Water Safety – PediaCast 348

Show Notes

Description

  • Dr Lara McKenzie stops by the PediaCast Studio to talk about water safety. We discuss creating and maintaining a safe swim environment, pool rules and supervision tips. Also covered: hot tub and bath tub safety. We hope you can join us!

Topics

  • Water Safety
  • Creating a Safe Swim Environment
  • Maintaining a Safe Swim Environment
  • Pool Rules
  • Water Supervision Tips
  • Hot Tub Safety
  • Bath Tub Safety
  • Drowning
  • Secondary Drowning
  • Dry Drowning
  • CPR Class

Guest

Links

Transcription

Announcer: This is PediaCast.

[Music]

Announcer: Welcome to PediaCast, a pediatric podcast for parents. And now, direct from the campus of Nationwide Children’s, here is you host, Dr. Mike.

Dr. Mike Patrick: Hello, everyone, and welcome once again to PediaCast. It’s a pediatric podcast for moms and dads. This is Dr. Mike, coming to you from the campus of Nationwide Children’s Hospital. We’re in Columbus, Ohio.

It is Episode 348 for July 13th, 2016. We’re calling this one “Water Safety”. I want to welcome everyone to the program.

So, we are most certainly knee deep in summer here in the midwestern portion of the United States of America. And I love this time of the year because it’s really reminds me of our Florida days back a few years ago. Those of you who are regular PediaCast listeners or have been for a long time know that pre-2011, we were coming to you from Florida for a few years.

And summer there was a bit more challenging, to say the least. We actually had a name for the humidity back then. We call it Sheldon. And if you’ve ever been to Florida in the summer, you know what I’m talking about. You’re inside in the establishment. Maybe you’re shopping or sitting down for a nice meal with the family. The air-conditioning is turned down really low. In fact, you maybe shivering and you suddenly wished you had brought a sweater or a sweat shirt along because those Floridians do love their air-conditioning. In fact, the windows looking outside are dripping with condensation because of the temperature difference between the two sides of the glass.

0:02:02

You finish up, you open the door, you step outside, and you’re greeted by Sheldon. Right? It’s like a wall of humidity. And he feels good at first, sort of warm, wonderful all the way down to your bones kind of feeling. You know, for about three to four minutes, and then you’re done with Sheldon, which is why the Floridians had cranked up their air-conditioners to begin with.

Now, fortunately we rarely have Sheldon come visit here in Ohio. I mean, he visits now and then, but it’s not day in and day out. So summers here in Ohio typically are more like Florida in April or October. So, in my mind, perfect weather. I know everyone has their own opinion what that looks like. But not too hot , not too cold, just right. And that’s the kind of summer we’re having here in Ohio this year with temperatures in the 80’s, sort of moderate humidity. Definitely not Sheldon levels, and life is pretty good.

Hopefully, you’re enjoying your summer, too, wherever home is for you. And in the honor of summer, I’d thought we’d focus on a great hot weather topic — or it’s warm weather topic — for today. And that is water safety because when it is summer, you would like get out there in the pools and enjoy the weather.

Dr. Lara McKenzie returns to the studio. She’s our resident safety expert. She’s visited us before to talk about fire safety in the winter and home poison safety. We talked about that in the Spring. This week, she’s going to stop by and talk about water safety — how to create and maintain a safe swimming environment, pool rules, supervision tips, dangers you might not think about and ways to prevent injuries from occurring.

So we’ll talk emergencies and drowning and even secondary or dry drowning, what’s that all about. So, we’ll cover it today. We’ll also consider hot tub safety and bath safety, too, because any body of water, even an inch of water, can be dangerous.

0:04:00

Of course, we want to help you keep your kids safe while still having a fun time in the water. Because, after all, this summer and being outside, it’s a good thing.

As I’m setting this interview up for you, in the back of my mind I’m realizing that we aren’t covering sunscreen as we talk about water safety. We’re really focusing on safety in the water and drowning prevention and how to create a safe environment. But as I’m thinking about it, sun screen is also an important topic and we’ve actually covered sunscreen many times on PediaCast. So if you want more information on that, do a Google search for PediaCast and sunscreen, and you’ll get several episodes that you can listen to.

So the bottom-line with sun screen is use it, apply lots of it, and reapply often especially when kids are in and around the water. Because it won’t lasts as long as the bottle might suggest if they are getting wet. So sunscreen — use it, reapply it. That’s the bottom-line there.

And I have a feeling we won’t get to that because we have so much to cover with regards to water safety. But that’s important, too.

All right, water safety is all we’re covering this week because there’s a lot to talk about regarding it. We’re going to have more answers to listener questions coming up next week.

Also, we’ll be celebrating our ten-year anniversary on PediaCast. July 18th, 2006 was our very first episode. So we’re going to talk a little bit about the history of the program — how we got where we are today, why we do what we do — next week as we celebrate our tenth year. I can’t even believe it, ten years of pediatric podcast.

As I mentioned, next week, we’ll be answering more of your questions. You may have a question for me. If you do, it’s easy to get in touch. Just head over to PediaCast.org, click on the Contact link and ask away. We’ll take all questions, topic suggestions. Sometimes we get specialists into the studio to answer your questions.

