Why children drown

Summer seems to bring a rash of tragedies: young lives lost at the beach, in the pool, even in a backyard wading pool. Here's how to make sure it doesn't happen to your family.

It was the last day of school. Gabriele Tar and her four kids were standing around their kitchen table in Markham, Ont., revelling in the excitement of two months of impending freedom. Mike, 14, and Kathy, 11, peppered their mom with questions about coming summer fun. “When can we go to Canada’s Wonderland? Are we going to the cottage soon?“ Stevie, almost three, and 18-month-old Krissy were trying to be part of the excitement they couldn’t quite understand.

Suddenly, something clicked on Tar’s mom-radar: “Where’s Krissy?” The toddler had been at her feet a minute ago.

Unable to see her, Tar started calling. At this point, she wasn’t thinking about the backyard pool. There were only two ways to get out there, a back door that was always locked and the big patio door just over a metre from where Tar stood. It was too heavy for Krissy to open by herself. Thinking she might have gone to raid her big sister’s gumball machine, Tar headed upstairs. Just in case, she sent Mike to check the front yard and told Kathy to look in the backyard. Tar was at the top of the stairs when she heard Kathy scream.

She doesn’t remember how she got down the stairs, out the door or into the pool. All she remembers is being in the water beside her daughter, who was floating face down. She pulled Krissy out of the pool and, yelling for Mike to call 911 (which he was already doing), ran with her limp body into the dining room, laid her on the carpet and started to administer infant CPR.

“Remember what you learned at Monique’s, Mom,” Kathy said. (Tar and her husband, Stephen, had recently completed an infant CPR course at a friend’s house.) Tar’s tears fell onto Krissy’s dripping body as she did compressions on the tiny chest.

Unlike some stories, this one has a happy ending. Within a few minutes, Krissy started to moan. By that time, Mike was on the phone with firefighters, who were on their way. “They need to talk to you, Mom,” he said. Mike — who had learned rescue techniques at swimming lessons and would later receive an award for his actions that day — took over, moving Krissy into the recovery position. He rolled her on her side, chin raised to keep the airway open, upper leg bent at the knee, hand under the head. Krissy coughed up a bit of water and started to breathe…and scream.

Each year, dozens of families experience a similar horror. On average, 63 Canadian children under the age of 15 drown each year; nine are toddlers who die in a backyard pool. The Canadian Institute for Health Information estimates that for every one of them, there are six to 10 like Krissy, who have a close call.

Fifteen years after that day, Gabriele and Stephen Tar still ask themselves why their daughter was spared. Krissy came home from hospital the next day. She was fine. But the family couldn’t face reminders of the near tragedy. Gabriele threw Krissy’s pink bathing suit in a hospital garbage bin. The curtains on the patio door remained closed for days. “It was a long time before we used the pool again…before we could even go in the yard,” Stephen recalls.

Stephen had raced from the golf course to the hospital after receiving a pager message, not knowing if his daughter was dead or alive. He now believes a combination of things saved Krissy’s life. One was Gabriele’s inexplicable mother’s instinct, which kicked in just in time. From the toddler’s rapid recovery, doctors estimated that she was only unconscious between 30 seconds and two minutes. After three minutes of oxygen deprivation, brain cells start to die. Neurological damage and death are not far behind.

Secondly, family members knew what to do: Gabriele’s CPR training was fresh in her mind, and Mike knew to put her in the recovery position. The third factor was Krissy’s age, which might explain why she experienced a “dry” drowning — when a laryngeal spasm closes the throat so no water goes into the lungs, only the throat. This can happen at any age, but it is more common in young children. A dry drowning can still kill you — you can’t breathe and pass out from the lack of oxygen. But victims who revive are less likely to suffer lasting damage.
It’s not as if we don’t know how quickly water can kill and that children have to be supervised closely any time they are near the water. We know that kids should wear life jackets in boats and that pools have to be fenced and gated securely. Stephen and Gabriele Tar knew all that stuff. Their back door was locked, as always, that day Krissy fell in the pool. And Gabriele and the older kids were steps away from the sliding patio door, which was normally kept closed (and was too heavy for a toddler to open), but must have been Krissy’s route to the pool. Still, the unthinkable happened. “We thought we were good parents,” says Stephen. “We watched our kids, even Mike and Kathy who could swim. This is proof that it can happen to anybody.”

He’s right. In a single moment, somebody turns his head, a child becomes curious and slips away, or a tot trips and falls near water. A family’s world changes forever.

It all seems to lead to a single safety message repeated over and over again: Watch them, stay close, watch them, stay close. However, parental supervision is not foolproof. A study by the US-based National Safe Kids Campaign found that 83 percent of children who drowned were in the care of an adult at the time. Here are several key pitfalls of adult supervision to watch out for.

Distraction In that survey, parents admitted to engaging in numerous other activities while supervising swimming children: talking to other adults, supervising other kids, reading, eating and talking on the phone.

False security in numbers When a lot of adults are around, it’s easy to believe that young swimmers must be safe under multiple pairs of eyes. In fact, adults in groups can distract each other and may assume that someone else is watching.

