Drowning: A Quick and Silent Killer In the time it takes to … …cross the room for a towel (10 seconds), a child in the bathtub can become submerged. …answer the phone (2 minutes), that child can lose consciousness. …sign for a package at your front door (4 to 6 minutes), a child submerged in the bathtub or pool can sustain permanent brain damage. 1

Safe Beginnings A prevention program for Sacramento County to reduce infant sleep-related deaths and drowning- related injuries and deaths in children ages Funded by California Kids’ Plates

Safe Beginnings Program Elements Educate Service Providers Educate Parents and Caregivers Program Materials Video Brochure Media Materials 3

The ABC’s of Drowning Prevention Training for Service Providers 4

Learning Objectives After training, participants will be able to: Recognize drowning as a leading cause of preventable deaths for children under the age of 6 Identify the risk factors related to drowning Explain “Layers of Protection” Identify the ABC’s of Drowning Prevention Identify resources for additional information on Drowning Prevention Utilize tools for hosting the ABC’s of Drowning Prevention Parent/Caregiver Training 5

Service Providers & Parents Sacramento County needs an education campaign focusing on: The importance of adult supervision Barriers CPR/swimming Information should be delivered by: Health Care Professionals Fire Departments Child Care Providers 6

Safe Beginnings Collaborative Parent Focus Group Responses 7 What do you know about drowning?  Drowning deaths are a major problem. (fact)  Lack of supervision was a huge problem. (fact)  Pools without barriers or barriers not used regularly are a problem. (fact) X Most drownings occur in rivers and lakes. (myth)

National Drowning Injuries & Death Statistics Drowning is the leading cause of injury-related death among children between 1 and 4 years old. It is the third leading cause of injury-related death among children 19 and under. Statistics only show deaths, but for every… 1 Drowning Death there are 4 Hospitalizations 1 Hospitalization there are 4 ED Visits 8

National Drowning Injuries & Death Statistics On average, 382 children younger than 15 fatally drown every year between 2010 and 2012 in pools or spas, with 76 percent (290) of the victims being younger than 5. An estimated average of 5,400 children younger than 15 were treated between 2012 and 2014 in emergency rooms for pool- or spa-related submersion injuries every year, with 77 percent of the injured being younger than 5. The annual cost of care per year in a chronic care facility for an impaired survivor of a non-fatal submersion event is $180,

National Drowning Injuries & Death Statistics With victims younger than 5 years old; 87 percent of the reported fatalities occurred at residential pools or spas. More than 75% of victims had been missing for 5 minutes or less A child loses consciousness in 30 seconds or less The brain suffers irreparable damage in 4-6 minutes The child can die within 10 minutes. 10

California Statistics 1,343 drowning deaths from , ages % (899 of 1,343) of child drowning deaths occur in children 6 years of age and younger Leading cause of injury-related death for children ages 1 through 6. CDPH EPIC 11

Sacramento County 78 drowning deaths from , ages % (53 of 78) of child drowning deaths occur in children 6 years of age and younger Leading cause of injury-related death for children ages 1 through % preventable CDRT

Sacramento County 13

Sacramento County Drowning Data Ages

Safe Beginnings Collaborative Research Results Why do children drown? Three factors contribute to a child’s risk of drowning: 1.The age of the child 2.Easy access to water 3.Inadequate adult supervision Children’s Hospital of Orange County 15

Risk Factor #1 – Age Developmentally – No fear Greater curiosity Master new skills quickly Physiologically – Head weighs more than the rest of the body Bones, tendons & muscles not fully developed Can drown in as little as 2 inches of water Children’s Hospital of Orange County 16

Risk Factor #2- Easy Access to Water Children under the age of 6 most often drown in a residential pool or spa. Lack of an effective barrier between a child and a body of water. Bodies of water include: Pool/ Spa Bathtub Toilet Bucket River/Lake Children’s Hospital of Orange County 17

Risk Factor #3- Inadequate Adult Supervision Children have more time and opportunity to access water when: Parents fail to communicate about supervision Older children supervising other children Parents are intoxicated during social gatherings Parents are sleeping or distracted Children’s Hospital of Orange County 18