So, please if you have something you want to us to talk about, let me know what it is. And again, just head over to PediaCast.org, click on the contact link. You can also call the voice line if you’d like to leave a message that way, 347-404-KIDS, 347-404-K-I-D-S.

0:06:19

Also, I want to remind you the information presented in PediaCast is for general educational purposes only. We do not diagnose medical conditions or formulate treatment plans for specific individuals. If you have a concern about your child’s health, be sure to call your doctor and arrange a face-to-face interview and hands-on physical examination.

Also, your use of this audio program is subject to PediaCast Terms of Use Agreement and you can find that at PediaCast.org.

All right, let’s take a quick break. And I will be back with Dr. Lara McKenzie as talk about water safety. That’s coming up, right after this.

[Music]

Dr. Mike Patrick: It’s a pleasure introducing our guest today. Dr. Lara McKenzie is the Resident Safety Expert here on PediaCast. She’s also a Principal Investigator for the Center For Injury Research and Policy at the Research Institute at Nationwide Children’s Hospital and an Associate Professor of Pediatrics at the Ohio State University College of Medicine.

She has joined us previously on Episode 336 to talk about fire safety, and on Episode 344 to talk about poisons in and around the home. She returns today for an important summer time topic, water safety. So let’s give another warm PediaCast welcome to Dr. Lara McKenzie. Thanks for joining us today.

Dr. Lara McKenzie: Hi. Thanks for having me again.

Dr. Mike Patrick: I really appreciate you stopping by. I do want to remind the folks that you’ve been instrumental on the national Make Safe Happen campaign. So, tell us about a little bit about that program in general.

0:08:11

Dr. Lara McKenzie: Sure. Nationwide Insurance started the Make Safe Happen program to raise awareness about childhood accidental injuries. The program, we’re a partner in their program, Nationwide Children’s Hospital. We have an app for parents and caregivers that they can learn safety tips in their home and the room-by-room. All the advice in the apps tailored for the age of their children.

And this is really important for parents because it can be very overwhelming to think about doing all the safety things that we recommend and that we’ve been talking about on our different PediaCasts. So, just being able to focus on the things that are important for your age children right now can feel a slightly less overwhelming, I think, as a parent or caregiver.

But Nationwide’s program Makes Safe Happen, they partnered with leading experts to produce this tools and resources for parents and caregivers to make their homes safer. And there’s a lot of great information they have on their website. It’s www.MakeSafeHappen.com. And yeah, I’m happy to talk about that program and share their information.

Dr. Mike Patrick: Yeah, it’s a great site and a great resource. So, listeners, if you have not checked out MakeSafeHappen.com, make sure you do. And there’s a convenient free mobile apps for both iOS and Android, and there are links on that website to find the particular apps. But there’s a ton of information on the website itself, too.

So, let’s start talking about water safety. What is drowning exactly?

Dr. Lara McKenzie: Well, I’d like to start by just saying anywhere that there’s water and children, there’s really a danger of a child drowning.

0:10:02

Drowning is basically dying through submersion and inhalation of water — submersion in and inhalation of water. And, drowning can happen really quickly and silently and in just a couple of inches of water. So, it doesn’t take a very deep pool or a lake or an ocean for a child to drown. It can happen in a bathtub. It can happen in a toilet, in a bucket, in a portable pool.

Drowning is the leading cause of unintentional death in children between the ages of one and four years of age. And in the summer, about every five days, a child in the US drowns in a portable pool. So, those are those little baby pools, the inflatable pools, the ones that we think, as parents and caregivers, that those are going to be safer for kids because they’re just very shallow and only a couple of inches but they can be very deadly.

Dr. Mike Patrick: We say you can drown in as little as an inch of water, but really, any amount of water that basically blocks the nose and doesn’t allow air in is going to be a problem.

Dr. Lara McKenzie: Exactly.

Dr. Mike Patrick: So for the little babies, than can be an inch or less.

Dr. Lara McKenzie: Yeah. And you know, there’s this misconception about drowning from what we’ve seen on television, I think, and we’re all susceptible to this image, too. We think that drowning is a loud splashy thing. And in children, it’s not. They can just go under or be very quiet when it happens.

So, I think a lot of people think there’s going to be “I’ll hear them,” or, “I’ll see that if that’s happening.” And, I can tell you, from personal experience as a lifeguard, that is not the case. When I was a lifeguard in high school, there was someone in our pool who almost drowned. And the other lifeguard and I thought he was playing around. We thought he was popping up in different spot and kind of going under. And it was hard to really tell that he was struggling. And that was an adult, so kids are just worse, really.

0:12:16

Dr. Mike Patrick: Yeah, absolutely. So how should parents supervise children in and around the water then?

Dr. Lara McKenzie: That’s a great question. So the first thing is to watch the children really closely. An adult should always watch children in the pool, in a bathtub. Never allow children to watch other children. OK? So we always want adults watching kids.