Distance Water safety experts say young children and non-swimmers should always be within arm’s reach, even in a shallow pool. “If adults fall face forward into waist-deep water, they simply put their feet down and will usually be able to stand up,” says Barbara Byers, public education director of Canada’s Lifesaving Society. “But toddlers or preschoolers have more of their weight in the upper part of the body. When they fall face forward in waist-deep water, their feet go up and their head goes down. They may not have the coordination and strength to right themselves.”

Silence Many of us have a cartoon image of a drowning victim — thrashing, head up, calling for help. In fact, drowning is usually silent, says Byers. “Struggling drowning victims are usually unable to call for help.” So you can’t rely on your ears to tell you if a child is in trouble.

Here’s a little good news on this grim topic. Drownings are decreasing in all age groups. In 2002, 42 Canadian children under the age of 13 drowned, compared with 84 in 1991, according to data from the Lifesaving Society’s Drowning Report 2004. The total number of drowning victims in all age groups was 373 in 2002, compared with 557 in 1991. Experts say we could reduce these numbers even further.

Please fence me out
Most preschool drownings in backyard pools could be prevented by improvements in fencing and gating, say two safety experts.

Robert Conn was a heart surgeon at Toronto’s Hospital for Sick Children until the summer he “harvested” hearts for transplant from four children who had all drowned in backyard pools. Not long after, he quit his job and launched a safety organization called SMARTRISK. Conn thinks it’s scandalous that few municipalities in Canada require backyard pools to be completely surrounded by a fence; most such bylaws allow the house to be the fourth side. That keeps neighbour kids safe, but not children who live in the house.

Peter Barss, a Canadian MD and injury prevention specialist now at United Arab Emirates University, agrees. In 2003, Barss authored a Canadian Red Cross report that analyzed 10 years of drowning data from across Canada. One finding shocked him: 94 percent of preschooler drownings in backyard pools involved a child who had gained access to a pool that did not have a self-closing, self-latching gate.

These gates close automatically via a spring mechanism and latch on contact. Although some municipalities require such gates, Barss says few parents seem to know, so it’s almost impossible to put the onus on owners. “In my opinion, no home pool should ever be installed without the safety equipment, and any vendor who does so should be liable for the death of children lost in such pools.”

Self-latching, self-closing gates can be found at building and fencing supply centres. According to Barss, the best gate closing device is Magna Latch, made by an Australian company called D&D Technologies. The magnetic mechanism can be opened only by pulling from the top and can be installed on virtually any gate. It is available in Canada by mail order, for about $65 (shipping and taxes not included) at tufware.com.

Swimming to survive
The Lifesaving Society has launched a new program called Swim to Survive, which teaches children, in three lessons, the minimum skills they need to save themselves in most water emergencies:
• treading water for one minute
• swimming 50 metres in any fashion (style definitely doesn’t count)
• a forward roll technique that enables kids to right themselves if they fall into water over their heads

The rationale is to help kids deal with the disorientation of falling into water unexpectedly, Byers explains. “Since two-thirds of drowning victims drown within 15 metres of shore, if children can right themselves, avoid panic and swim 50 metres, many will be able to save themselves.” Swim to Survive is designed for children five and up, and is not meant to replace regular swimming lessons, which are also important. “We’re hoping schools will make Swim to Survive a standard part of the grade-three physical education curriculum,” says Byers. For more information, go to lifesavingsociety.com or call (416) 490-8844.
Finally, an infant PFD
Up to now, parents who wanted to put young babies in a personal flotation device (PFD) have had to resort to models designed for bigger children. That’s better than nothing, but PFDs designed for kids up to 20 pounds (9.1 kilograms) can’t be counted on to stay on an infant, or keep her head out of the water in an emergency. A Kitchener, Ont., company called Salus Marine Wear has developed a new PFD designed for babies as small as nine pounds (4.1 kilograms). The Bijoux Baby Vest has all its flotation material in the front and behind the head, so a baby who falls in the water face first is quickly flipped onto her back. The Bijoux Baby Vest retails for $69 and is available at marine supply and specialty outdoor stores. For more information, see salusmarine.com or phone 1-877-418-9998.

The Tar family eventually started using their pool again, but shortly after the near tragedy, they installed a four-sided fence with a self-locking gate. And, in hopes of perhaps preventing a tragedy in another family, Stephen Tar now sponsors infant CPR clinics in his community. It was about 10 years before he was able to talk about Krissy’s near-drowning publicly. “You have no idea how much it hurts to talk about it,” he says. “And I’m one of the lucky ones. I got my daughter back.”

Drowning by Numbers
• Drowning is the second leading cause of death in young children, after car accidents.
• Kids are most likely to drown or almost drown when they’re aged one to four.
•Most child drownings do not occur in the context of a planned swim. Three-quarters of children who drowned or nearly drowned in Ontario in 2002 and 2003 were not swimming at the time. Most fell into a lake, river or pool while walking or playing nearby.
• Children are much less likely than adults to drown during a boating activity. The typical boat-related drowning victim is a male adult or youth who wasn’t wearing a life jacket or PFD.
• Children sometimes drown in water that isn’t over their heads. Between 1996 and 2000, 33 Canadian children drowned in bathtubs.

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