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Educate
Teach your child never to:

• Jump into an unknown body of water
• Run, push, or jump on others in and around water
• Swim alone
• Jump in to rescue someone who is drowning

SINK OR SWIM

Ninety percent of drowning incidents are preventable. So why does the tragedy of losing a child to drowning unfold in more than one home, every day in South Africa?

According to Dr Glen Staples, Medical Director at Netcare 911, “For every child who dies from drowning, five suffer from permanent brain damage as a result of near-drowning”.

Mark Roxburgh, founder and director of RescueRoxy, which teaches children about safety, and author of A Paramedics Children, explains that there are 4 links that medical professionals refer to as the Child Chain of Survival. These are steps that need to be taken to prevent a child’s death from unnatural causes like drowning.

THE FOUR STEPS

1. Prevention of injury
2. To administer safe and effective CPR
3. Call emergency services
4. Advanced life support

Mark emphasises that medical professionals only administer the fourth and final link in this chain of survival. This means 75% of your child’s chances of survival falls into your hands or your caregiver’s.
Mark says, “without parents ensuring their child’s environment is as safe as possible, being fully trained to administer CPR and keeping emergency numbers in accessible places at all times, even well-trained and experienced paramedics have little hope of saving their child’s life”.

In an emergency every second counts. After a mere four to six minutes, brain cells start to die and irreversible brain damage occurs. This chilling reality drives home the importance of taking this parental responsibility seriously.

We examine the three crucial parental roles: prevention of injury, CPR and calling the emergency services.

PREVENTION

Layers of safety need to be applied to make prevention a viable option. No single method is able to override all the complexities of human behaviour.

Supervision
The ultimate in drowning prevention is constant supervision. Yet, 90% of children who drown do so under the care of an adult and are seen less that five minutes before they are found unconscious. So, where do things go wrong?
Malcom Midgley, spokesperson for Johannesburg Emergency Medical Services says, “Being close by doesn’t do it”. He tells of a child who fell into a half-full pool 2m from the braai area where his family was gathered, and drowned without anyone noticing.
A young child drowns in silence. When the child first slips under the water, he is in shock and struggles just to breathe. He may struggle but not loudly enough to alert you.
The American Academy of Paedatrics (AAP), stresses that “touch-type” supervision, where an adult is always within arm’s reach of a child, should be used.

Swimming lessons
Malcom Midgley recalls several parents of drowning victims relaying that their child was “drown-proof”. There are discrepencies in swim school teaching methods across the country, so as caregivers it’s important for us to ask tough questions.

What is “drown proofing”?
Nell White, founder-director of Aquatots Swim Program and author of Todswim SA, says “This approach is a hard-line, adult-centred approach to teaching infants to stay afloat with the minimum amount of assistance, after having been placed in the water. When they sink, they are left to fully submerge before being nudged back up again. Parents must be prepared to subject their children to a life-threatening ordeal, with all accompanying anxiety and trauma each time they have a lesson.”
Nell points out that most infant swim lessons focus on this method, which is referred to as Survival Back Float. The difference is in the teaching approach.

How can you build water safety into your lifestyle?
Your child can drown in less than 4cm of water. Small children are born explorers and don’t understand consequences. They depend on adult caregivers to be responsible and patient with them as they learn. Educate your child about safety but don’t depend on it.

Take action:

Water Collection
Inspect your home for water collection points. Empty and turn containers upside down immediately after use. Watch out for: buckets of water, bath tubs filled with water, bathrooms with the door open and the seat toilet up, the blow-up pool in the garden, the uncovered fish pond, the empty container near a dripping tap, uncovered drains and holes in the garden, and anything else that may not be obvious, until you switch on your baby safety radar.

Bathrooms

• Minimise toilet bowl access
• Use prevention provisions like non-slip bath mats
• Children under the age of 6 should not be left in the bath unsupervised.
  Pools – swimming, jacuzzis, koi ponds
• Provide two barriers around and over bodies of water. One is not enough. 70% of all child drownings in the USA occurred in fenced pools.
• An SABS-approved fence, a minimum of 1.2 metres high, which is lockable and spring-loaded to activate self-latching.
• A professional, fitted pool net, which holds your child above the water over the entire pool area.
• A sub-surface pool alarm to alert you if a child enters the water. Surface pool alarms tend to trigger false alarms and may make you complacent in response.

CPR

Preventative methods may be unsuccessful and you have take the next step to promote your child’s survival – administering safe and effective CPR.
It is important to understand what happens to your child, physically, during the stages of drowning.

At first a young child submerged in water is focused on being able to breathe rather than on how to get out of the water as they are in a state of shock and discomfort. Water will start to enter the mouth and cause the epiglottis to close over the airway. Without oxygen, the child will become unconscious and motionless. Breathing has stopped, so he is respiratory arrest. Due to the lack of oxygen to the brain, the victim may look as if he having a convulsion. Skin turns blue, especially the lips and fingernail beds, and the body may appear rigid. Clinical death occurs when both breathing and circulation stop. The heart stops pumping blood and the child is in cardiac arrest. The vital organs are no longer receiving oxygen-rich blood.

The earlier a lifesaver begins cardiopulmonary resuscitation (CPR) after the child’s heart stops and the alerts the emergency services to provide defibrillation (if necessary), the better the child’s chance of survival.

Every parent and caregiver needs to complete a Basic Life Support course that will enable them to fulfil their role of supplying oxygenated blood to the child’s brain, until the emergency services arrive to provide advanced medical care.
To obtain the details of accredited basic life support training centres contact the Resuscitation Council of Southern Africa. It will cost you around R300, half a day in time, and you’ll only need to update again after two years. If you are faced with an emergency before you undertake your training, any CPR is better than no CPR at all. It is your child’s only hope!

It is recommended that you alert someone to call EMS while you start CPR. If you are totally alone perform five cycles of two rescue breaths and 30 chest compressions, then call the EMS and continue CPR until they arrive.

EMERGENCY MEDICAL SERVICE (EMS) NUMBERS

• Keep the numbers of all the emergency service providers on you, in your cell phone and visible in your home.
• Stick them on the phone and the fridge.
• Practise the national landline and cell phone emergency number with your children regularly. Let them sing the number 10177 and make sure the number forms with their hands.
• Ensure they know who to call in an emergency. Teach them how to the phone and press speed dial.
• Tell them what will be asked of them and teach them the address they need to know, such as their address.
• Call all the relevant emergency service providers. By calling only one service, you may lose time as another provider may be closer to you.
• DON’T hesitate. There is no turning back time.

Article from YOUR BABY magazine September 2007

Resources:
Mark Roxburgh, www.rescueroxy.co.za
Arthur Cronwright, Advanced Life Support Paramedic
Malcolm Midgley (JHB EMS)
Nell White, Aquatots Swim Program
Nelmarie du Toit, www.childsafe.org.za
Swimming SA Call Centre, www.swimsa.co.za
Dr Walter Kloeck, Resuscitation Council