An adult should really be within arm’s length of infants, toddlers, or weak swimmers in the water, so that you can reach them really quickly. So, this means for parents, get in the pool with your kids, which can be really fun. I mean, I’ve got triplets that are learning how to swim. They’re about to turn five, and my husband and I are in the pool with them, when we’re at the pool.

Dr. Mike Patrick: Even if there’s a lifeguard present.

Dr. Lara McKenzie: Even because we have got million lifeguards at our pool, we are always in with them. Because you just got to be close to them.

Dr. Mike Patrick: And then, for those older kids, you may not need to be right there with them but you probably should still be paying attention, right?

Dr. Lara McKenzie: Absolutely. So we don’t want to have any distractions. You really need to give kids your full attention when they’re in the pool. So you don’t want to be reading or talking on the phone or really chatting with other people. And, if you’re going to do that, then you need to designate someone else to be the watcher, the water watcher, basically of the kids. If you know you’re going to be let’s say at a barbecue or a pool party, and you’re going to be cooking and hosting or doing something else, then we need to identify who is going to be watching the kids.

Dr. Mike Patrick: It reminds me of meerkats.

[Laughter]

Dr. Mike Patrick: You know, they got the one sentry. There’s someone that’s always watching. So when you have parents around the pool, someone needs to be the meerkat sentry.

Dr. Lara McKenzie: Someone needs to be. And to identify with the other adults who that person is going to be. So that there’s not any misunderstanding that “Oh, I thought you were,” “Oh, I thought you were.”

0:14:11

And it’s really important to learn CPR. So when you only have seconds, when someone may be having near drowning experience or some other swimming injury, knowing CPR can really save their life.

Dr. Mike Patrick: Yeah. What about life jackets?

Dr. Lara McKenzie: For little kids in pools, we want something that is not one of the inflatables basically. So, things that are inflatable can deflate, and they can also slip off. So we want something that’s lifeguard-approved and usually has the inserts in it that gives a little more sturdy shapes and buoyancy. We don’t want to use thing like the water wings, the inflatable water wings, but life jackets are fine — coastguard-approved life jackets.

Dr. Mike Patrick: Coastguard-approved life jackets.

Dr. Lara McKenzie: Coastguard-approved life jackets.

The American Red Cross has kind of a sub-site called the Longfellow’s WHALE Tales. It has a lot of water safety tips and ideas, and they do have a whole section on coastguard-approved life jackets, things that you should use, things you should not use. And I’ll put links to those in the Show Notes for this episode, 348, over at PediaCast.org, so folks can find that resource pretty easily, too.

What about swimming lessons?

Dr. Lara McKenzie: So, swimming lessons are a great idea. The American Academy of Pediatrics recommends a swim lesson age, that kids are ready about on their fourth birthday, fourth or fifth birthday, I think. It doesn’t mean they can’t taking swimming lessons sooner. A lot of people want their kids to be comfortable around water, but really, kids don’t learn how to hold their breath well and really sort of master the skill of swimming until they’re about four years old. So it’s fine to enrol them in swim lessons, but I wouldn’t ever rely on or trust that age swimmer by themselves.

Dr. Mike Patrick: What about those baby swimming classes? Are those useful at all?

0:16:23

Dr. Lara McKenzie: I think they’re maybe a fun activity for parents and their infants, but again, I wouldn’t trust the toddler and infant around the pool just because they’ve taken the swim class. At all.

Kids are really curious. They have no idea about depth at that age. They don’t realize danger at that age. They’re also attracted to water and to toys. And because of the point we made earlier where drowning can be very silent thing, a little kid can slip into a pool. We’ve heard this story over and over again.

Dr. Mike Patrick: Absolutely. And I’ve seen YouTube videos out there where they take babies and just basically drop them in the water, and then show you that these babies have been trained to float on their backs. But that’s extremely dangerous, right? I mean, they lucked out on that video.

Dr. Lara McKenzie: Yeah, I would not do that, though. I wouldn’t do that even it’s been… They’re not like dogs…

Dr. Mike Patrick: Yeah, absolutely.

[Laughter]

Dr. Mike Patrick: Not a safe thing.

Dr. Lara McKenzie: That can sort of… They instinctually know how to swim.

Dr. Mike Patrick: I’ve had listeners submit links to those videos before, and it’s just crazy that people would do that to their babies.

Dr. Lara McKenzie: I’ve also seen an inner… It’s like inflatable inner tube that they put around a baby’s neck to keep the baby’s head above water. I would also never recommend something like that. Not only because it’s… And, one, because it’s an inflatable and you can’t trust it. But that just does not seem…

Dr. Mike Patrick: Yeah, it could open and keep your heads underwater.

Dr. Lara McKenzie: Underwater, exactly, yeah.

And while we’re talking about sort of add-on, using things on the pool, even for older and stronger swimmers, I would not recommend things like the mermaid tails or the mermaid fins. So, mermaid tails are some things that can be worn sort of from the waist down that keeps the legs binded, legs are bound together so you look like a mermaid and keep your feet together.

