A person is splashing in the water, waving their hands, and screaming for help; someone immediately jumps in the water and saves the person in distress. You have seen it numerous times on TV and in movies. But how many times have you watched the news wondering how a child can drown in a crowded pool? Real-life and Hollywood are not the same. The truth is that splashing and screaming don’t occur. Drowning is quick and silent.   

Drowning statistics are sobering. After birth defects, it is the most common cause of death in children ages 1-4. It’s the second leading cause of death by injury in ages 1-14. For every child that dies of drowning, eight more children are treated for nonfatal drowning in emergency departments. Many nonfatal drownings result in brain damage or permanent disability. Children can drown in 30 seconds, and it can happen in as little as one to two inches of water.  

There are many actions parents can take to protect their children in the water. Supervision is key. Keep small children within an arm’s length and maintain constant touch with them. You can use a life jacket in a pool as well. Floats will not keep a child’s face out of the water; don’t rely on them.  

If you are going to be with a group, assign an adult to be the “water watcher,” who will constantly monitor the children and not be distracted. Most importantly, the water watcher should know the signs of drowning. Look for a quiet child low in the water with their head back, mouth open just barely out of the water. The child is not using his or her legs much but is pushing down with his or her arms as if trying to push out of the water. A drowning child is doing everything possible to keep the airway out of the water and is unable to splash and scream for help.   

Drowning prevention begins well before children enter the pool. For young children, create layers of protection around water. Use fences completely around pools to limit access. You can also use a door and/or gate alarm in addition to—not as a substitute for—fences. Consider these measures for other outdoor bodies of water such as fountains or ponds. Make sure there is no direct access from the house to a body of water. In drowning events for children under 4 years old, 70 percent of the children were not expected to be near water. Of those, 46 percent were last seen in the house.   

Swimming lessons are another layer of protection to prevent drowning. Look for classes that teach swim stroke techniques and water survival competency skills such as getting out of the pool or propelling to the surface from under the water. Children should continue these classes until they have mastered the skills, but parents should never rely solely on swim classes to prevent drowning. 

Drowning risks exist inside the house as well. Children have drowned in buckets, bathtubs, coolers with melted ice, large pet water bowls, and more. Toddlers can easily fall headfirst into any of these items. Without the strength and skill to remove themselves, this can quickly become a hazard. Remember to empty open-top water containers immediately after use and block unsupervised access to bathrooms. Some families place latches on toilet seats to keep them closed. 

Older kids are not exempt. Teenagers, specifically 15-19 years old, have the second-highest fatal drowning rate and are more likely to overestimate their skills and underestimate the dangers. They are also at risk of using substances that could impair their judgment and ability to reason. Ensure that your teens know how to swim, supervise them, and teach them what to do in an emergency. Stress the importance of wearing life jackets on boats. Stress also the importance of knowing how to enter unknown waters. My first ICU patient was a teenager who became a quadriplegic after striking a rock when jumping into a lake with friends. 

The water is fun and exciting. Be sure to take the time to practice water safety so it remains that way for your family.  

David Butler, DO, is a pediatrician with Physicians' Primary Care of Southwest Florida with offices throughout Lee County ( ppcswfl.com; 239-275-5522).