1. Beal, Judy A. DNSc, RN, FNAP, FAAN

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In March 2019, the American Academy of Pediatrics (AAP, 2019a, 2019b) published an update to its 2010 Policy Statement on the Prevention of Drowning (AAP, 2010). Drowning is the single largest cause of injury-related deaths in children 4 years of age and younger with nearly 1,000 children dying each year (AAP, 2019a, 2019b). Adolescents are also at risk with approximately 370 drowning each year among 10- to 19-year-olds. Although curiosity and unexpected access to water are the most obvious causes of younger children drowning, overconfidence in swimming ability and alcohol use increase risk for adolescents (AAP, 2019a, 2019b). Research on childhood drowning has shown that swimming ability is related to a reduced risk in younger children (Brenner et al., 2009). Cardiopulmonary resuscitation (CPR) is associated with improved outcomes (Kyriacou, Arcinue, Peek, & Kraus, 1994) and half of all boating accidents would be averted if life jackets were worn (Cummings, Mueller, & Quan, 2011).


Although swimming lessons decrease risk of drowning in younger children, per AAP (2019a, 2019b) even the best swim lessons cannot "drown proof" a child. In addition to recommending a four-sided fence that completely surrounds a pool as the most important safety measure for families with a pool, other AAP recommendations include:


* Caregivers should never leave a child alone or in the care of an older child while in or around bathtubs, pools, spas, or other open water.


* Adults should empty water from containers immediately after use.


* Children should never be left alone in the bathroom. Toilets should be locked.


* When young children are in or near water, a supervising adult with swimming ability must be vigilant and at arm's length.


* Even with older children and those with swimming ability, the supervising adult should focus on the child and not be engaged in distracting activities.



The AAP offers many comprehensive resources for providers and caregivers including: talking points for advocacy (American Academy Press Room, 2019); a drowning prevention tool kit, parent's guide to water safety, and a variety of other brochures for families on swim lessons, infant water safety, water safety for teens, and pool dangers and drowning prevention (American Academy Press Room). The drowning prevention tool kit includes:


* Key points for water safety;


* Videos and public service announcements that among other topics include testimonials from parents whose children drowned;


* Infographics on pool safety;


* Water safety tips at different developmental stages;


* Water safety for teens; and


* Social media graphics.



Pediatric nurses can play a crucial role in educating parents, caregivers, children, and teens on water safety and in state-level advocacy. The AAP resources are an excellent for sharing. Encourage parents and caregivers to practice pool and water safety principles at home, while traveling, and when considering having their children and adolescents visit homes of friends, relatives, or caregivers. Parents and caregivers should be aware when their children are participating in activities in settings where there is water or a pool. Children and adolescents should be taught water safety early and receive frequent reinforcement.




American Academy of Pediatrics. (2010). Prevention of drowning (Policy Statement). Pediatrics, 126(1), 178-185. doi:10.1542/peds.2010-1264 [Context Link]


American Academy of Pediatrics. (2019a). AAP updates recommendations to prevent drowning in children. Retrieved from Accessed July 2, 2019. [Context Link]


American Academy of Pediatrics. (2019b). Prevention of drowning (Policy Statement). Pediatrics, 143(5), e20190850. doi:10.1542/peds.2019-0850 [Context Link]


American Academy Press Room. (2019). Drowning prevention toolkit. Retrieved from Accessed July 2, 2019. [Context Link]


Brenner R. A., Taneja G. S., Haynie D. L., Trumble A. C., Qian C., Klinger R. M., Klebanoff M. A. (2009). Association between swimming lessons and drowning in childhood: A case-control study. Archives of Pediatrics and Adolescent Medicine, 163(3), 203-210. doi:10.1001/archpediatrics.2008.563 [Context Link]


Cummings P., Mueller B. A., Quan L. (2011). Association between wearing a personal floatation device and death by drowning among recreational boaters: A matched cohort analysis of United States Coast Guard data. Injury Prevention, 17(3), 156-159. [Context Link]


Kyriacou C. L., Arcinue E. L., Peek C., Kraus J. F. (1994). Effect of immediate resuscitation on children with submersion injury. Pediatrics, 94(2), 137-142. [Context Link]