0:18:24

It’s very hard to right yourself when your legs are tied together. This is something, I guess, we challenge even sort of Navy Seals with, how to swim when you’re bound together. But we don’t want to challenge even our strong adolescent or young swimmers in this way because it is difficult to sort of get yourself back up to a good position when your legs are tied together.

Dr. Mike Patrick: Absolutely.

Dr. Lara McKenzie: A lot of local pools are banning the use of those kind of garments or that kind of device, but I would recommend not using them even in your private pools.

Dr. Mike Patrick: And the kids who are pretty strong swimmers and they’re taking swimming lessons from age four and up, and they’re in advance swimming lessons, you still want to pay attention when those kids are in the pool.

Dr. Lara McKenzie: Absolutely.
Dr. Mike Patrick: Don’t use it as a safety net that, “Well, they know how to swim. We don’t need to pay attention to them.”

Dr. Lara McKenzie: Right. Because there are other kids, there’s others splashing or maybe roughhousing. They may be fatigued. They may be trying to do something they’ve never done before or in a depth that is unusual for them. Just because they know how to swim does not mean they’re immune to drowning.

Dr. Mike Patrick: And even if they’re strong swimmers, keep in mind too, open water is different than being in a pool, correct?

Dr. Lara McKenzie: Absolutely. So, depending on what kind of open water you’re talking about, there could be currents or waves or undertow. The depth can change when you’ve been talking about big lakes or ocean. So what you might be used to one day is going to be vastly different conditions than the next. I mean, it can change hour by hour in some natural bodies of water.

0:20:08

Dr. Mike Patrick: Yeah, absolutely. You talk about horseplay. What are some of the rules that we should enforce around the pool?

Dr. Lara McKenzie: PoolSafely.gov has some really good tips about pool safety and a Pool Safely pledge. So that’s one place to check out some tips for around the pool.

As I mentioned before, knowing how to perform CPR on children and adults is a great tip. Never leaving children unattended in or near water. Learning how to swim and ensuring that your child knows how to swim are good tips. We also want to install proper barriers, covers and alarms on an around your pool and spa.

We don’t want to use any air-filled swimming aids like inflatable armbands in the place of life jackets because these can deflate, and they’re not designed to really keep swimmer safe. Again, no mermaid tales or mermaid fins.

It’s also important to know the depth of the water and any underwater hazards. So this is maybe not as important for pools in terms of underwater hazards, but in other natural bodies of water, it might be really relevant. But certainly knowing the depth of water in a pool is important because jumping or diving can really be affected if it’s too shallow.

Dr. Mike Patrick: Yeah. Really when they get in the pool, especially in the beginning, always feet first, right?

Dr. Lara McKenzie: Yup, feet first.

Dr. Mike Patrick: Until you know for sure that it’s more than nine feet deep and you have been trained to dive.

Dr. Lara McKenzie: To dive.

Dr. Mike Patrick: That that’s been a part of their swimming lessons.

Dr. Lara McKenzie: Yeah, I’ve seen a lot of belly flops.

[Laughter]

Dr. Mike Patrick: Yeah, yup.

Dr. Lara McKenzie: We also want to avoid distractions when we’re supervising children around the water. So, the adults that are watching kids in or near the water have to avoid distractions like reading books, talking on the phone. So, this is not the time where mom and dad get to relax. Maybe they can take turns doing that, but one person needs to really always be watching the kids in the water.

0:22:13

More than half of pool drownings really can be prevented if parents put up a four-sided fence around the pool. In this fence should be at least four feet high and have a gate that closes and latches on its own. So, when we say four-sided fence around the pool, that means one of the sides cannot be the house, basically, because you need to fence off access to the pool all the way around. A lot of kids have drowned in home pools because they are able to walk out the back sliding door or some other way to get out into the pool area and slip in to the pool very quickly and silently.

And I think the other one’s, yeah, we’ve talked about watching kids in the pool and being within arm’s reach.

Dr. Mike Patrick: No eating or drinking when you’re in the pool.

Dr. Lara McKenzie: That’s right, mm-hmm.

Dr. Mike Patrick: Do worry they could choke.

Dr. Lara McKenzie: Yeah. They’re already trying to swallow pool water when they’re playing. So, yeah, we don’t want anything in there like that and just concentrate on the swimming and having fun.

Dr. Mike Patrick: Yeah, absolutely. What about the drain, the pool drain? That can be dangerous for some kids too, correct?

Dr. Lara McKenzie: Yeah, the suction in pool drains can be really dangerous. So you want to avoid entrapment by keeping children away from the pool drain, pipes or other openings. We also want to teach kids to stay away from the drains. The suction can be really powerful. It doesn’t seem like it would be because you’ve got this huge pool of water and you don’t notice the pool so much in a drain. But it is very powerful and kids, if they get too close to it, or what happened in a lot of cases is kids get their hair or something caught in the drain and they can’t free themselves because the suction is so powerful.

0:24:07

So this is something we want to check in our backyard pools, our public pools. We want to make sure they have compliant drain covers. There’s been legislation passed in the last, I don’t know, maybe ten years I think about changing the pool covers on drains. So this is a protection matter so the kids aren’t as susceptible but it can still be something to watch out for.

