Clinical Reference Systems: Pediatric Advisor 10.0

FIRST AID

Have someone call a rescue squad (911) immediately.

1. Resuscitation

   Begin mouth-to-mouth breathing as soon as possible. This should be started immediately in the boat, in a life preserver, or at the latest when the rescuer reaches shallow water. It should be continued until the child is brought to a medical facility; some children have survived long submersions (especially in cold water).

2. Neck injury

   If there is any possibility of a neck injury (for example, a diving accident), protect the neck from any bending or twisting. If the child is still in the water, he or she can be helped to float on the surface until a spine board is applied or until several people can remove him while supporting his head and back as a unit.

3. Vomiting

   Vomiting is common because the stomach is usually filled with water in drowning. If vomiting occurs, quickly turn the child on his or her side, face down, and try to keep the water from entering the lungs. The lungs are usually free of water because they are protected by spasm of the vocal cords. Avoid pressure on the stomach during resuscitation because it can trigger vomiting.

PREVENTION

1. Never leave a child under age 3 unattended in the bathtub or a wading pool.

2. Never leave children who can't swim well unattended near a swimming pool. (More children drown in backyard swimming pools than at beaches or public pools.)

3. Make sure that neighborhood pools are fenced off and the gates are kept locked.

4. Try to arrange swimming lessons for your child before age 8. (Children are often ready by age 4.)

5. Infant water programs should teach water "fun," not "swimming." Children cannot be made "water safe" before age 3.

6. Infant programs that encourage submersion of the head for more than a few seconds should be avoided because some babies swallow enough pool water to cause seizures and brain damage.

7. Caution children of all ages to check the depth of the water before diving in and to avoid any diving in the shallow end of a pool.

8. Caution children not to overbreathe as a way to stay underwater longer. This practice can lead to passing out underwater.

9. Caution the accomplished swimmer to continue to swim with a buddy.