CHILD DROWNING MYTHS AND FACTS Role playing exercise, Part 1 19

Child Drowning Myths and Facts – Part 1 Myth: “Drowning takes a long time.” Fact: Children lose consciousness in 30 seconds or less. If a child is missing, always check the pool or other water sources first. Every second counts! Myth: “As long as there are other adults around, children are safe.” Fact: Children can drown even though they are surrounded by adults. Myth: “My child can’t get to the pool by himself yet.” Fact: Children don’t announce when they’ve mastered something new. Just because your child could not open a sliding glass door yesterday, does not mean he or she can’t today. Myth: “Drownings only happen to families who don’t know better.” Fact: Drownings occur in every neighborhood, socioeconomic and ethnic group, regardless of education level. 20

Drowning Prevention Layers of Protection 21

Drowning Prevention Layers of Protection No single device or solution can prevent child drownings. Multiple strategies or devices (“layers”) should be used constantly and simultaneously. – NDPA “Layers of protection” are backups to the primary means of accident prevention: Responsible Adult Supervision. - APSP 22

Drowning Prevention Layers of Protection Children are most at risk in their own backyard, when parents believe they are safely inside the house. Devices can delay a child’s unsupervised access, or warn of the child’s presence. Protect the area between the house and the pool. 23

Building a Sacramento Program Research Surveys Models = 24

Sacramento County ABC’s of Drowning Prevention A is for Adult Supervision B is for Barriers C is for CPR & Classes 25

A is for Adult Supervision Supervision during non-water activities Children drown without a sound 69% of children who drowned in swimming pools were not expected to be in or around water so know where your children are at all times. 26

A is for Adult Supervision Supervision during water activities Children should be watched by a responsible adult 100% of the time they are in or near the water. Keep children under age 5 within arm’s reach in the water Water wings, floaties and life jackets should never take the place of adult supervision. Assign a “water watcher”, a person who knows how to swim whenever around water. Keep children away from pool drains, pipes and other openings to avoid entrapments. 27

B is for Barriers The only proven effective barrier is a 5 feet tall non-climbable fence with self-closing, self- latching gates that completely encloses the pool. Secondary barriers include alarms and pool & spa covers Install, inspect and always use barriers 28

B is for Barriers Remove toys from in or around the pool area. Toys can attract young children to the pool. Keep chairs, tables and other climbable things away from fence. Visit National Drowning Prevention Alliance website to learn more about layers of protection. 29

B is for Barriers 30

C is for CPR & Classes Learn CPR (Cardiopulmonary Resuscitation) and rescue breathing. Start CPR and rescue breathing at pool side. To find CPR classes ask at a local Red Cross, parks and recreation district or family resource center. 31

C is for CPR & Classes Enroll all children and adults in your family in swim lessons and water safety training, but remember these classes never take the place of supervision or barriers! To find swimming classes ask at a local community pool, parks and recreation district or family resource center. 32

ABC’s of Drowning Prevention Video View on Sacramento Metro Fire’s YouTube page or go to YouTube and search “ABCs Drowning Prevention Sacramento” Video 33

CHILD DROWNING MYTHS AND FACTS Role playing exercise, Part 2 34

Child Drowning Myths and Facts – Part 2 Myth: “It can’t happen to me. I’m a good parent.” Fact: All parents whose children have drowned felt this way. No one believes a drowning could happen to their child or the children under their care. Without layers of protection, no child is safe from the tragedy of drowning. Myth: “My child is safe because he’s had swimming lessons.” Fact: When a child enters a pool alone, he may not behave the same way he does in a swimming lesson because no one is there to cue him to swim or behave in a certain manner. Myth: “I’ll hear my child if he’s in trouble.” Fact: Drowning is a silent event. Drowning children don’t splash, cry, or call out for help. “Kids drown without a sound”. Myth: “My child is safe because he’s inside the house with me.” Fact: Don’t assume your child is safe because you last saw him napping or playing. Toddlers move fast. Unless the child is within your direct sight, there is the possibility he is in the water. 35

Training in a Box Contents Binder Thumb Drive DVD Hat Water Wings Life Jacket Brochures 36 Binder Sign-In Pretest Posttest Class Evaluation Tracking Form

Resources Safe Kids Worldwide CPSC – Pool Safely National Drowning Prevention Alliance Add local swim lesson information to your presentation 37

Thank You! Jennifer Rubin Safe Kids Greater Sacramento Coalition Coordinator Dignity Health Mercy San Juan Medical Center