Dr. Mike Patrick: So if you see a flat drain just with holes in it, that’s going to be the most dangerous kind.

Dr. Lara McKenzie: Yeah, we want something that sort of has a dome.

Dr. Mike Patrick: Yeah, that’s something to check in. Just don’t let your kids in the pool if it doesn’t have a protective cover.

Dr. Lara McKenzie: Exactly.

Dr. Mike Patrick: Even if it has protective cover, still teach them to stay away from the drain because it doesn’t protect it a 100%.

Dr. Lara McKenzie: Yeah. And this is something I think people are might not even be aware of for hot tubs and spas. The concept here is still the same in that you don’t want kids to be near that drain, can be really powerful, that suction.

Dr. Mike Patrick: Speaking of hot tubs, are there rules for hot tubs? When are kids old enough to go into a hot tub?

Dr. Lara McKenzie: I’ve seen different recommendations on this. Or not recommendations. I guess I’ve seen different… I don’t know if they’ve decided on the age actually. Maybe this is why I’m getting confused here because I don’t know if there’s a safe age for kids to use hot tubs. The reason is, the temperature is just so hot. What feels warm and comfortable to us in a hot tub or spa is going to be perhaps too warm for very little kids.

And, I think, a lot of people think, “Oh, it’s just a little thing. It will be warm enough for them.” But it actually could be too hot for them.

Dr. Mike Patrick: Yeah. And you want them to be at least tall enough that if they’re standing on the bottom of the hot tub, their heads are above the water. You don’t want them to… You as an adult want to be in a hot tub that’s…

Dr. Lara McKenzie: You couldn’t touch.

Dr. Mike Patrick: Yeah. It’s going to be a little disconcerting.

0:26:06

Dr. Lara McKenzie: Yeah. And the seats in those are usually pretty low. So even for a normal sized adult, you kind of are lifting your head above the water. So little kids that are going to be underwater for sure.

Dr. Mike Patrick: And if they’re going to be in there, keep it short. Five minutes or less because they vasodilate in order to try to regulate their temperature. And then, that can cause a blood pressure to drop. Then, they can pass out. I’m sure anyone, even adults, who’d been on a hot tub too long know what I’m talking about with that. And it’s going to happen even faster with kids, so that’s the reason to sort of just keep that to a few minutes. And I think 104 degrees is about as hot as you’d want it to be.

Dr. Lara McKenzie: Yeah.

Dr. Mike Patrick: And in terms of all these pool rules, you have mentioned PoolSafely.gov, I believe. And we’ll put a link to that in the Show Notes for folks for this episode, 348. And the WHALE Tales from the American Red Cross, they also have a nice listing of pool rules. We’ll put a link to that, too.

You mentioned fences on all four sides of the pool. What about pool alarms like the floating ones? Are those a still good idea to do? Or, if, let’s say you can’t logistically put that fourth fence, maybe have a house that’s already… You just bought the house. It already has the three fences. Is there a way to protect? I mean, I know having the fourth fence is ideal, for sure. But is there a way to protect if you can’t do that?

Dr. Lara McKenzie: Yeah, so there are mesh fences that can be installed, sort of after the fact, that go around the pool. So those I would definitely recommend. I would not rely on that fourth wall being the house, if at all possible.
But pool alarms are maybe one thing you could use. Another one would be a lock on the door out to the pool or an alarm on the door out to the pool. So that you’ll know if it is opened, that someone’s gone out there.

Dr. Mike Patrick: But keeping in mind too that alarms can fail. The batteries can run out, so you’d want to check that equipment, make sure it’s working and pay attention to alarms when they go off.

0:28:03

Dr. Lara McKenzie: I would say, as a parent, I would not want to rely on one of those. I would be really nervous about that. I’d rather invest in getting their fence closed off if I were going to have a pool in my home.

Dr. Mike Patrick: Yeah, absolutely.

And then, slips and falls happen in and around the pool too, so you want to make sure that it’s not too slippery. And that your kids aren’t running.

Dr. Lara McKenzie: Everybody’s been in a pool when a lifeguard says “Stop running,” or “Don’t run.” There’s a reason they do that. They probably go through a ton of Band-Aids with scraped knees and stuff. But pools, the areas surrounding the pool can be really slippery when it’s wet.

Dr. Mike Patrick: What kind of rescue equipment should home pools have available?

Dr. Lara McKenzie: I think a hook is always good. Sometimes, just using the other end of pool net that you’re using to skim the pool can be used in the same way. When you’re rescuing somebody who’s drowning, you want to do everything you can and not get in the pool with them, if you can at all rescue them without getting in the pool. So, this would be you’re sort of reaching a shepherd’s crook or a pole to them to see if they can grab that and pull them in.

And the reason to not get in the pool with someone who’s drowning or trying to go up to somebody’s drowning, they’re trying to grab on to something and they will try to grab on to you.

Dr. Mike Patrick: Yeah, especially if it’s deep water.

Dr. Lara McKenzie: Exactly.

