LAUSR

Drowning is the leading preventable cause of death for children between the ages of 1 and 4 years worldwide. (1) It is also the second leading cause of unintentional death for children under the age of 14 years in the United States. (2) Adolescents are the second highest risk age group for drowning after children 1 to 4 years of age. Drowning also adversely affects children from a variety of ethnic groups and socioeconomic levels.1 In 2017, it was reported that Texas and Florida ranked number one in the nation in drowning deaths for children between 1 and 14 years of age, and Texas remains in the top 3 states nationally on an annual basis.2 Drowning can occur in any body of water, including but not limited to bath tubs, swimming pools, and open water.3 The CPSC (Consumer Product Safety Commission) has reported that 69% of drownings for children <5 years occurred during non– swim times when they were not expected to be in water.4,5 Although current interventions have been unsuccessful in eliminating drowning deaths, this is a preventable problem. There is no single way to prevent drowning, and a multi-pronged approach to water safety must be employed.6 Barrier fencing is the most proven way to prevent drowning by using four-sided fencing around residential pools with self-closing and latching gates.6 Swim lessons are now endorsed by the 2019 American Academy of Pediatrics (AAP) policy statement for most children between 1 and 4 years of age if developmentally ready.6 This is in contrast to the previous position in 2010 when there was insufficient evidence to recommend swim lessons for children 1 to 4 years of age.6 Supervision is an important water safety strategy involving education of caregivers to utilize “touch supervision.” This concept is based on having a designated adult water watcher (who is not distracted by social media, phones, or other activities) who keeps young children at arm’s reach. Other water safety strategies include use of life jackets, cardiopulmonary resuscitation training, pool alarms, and abstinence from alcohol use in adolescents.6 Lifeguards offer an additional layer of protection to prevent drowning, but they do not replace direct caregiver supervision.7,8 Of these listed factors, parental and provider education was the focus of our intervention, specifically regarding touch supervision for young children in or near the water.