What to Do if a Child Is Drowning: New Guidelines

Drowning is a leading cause of death for young children and it can often happen silently. Though it’s a topic no parent wants to think about, it’s important to understand both how to prevent drowning and how to help a child experiencing a water-related medical emergency.

“While we consistently focus on how to lower the risk of drowning for children with education and prevention, we also need parents to be prepared in the event that a water emergency occurs,” says pediatrician Tracy McCallin, MD, faculty member in the Division of Pediatric Emergency Medicine at University Hospitals Rainbow Babies & Children's.

Dr. McCallin shares new guidelines for what to do if a child is drowning, recently updated by the American Heart Association (AHA) and the American Academy of Pediatrics (AAP).

Start With Drowning Prevention

The first and most important strategy for parents is drowning prevention, says Dr. McCallin. This requires a multi-layer protection plan as there is no single way to prevent drowning.

Experts recommend five key protection strategies to help prevent accidental drowning:

• Install pool barriers to prevent unanticipated access to water, especially in the 1-4 year age group.
• Provide consistent supervision when children are in the water.
• Enroll children in swimming lessons to learn water competency skills.
• Use life jackets for all water activities.
• Have an emergency plan in place, including CPR training.

Nearly 88 percent of child drownings occur with at least one adult present, so it’s important to always be vigilant. “Make sure young or inexperienced swimmers are always within an arm’s reach of a supervising adult—designated as a ‘water watcher’—to keep a constant eye on all children in or near the water,” says Dr. McCallin. In addition to CPR training, designated water watchers should have swimming skills in case they need to assist a child.

It’s also important to be aware that nearly 70 percent of drownings in children younger than 5 years occur when they're not expected to be in the water. This highlights the importance of barriers around bodies of water, especially residential pools, where children can slip out of the house unnoticed and get in the water. Always be aware of potential water hazards when visiting a new location, such as a friend or neighbor’s home, or a vacation home rental.

Every Second Counts

If a water emergency does occur, it’s essential to know what to do. First, call for help, provide a flotation device and rescue the child from the water if it's safe to do so. Since every second counts in a water emergency, it’s vitally important to begin CPR as soon as possible after the child is safely removed from the water. (In-water rescue breathing should be given only by rescuers trained in this special skill.)

Early CPR is one of the most critical factors during a water emergency. The new guidelines call for CPR to be started on anyone removed from the water without signs of normal breathing or consciousness. “Drowning generally progresses quickly from respiratory arrest—when a person is unable to breathe—to cardiac arrest, meaning that the heart stops beating,” says Dr. McCallin. “So CPR in drowning should focus on restoring both breathing and blood circulation, with both chest compressions and rescue breaths.”

Dr. McCallin also recommends that parents and caregivers update their CPR training every year or two, to ensure they are prepared to provide it in the event of an emergency.

When to Seek Emergency Care

The AAP and AHA recommendations also advise caregivers to take any child involved in a drowning event (where they were submerged under water) to a hospital for evaluation, monitoring and treatment. Typically, any concerning symptoms or signs of drowning-related problems will develop within the first couple of hours after a drowning event.

“If you notice your child experiences cough, confusion, fatigue or lethargy, vomiting or trouble breathing after being in the water—even if they seemed okay coming out—call 911 or take your child to the nearest emergency room for evaluation,” Dr. McCallin adds.

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