Dr. Mike Patrick: If it’s a littler kid in shallow water, then…

Dr. Lara McKenzie: Yeah, just grab him.

Dr. Mike Patrick: Get in there, if you can grab him. But if someone’s struggling in the water, it’s best to throw them something.

Dr. Lara McKenzie: Yeah, a ring. A safety ring is always good with the rope on end and a shepherd’s crook is another thing or a pole.

Dr. Mike Patrick: Yeah, absolutely. And then, CPR instructions, is that something that’s a good idea just to have on hand? It’s better to know CPR.

Dr. Lara McKenzie: Probably, it is better to know, but to have your cell phone available and to call 911. If you don’t know CPR, you’re not certified, I would say best to call 911. Well, call 911 regardless. That would probably be the first thing you should do.

0:30:07

Dr. Mike Patrick: Yup, absolutely. And a first aid kit may be a good idea just to have on hand, some bandages and Band-Aids.

Dr. Lara McKenzie: At least pack bandages.

Dr. Mike Patrick: Yeah, triple antibiotic ointment and that kind of stuff.

Now, in terms of keeping things maintained, so we’ve kind of created the safe environment. We said that these are rules that we need to uphold. We also want to sort of just check the equipment. It’s easy for ladders and hand rails and if you have a diving board, things to become loose or damaged. So you just on a regular basis sort of want to check all of that stuff out, correct?

Dr. Lara McKenzie: Right, we want to make sure fences are sturdy. We want to make sure the safety latches work. We want a self-latching gate, one that closes and latches by itself.

Try not to leave toys in or around the pool. The reason here is not just a tripping hazard. It’s because those are attractive to little kids. And so, they might try to reach for something that’s in the pool, like a floating something rather, a ball or a toy that they want. And they don’t realize they can’t reach it, they fall in. They drown.

Dr. Mike Patrick: Get that stuff out of the pool when done.

Dr. Lara McKenzie: Get that stuff out, yeah, when you’re done.

Dr. Mike Patrick: Out of sight, even.

Dr. Lara McKenzie: Exactly. It’s good to put it in the shed or put it away somewhere away from the pool.

Another thing is depth markings, to make sure that those are really clear or that it’s marked clearly to not dive. So that people who might be new to your pool know that it’s not deep enough to dive. And then, you mentioned sharp edges and surfaces, those are things you want to keep in good repair. Ladders and different screws can come loose and have sharp edges. This is stuff that people got cut on and they get stitches.

Dr. Mike Patrick: Kind of do an inspection here and there, absolutely. So let’s say there is an emergency. What is the procedure? What do you if there is an emergency?

Dr. Lara McKenzie: I would call 911 first and even as a lifeguard, that was what we were trained to do. So you want to keep a cell phone and another phone charged and nearby. So this is not because you want to check Facebook. This is because you need to have a way to call emergency help. You need it. And knowing CPR is the other.

0:32:19

Dr. Mike Patrick: And CPR, most communities are going to have a place where you could take a CPR class. American Red Cross for sure has lots of CPR classes around. And they have a site as it turns out called Find a Class. We’ll put a link to that in the Show Notes for this episode, 348, over at PediaCast.org, so you can find the CPR class. Because that’s going to be really important to do.

And then, just to be alert and to recognize when someone’s having a problem and initiate the emergency procedures right away.

Dr. Lara McKenzie: Yeah, we definitely want to not wait to see what’s happened.

[Laughter]

Dr. Mike Patrick: Yeah, right. Right.

Dr. Lara McKenzie: We want to get in, get them out.

Dr. Mike Patrick: Yeah, and if you’re concerned that someone has injured their head or their neck, you want to keep their head and neck still as well until emergency personnel arrive, just in case they have a head and neck injury.

Dr. Lara McKenzie: Yeah, that’s a different kind of rescue than most people might be used to, but you want to maybe not move them. But obviously get their face and everything out of the water so that they’re breathing.

Dr. Mike Patrick: Yeah, absolutely. And then a lot of folks has kind of been out of the news a lot lately about secondary or dry drowning. And this really is just symptoms of drowning that occur after a period of wellness. So a kid can look okay for an hour. Let’s say, and then start to have respiratory problems. And those symptoms can actually start up the 24 hours after submersion event.

So, if you do have a kid that goes under, but they kind of gasped or choked or coughed — there’s some evidence that air did get in and around their airway — then it’s a good idea to keep a close eye for up to 24 hours afterward, and if they start to have any respiratory problems at all, to have them checked out.

0:34:12

Dr. Lara McKenzie: Yeah, that’s a great idea. It is a little scary to think because the image that comes to mind is the drowning on land basically. It’s because they’ve had some kind of distress in the water.

Most kids are fine. Most kids are fine that this happens to.

Dr. Mike Patrick: And there’s no way to predict which kids that it is going to happen to. So you just want to keep a close eye on them, have a low index of suspicion for getting them and to have someone take a look at them. But also not to worry about it. I mean, watch them but don’t lose sleep over it, because it usually does not happen for most kids.

