations. They are responsible for an entire large chunk of the pool, which on a busy day can contain hundreds of patrons, so no, they are not just watching your children. Do not ask them to watch your kids as you go to the bathroom, get a snack, or check your phone. You as the parent need to be in the water, within arms reach of your children AT ALL TIMES because it is so much easier for you to grab your child if they start to struggle than it is for the lifeguard to identify the child, jump in, swim to them, and rescue them. I can't tell you the amount of parents I fight with on a daily basis to be in the water with their children (it's a rule at our facilities) to the point that I've had to call the police to have families escorted out because they refuse to follow that simple rule. I don't care if it's a cloudy, windy, 60 degree day out...if it's warm enough for your children to get in the water, it's warm enough for you to get in the water. After each rescue in our facilities, a Rescue Report is filled out to send to our insurance company that details the age and circumstances of each rescue, and the statistics each year overwhelmingly spell out that all the rescues we perform are on children under the age of 10 who were unsupervised by a parent or guardian and ended up getting overwhelmed in water that was too deep for them. Parents, please help us help you. We want your children to be as safe as you do, but you need to play an active role in keeping them safe. I really could not give less of a damn if I'm inconveniencing you...my only priority is to keep your children safe. So please: get off your phones, put down your books, finish your conversation with your friend, and get in the water with your kids.

Misconception #2: My child is in a floatie/lifejacket, so they'll be fine on their own. A child in a personal flotation device (PFD) signals to us as lifeguards that your child is a weak swimmer, which is even more of a reason to be within arms-reach of them. My staff and I have rescued kids in PFDs that have flipped face-down in them and couldn't flip themselves back over, have gotten their head trapped inside because it was ill-fitted, and have drifted too far into deep water and became overwhelmed. I even jumped in for a baby once who was in an inflatable neck tube, his mouth and nose slipped down below where it fastened and got trapped underwater, and the parents didn't notice the baby struggling because the were too deep into conversation with their friends nearby. Keep in mind, not all PDFs are created equal, and Coast Guard Approved PDFs are your best bet for safety and durability rather than inner tubes and water wings. Coast Guard Approved PFDs are much more rigorously tested than regular PFDs, and they'll have a panel in them that says that they are Coast Guard Approved. So if your child needs a PFD, fantastic, but be that second layer of protection and stay within arms-reach of them so they stay safe.

Misconception #3: Lifeguards are just getting paid to get a tan, they're not really doing anything. With every industry, there are the good, the bad, and the ugly. Yes, unfortunately there are facilities where lifeguards have minimal training, are not rescue-ready, and can often be more of a liability than an asset. But on the other end of the spectrum there are many facilities that train and employ top-notch lifeguards and run incredibly safe facilities. You can generally tell how well trained the lifeguards in your facility are in the following ways: a) are they sitting at the front of their chair, feet planted on the stand, with their guard tube across their lap, their extra slack maintained, and consistently moving their head scanning the pool? Are they standing every 5 minutes to get the blood flowing and change their perspective? b) does your facility run simulated emergency drills for their lifeguards daily, or even better, multiple times per day? c) are the lifeguards being rotated in a timely manner, spending no more than 30 minutes per spot in the rotation? If any or all of these questions warrant "yes" as an answer, your facility is most likely pretty on top of their safety game. If not, I would suggest keeping the aforementioned criteria in mind and find a different facility to swim at, or be twice as diligent with your children at your current pool of choice.

While this is just a brief overview on what us working in aquatic safety wish everyone would know, it's a good place to start the conversation, as well as a launching pad for further research. We all want everyone to be safe, have fun, and make positive memories this summer and every summer in the future, and I hope that I've given you the tools in order to do so.