Let’s proactively support summer water safety

Summer is here, and at last, there is hope that the summer of 2021 will provide individuals and families’ opportunities to return to a more normal lifestyle, as many states and regions in the United States have achieved a COVID-19 vaccination rate at or approaching herd immunity. As exciting as this news is, the June issue of Contemporary Pediatrics brings us back to the reality of summer and reminds pediatric nurse practitioners (PNPs) of the possible perils of “summertime fun.” In the blink of an eye, a child can quickly go from being healthy and inquisitive to sustaining an injury, a life-threatening disease, or die in a water-related accident. There are 3 articles that focus on summer concerns: Drs. Hefter and Hamdy’s article entitled "Common recreational water illnesses in children;" Dr. Jellinekarticle entitled “Preventing summer accidents;”and Dr. Porter and Ms. Hughes article, “How one child’s tragedy is making us reconsider our approach to drowning prevention.”These authors present substantial evidence for inclusion of information about summer safety as a routine part of anticipatory guidance for all parents, children, and adolescents. Many parents may not have appointments for their children in the pediatric office early in the summer months; thus, pediatric providers should consider messaging parents, either via email, text or via their office-based websites, anticipatory guidance that increases the awareness of parents about summer safety concerns. We cannot reverse some potential summertime tragedies, but we can strive to prevent them.

Water illnesses

In their article, “Common recreational water illnesses in children,” Drs. Hefter and Hamdy present information and treatment for water illnesses that are responsible for a number of summertime office visits, including gastrointestinal, skin, otitis externa, and acute respiratory infections. Recognizing the offending organisms and prompt treatment is an essential role of the pediatric provider. Additionally, the authors present key tips that PNPs can use as part of parental anticipatory guidance for summer safety via avoidance of infections by using safe water practices. This article is a must read for all PNPs.

Preventing summer accidents

In the article, “Preventing summer accidents,” Dr. Jellinek presents a comprehensive list of history questions that PNPs can choose to ask parents and/or teens about summertime behaviors including those that address the emotional and psychosocial issues that impact the risk for summertime injuries. Dr. Jellinek recognizes the need to prioritize summer safety as part of routine care prior to and throughout the summer months. I recommend reviewing the history questions and make a note of those you would like to include when talking to parents and teenagers.

Approaches to prevention of drowning

You feel and experience sadness as you read the article “How one child’s tragedy is making us reconsider our approach to drowning prevention”by Dr. Porter and Ms. Hughes. Details of the tragic drowning death of Ms. Hughes’ 3-year-old son are presented. “One moment, he was sitting on the couch watching TV. In the next, I was pulling his lifeless body from the bottom of a pool.” All efforts to save the life of this young child failed. PNPs have heard these stories, have been on the scene in the emergency department when a child/adolescent arrives, and have taken care of the near-drowning victims in the intensive care unit, and in long-term pediatric care facilities. Data revealed that 40% of drownings treated in the emergency departments require hospitalizations or transfer for further care.1 There are no words to comfort parents, siblings, and family members…just overwhelming sadness.

In the United States, drowning is the second leading cause of unintentional death in children aged 1 to 4 years.¹ Dr. Porter and Ms. Hughes researched the type of swimming lessons available for infants and children aged 6 months to 4 years. Their search of the literature showed a lack of research evidence-supported types of swimming lessons that would protect young children and prevent death or near drownings. The characteristics of formal swim lesson programs for children aged 6 months to 4 years are primarily family centered with a focus on treading water and swimming, rather than on aquatic survival. Only 1 of the 3 types of programs presented identified the primary goal for infants and young children as aquatic survival. In an aquatic survival program, infants and young children are trained to float and to roll the body to find the surface and get air. The focus of the swim lessons was on survival and a respect for water.

Ms. Hughes discusses how much children like water and are attracted to water, and that many children wear flotation devices that make them falsely believe that water is safe. This false belief places infants and young children at increased risk of drowning. They do not have the intellectual comprehension to understand the danger.

Recently, I saw an advertisement for ‘coloring the water’ in at-home in-ground swimming pools. When I saw the advertisement for dark water in the swimming pool, I immediately realized the danger to everyone who would swim or be near that pool. I was most concerned about young children, thinking how would an infant or child be seen if he or she slipped under the water.

There are so many advances in technology, that the question should be raised: Can technology, yet to be developed, change the outcome of deaths due to unintentional drowning in infants and young children? I wonder if a sensor could be designed for swimming pools that activated an alarm if anyone weighing less than 50 pounds entered the swimming pool when there was no adult supervision. Dr. Porter and Ms. Hughes support research on water and pool safety. There are so many drownings to be prevented each year. Rigorous research studies on drowning prevention are so needed.

Reference

1. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based injury statistics query and reporting system (WISQARS). Accessed June 14, 2021. https://www.cdc.gov/injury/wisqars/index.html