As it turns out, I did write a blog post on secondary drowning for 700 Children’s, and I’ll put a link to that in the Show Notes as well, so folks can read more about secondary drowning. And then, to prevent that, again, it’s just the same ways as to prevent regular drowning is just, again, all those safety tips that we’ve been talking about.

What about bathtubs? You mentioned that sort of in the very beginning. Are there additional particular safety concerns or rules that we should think about when kids are getting baths?

Dr. Lara McKenzie: Sure. So, again, young children or any size children can drown in bath tubs, toilet sinks, buckets, coolers or any place in the house that water can collect. Most of the drownings in the home happen in the bathroom . Parents with young kids really always need to keep the bathroom door shut, putting a safety cover over the door knob will help prevent little kids from getting into the bathroom when they shouldn’t.

So, once they’re in there, a toilet lock on the toilet can be good, and not leaving the bath tub full when you’re done. So, emptying the bath tub as soon they’re done bathing.

Having an adult, not an older sibling, watching infants and young children in the bath tubs at all times. Children can drown in the time it takes to answer the phone basically, so we don’t want to ever leave them alone.

0:36:18

Some parents think that using a bath seat or baby bath seat will keep their child safe but bath seats don’t prevent drowning. I would recommend not using them.

Another thing we’ve seen a lot lately are putting kids in a laundry basket in the bath tub. And I think people are doing this because they want to keep the toys that the child is playing with close to the child. But I think I would argue that a laundry basket is actually even worse than a bath seat because it doesn’t have the suction. It can float. Kids can get turned over in it, and it doesn’t do anything to prevent drowning. It might keep your toys close together but that’s not going to help a child not to drown. So I wouldn’t use those.

Dr. Mike Patrick: And it could flip over, right? Again, that would be scary.

Dr. Lara McKenzie: Yeah. Then they’re just trapped underneath it. I wouldn’t use those at all. And always drain the bath tub immediately after you’re done using it.

Dr. Mike Patrick: Great, great safety tips. The toilet one is particularly disconcerting to me because I could see it’s just that right height that a toddler can lean over at the waist to look inside and bang their heads underwater.

Dr. Lara McKenzie: Yeah, and kids are top heavy. They’ve got bigger heads and smaller bodies when they’re little like that. And they can have trouble righting themselves, the same way we talked about with mermaid tales. They got all this weight at the top of their body and their head is heavier, so it’s hard for them to kind of pull themselves out. And they would be confused and they might be scared, and all those things.

Dr. Mike Patrick: Absolutely. And this is another reason to learn CPR, even if you don’t have a home pool or you’re not really planning on taking your kids swimming or it’s the middle of winter. It really just…

0:38:05

Dr. Lara McKenzie: You got a toilet.

[Laughter]

Dr. Mike Patrick: Yeah, and a bath tub.

Dr. Lara McKenzie: And a bath tub, probably.

Dr. Mike Patrick: Yeah, every parent should find an American Red Cross CPR class. Again, we’ll put a link in the Show Notes, so you can find one in your local area. In the Show Notes for Episode 348 at PediaCast.org.

One last thing, especially as we think about baths, water temperature is also an important thing to think about. What are the rules again? And we talked about this, I think, when we did fire and burn safety. But just a reminder, what are the rules for water temperature at home?

Dr. Lara McKenzie: Sure we want to test the water temperature at your home. This is something not necessarily drowning prevention. This is a scald prevention but it has to do with the temperature of the water throughout your house. So, the water temperature on your water heater should be set to 120 degrees Fahrenheit.

The way that you’d know or test the water is to run the hot water from the faucet for about a minute. This is not when you’ve just taken a hot shower or don clothes. This is when maybe the water hasn’t been on for awhile.

This is going to be the true test of your temperature.

So you going to fill a cup with hot water. You going to check the water temperature using a thermometer that goes up to 120 degrees Fahrenheit or more. This can be like a candy thermometer, meat thermometer. They usually go up higher than that. And you’re going to see what the water temperature is. That will be the real test of what your hot water temperature is. And then, you make some adjustments from there typically, because sometimes your water will be hotter. You want to turn the dial down on a hot water heater if it’s higher than a 120 degrees Fahrenheit.

And for gas water heaters, you can usually turn the dial. It may have actual degree markings to a 120. And for dials that have words like warm, hot, vacation you usually want to turn it towards warm. For electric hot water heaters, you should really call an electrician or your landlord because it’s not really safe to adjust an electric hot water heater by yourself.

0:40:06

And then, the last step of checking your water to wait about an hour and then recheck that water temperature. So you’re basically going to repeat the steps from before. You going to run that water, hot water for a minute. Take a cupful and measure it again. See if you’ve gotten it down to the right temperature.

Another way to prevents scalds in faucets and in showers is to install anti-scald devices. These shut off the water immediately, the hot water immediately, when the water temperature goes above 120 degrees on a faucet or a shower.

Now, I would just like to tell people this is a 120 degrees, having your water that high is still hot enough for you to take a hot shower and wash your clothes and wash your dishes. This is not where you going to be bathing in cold water. But this is a better temperature so that kids don’t get scalded right away from hot water. Their skin is thinner than adult skin. It burns faster with hot water than an adult.

