A Handle on your Health: Protecting against drowning
Texas has over 150 lakes within its borders as well as thousands of pools, ponds and rivers. Here in the Hill Country you can just about swim year round but we hit it hardest in the summertime. Unfortunately drownings can occur anytime we get around water. It is the second leading cause of death in children up to age 14 and it is for the most part preventable which is why it’s so heartbreaking when it occurs.
In 2019 there have been 34 kids who have drowned already. One Texas State University student died in a pool recently in San Marcos. Overall, drowning is the fifth leading cause of accidental death in the U.S. resulting in about 3,500 deaths a year.
Texas ranks behind Florida in deaths from drowning. For kids age 1-4 drowning is the second leading cause of death; 80 percent occur in pools and another 10 percent in bath tubs. For every child who dies from drowning, another five are seen in the ER and 50 percent of them require admission. Males account for 80 percent of drownings and this may stem from our tendency to overestimate our abilities. Autistic children are 10 times more likely to die from drowning . In fact, in causes of death of autistic children, drowning is responsible for 90 percent.
Most drowning accidents occur in lakes followed by pools and rivers. The ocean is involved about 10 percent of drownings. While pools are the most common location for children to drown, lakes and rivers are more common for older children and adults. Older children and adults are also more often involved in boating accidents — where alcohol is overwhelmingly involved.
What does it mean to drown? Simply stated, it means the intake of water that results in respiratory impairment. This usually means submersion underwater and not choking on your big gulp from 7-11. If you’ve ever experienced a near drowning event, then you know how scary it is not being able to breath because your airway has water in it.
So what do you do if someone is drowning? First thing is to get the person’s head out of the water as soon as possible. Then begin CPR if they aren’t breathing. The priority here is breathing.
Even if the person doesn’t have a pulse, the problem is fluid in the lungs so if we can help open up the airway the heart has a better chance of restarting. In normal CPR we concentrate on chest compressions first but in drowning victims it’s the airway first then breathing then compressions. Usually cervical spine (Neck) immobilization isn’t a concern unless the victim was involved in a trauma during their drowning. Contact 911 as soon as possible. Contrary to the cartoons we grew up with you can’t push on the victim’s belly to force the water out. Rescue breaths and keeping the airway open are the most important factors here.
The victim may never go unconscious and their airway spasms may resolve quickly after you start the rescue, but still call EMS for evaluation. If they were unconscious or required CPR then they must be transported to the hospital even if your rescue was successful at returning them to normal breathing before EMS arrived. If a person is submerged less than 6 minutes they have a much better chance at regaining normal brain function. After 6 minutes, the studies unfortunately indicate significant brain damage.
The studies also indicate water temperature may not be much of an influence on outcomes. You’ve probably heard that drowning in cold water gives you a better chance at recovery but that may not be true. Also, drowning in salt water is no better or worse than drowning in fresh water.
What is the most important thing we can do about drowning? Prevention.
In fact, swimming lessons have proven to decrease drownings by almost 90 percent. Barriers around pools help prevent child drowning; reduced alcohol consumption when we’re around water would obviously help; using life vests when boating and never turning your back on young children and toddlers especially around pools and bathtubs.
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Dr. John Turner is a family medicine and emergency medicine doctor with 25 years of experience. He is also the owner of My Primary Care Clinic and My Emergency Room 24/7 here in Hays County. Dr. Turner may be reached at 512-667-6087.