But I would also just make sure people know a 120 degrees is too hot for a baby. This is not the temperature you want to bathe someone. This is the maximum hot temperature that you want for the water in your home.

Dr. Mike Patrick: Yeah, because you wouldn’t fill the bath with just hot water, right?

Dr. Lara McKenzie: With just hot water, right. You will burn yourself if you did that.

Dr. Mike Patrick: So a 120 degrees, don’t trust the degree markings on the tank. Test the water temperature with a thermometer. Our hot water tank actually has letters. It’s just not very helpful at all. It has A,B and C.

Dr. Lara McKenzie: A lower than C.

[Laughter]

Dr. Mike Patrick: You can’t even tell, really. So we put it at B and then test it to make sure that it’s at the right place. But it still can be very confusing, so it’s important to check that out.

All right, so remind us again, Make Safe Happen, where can folks find much more in terms of not only water safety but outdoor safety and other safety tips around the home? Really sort of going room by room.

0:42:10

Dr. Lara McKenzie: Room by room so MakeSafeHappen.com is the website. The app can be found at iTunes or Google Play.

And there is one more thing I wanted to mention about what Make Safe Happen is doing in terms of water safety. They’re helping to make an impact through supporting the Red Cross Aquatic Centennial campaign. We’ll help teach 50,000 people about water safety and how to swim across 50 cities where the drowning rates are the highest. This is going to allow adults and children who wouldn’t otherwise have the opportunity to learn this life-saving skills to learn them. So that information is available at MakeSafeHappen.com.

Dr. Mike Patrick: Great. So we have a tons of links in the Show Notes this week. We’ll have the previous two episodes that Lara has stopped by for, Fire Safety, PediaCast 336 — fire and burn safety — and poison safety which was Episode 344. We’ll have links to those.

Make Safe Happen, obviously, we’ll have a link to that. And then the various ones that we’ve talked about — the PoolSafely.gov and the American Red Cross Find A Class, the Longfellow’s WHALE Tales resources. Lots of stuff for you in the Show Notes this week over at PediaCast.org. Again, in the Show Notes for Episode 348.

So Dr. Laura McKenzie, Principal Investigator with the Center For Injury Research and Policy here in Nationwide Children’s Hospital. Thanks again for stopping by.

Dr. Lara McKenzie: Thanks for having me.

[Music]

0:44:13

Dr. Mike Patrick: All right, we are back with just enough time to say thanks to all of you for taking time out of your day to listen to PediaCast, we really do appreciate that.

Also, thanks to Dr. Lara McKenzie, Principal Investigator with the Center For Injury Research and Policy at Nationwide Children’s Hospital. Really appreciate her stopping by to talk with this about water safety and drowning and all those things. So, really important topic, please share that with all the parents that you know so that their kids, too, can be safe around the water.

That’s all the time we have today. PediaCast is a production of Nationwide Children’s Hospital.

Don’t forget you can find PediaCast in all sorts of places. We’re in iTunes in the Kids and Family section of their podcast directory. We’re also in most podcast apps for iOS and Android. If you can’t find us in your favorite podcasting app, be sure to let know, and I’ll do my best to get the show added to their particular line-up.

We’re also on iHeart Radio where we not only have this program but also PediaBytes, B-Y-T-E-S. These are shorter clips from the show that can be weaved together with other content providers to make your own custom talk radio station.

There’s also the landing site, PediaCast.org, where you’ll find hundreds of past episodes, Show Notes, transcripts, our Terms of Use and a handy Contact page to ask questions and suggest show topics.

We also have a voice line, if you’d rather phone in your question or comment. And that number is 347-404-KIDS. 347-404-K-I-D-S

We’re also on social media including Facebook, Twitter, Google+ and Pinterest with lots of great content you can share with your own online audience.

And, of course, we always appreciate you talking us up with your family, friends, neighbors and co-workers, anyone with kids or those who takes care of children, including your child’s healthcare provider. In fact next time you’re in for sick office visit — maybe it’s a well check-up or sport physical, a medicine recheck — really whatever the occasion, let them know you found an evidence-based pediatric podcast for moms and dads. We’ve been around for a decade now, so tons of content, deep enough to be helpful but in language that parents can understand.

0:46:13

And while you have your provider’s ear, let them know we have a podcast for them as well. We call it PediaCast CME, which stands for Continuing Medical Education. It’s similar to this program but we turned that science up a couple of notches and offer free Category 1 CME credit for listening. Shows and details are available at PediaCastCME.org.

We also have posters available, and always appreciate you sharing the show that way on a bulletin boards in day care centers, really wherever parents congregate. It’ll just be helpful to let them know about the show, and you can find the posters at PediaCast.org, again under the Resources tab.

Thanks again for stopping by. And, until next time, this is Dr. Mike saying stay safe, stay healthy, and stay involved with your kids. So long, everybody.

[Music]

Announcer 2: This program is a production of Nationwide Children’s. Thanks for listening. We’ll see you next time on PediaCast.

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