Drowning is one of the leading causes of unintentional injury and death in children and knowing the correct first aid procedures can be life-saving. When a child is drowning, prompt and effective action is essential. It is not always as dramatic as it is often portrayed in films; in fact, a child may drown silently and quickly, even in shallow water. Recognising the signs of drowning and delivering immediate care can improve the chances of survival and reduce the likelihood of long-term injury.
First aid for a drowned child involves a series of critical steps that must be performed with both urgency and care. If a child is found unresponsive in the water, they must be removed from the water as quickly and safely as possible, while an observer is instructed to call for emergency medical services. It is crucial to check the child's breathing and pulse and to commence rescue breaths and chest compressions if they are not breathing normally.
Children are more vulnerable to drowning incidents due to factors such as their curiosity, lack of swimming experience, and smaller body size. Supervision around bodies of water is vital, but if an incident occurs, knowing what to do in those critical first moments is of paramount importance. First aid knowledge equips bystanders with the skills to provide immediate care that can keep a drowning child's vital systems functioning until professional help arrives.
Drowning is a serious respiratory distress occurring when water enters the lungs, which can potentially lead to fatal outcomes such as secondary or dry drowning if not addressed immediately.
Dry Drowning: Contrary to what the term might suggest, dry drowning involves no water actually reaching the lungs. Instead, it's a spasm of the airways caused by inhaling water, leading to difficulty breathing.
Secondary Drowning: This type of drowning occurs when water does enter the lungs, causing inflammation and difficulty in exchanging air, which can manifest as respiratory problems up to 24 hours after the initial event.
When an individual is submerged in water, the natural response is to hold one's breath. However, once the urge to breathe becomes too strong, water is inhaled into the lungs. This introduction of water interferes with the lungs' ability to exchange oxygen and carbon dioxide, leading to a decrease in blood oxygen levels and, eventually, the loss of consciousness.
Fluid in the lungs also impairs lung function, a condition sometimes referred to as pulmonary edema. The immediate risk post-rescue includes the body's reaction to remaining water, which can lead to complications such as secondary drowning due to physiological responses aimed at healing.
When a child is drowning, immediate actions can make the difference between life and death. Quick assessment of the situation and calling for help are critical first steps in a rescue effort.
One must swiftly evaluate the scene to confirm that a child is in distress and identify whether they are conscious or having breathing problems. If the child is in the water and struggling, it is imperative to assess any dangers to the rescuer before attempting a rescue.
It is crucial to alert a lifeguard if one is present. If there is no lifeguard on duty, bystanders should call 999 or 112 for emergency help immediately. While someone is making the call, others should commence assistance to the drowning child, following correct first aid procedures without delay.
When a child is unresponsive and not breathing, performing CPR (Cardiopulmonary Resuscitation) promptly is critical. This section delineates the specific steps required to carry out CPR on a child.
CPR for children involves a combination of rescue breaths and chest compressions, aimed at simulating heart function and breathing until emergency services arrive. The procedure differs slightly from adult CPR and should be adapted if the rescuer has not undergone formal CPR training. Prior to commencing CPR, it is critical to ensure the safety of the child as well as the rescuer. Check for responsiveness by gently tapping the child and shouting. If there is no response and no normal breathing, call for emergency help and begin CPR immediately.
Rescue Breaths: Once the child is on a firm surface, tilt their head back and lift the chin to open the airway. Pinch the child’s nose shut, place your mouth over the child's mouth to create an airtight seal, and give 5 initial rescue breaths – each breath should last about 1 second and make the chest rise.
Chest Compressions: After the initial breaths, interlock your fingers and place the heel of one hand on the centre of the child’s chest. For effective chest compressions:
Continue this cycle of 30 compressions to 2 breaths, without stopping, until:
Ensure not to use excessive force to avoid injuries. Implementing these first aid steps can be crucial in improving the child's chances of survival until professional help can take over.
When attending to a child who has been submerged in water, it is critical to address immediate breathing challenges and guard against complications such as hypothermia. The following measures should be conducted with precision and care.
A clear airway is essential for effective breathing. If the child is not breathing, one should gently tilt their head back and lift the chin to open the airway. Check for any obstructions and remove visible blockages if possible. If trained and necessary, initiate rescue breaths to support the child in receiving oxygen.
Even in warm water, a child can become hypothermic. After ensuring the airway is not obstructed, remove any wet clothing and cover the child with a blanket to retain body heat. Avoid any abrupt movements as they might exacerbate the condition. Monitor the child's temperature, and if you suspect hypothermia, provide warmth and seek medical attention promptly.
After a child has been rescued from a drowning incident, it is vital to monitor them closely for any signs of complications. Immediate medical assessment is paramount, even if they appear to be physically unharmed, due to the potential for delayed symptoms.
It is essential for carers to observe the child for any immediate and delayed symptoms post-rescue. Key signs to watch for include persistent coughing, difficulty breathing, or chest pain, which may indicate water in the lungs or inflammation. These symptoms can evolve into more serious conditions, such as respiratory distress or secondary drowning, where medical professionals should be involved.
One should also be vigilant for behavioural changes or a decline in the child's responsiveness, as these can also suggest significant underlying issues. Keep a log of any symptoms along with their onset time to assist healthcare providers in the event of medical intervention.
Immediate contact with medical professionals is required if the child exhibits any signs of respiratory distress, altered consciousness, or continues to cough persistently post-rescue. Assistance from trained medical personnel can help to prevent complications such as pulmonary oedema - where fluid accumulates in the lungs.
Even if the child seems well initially, they must be examined by a healthcare provider due to the risks associated with secondary complications, which may not be immediately evident. If the child experiences any symptoms such as trouble breathing, persistent coughing, or chest pain, emergency services should be contacted without delay.
A follow-up visit within the next 48 hours is advisable to ensure the absence of late-onset complications, which could occur even after the initial absence of symptoms. Take note of St John Ambulance's advice on the appropriate steps to follow after a drowning incident, particularly if any concerning symptoms develop.
Preventing child drowning requires vigilant supervision and a strong understanding of water safety. By taking proactive steps, the risk of drowning in various environments, such as swimming pools, baths, and open waters like rivers and canals, can be significantly reduced, especially for young children.
Supervision is the cornerstone of child drowning prevention. It involves constant, undistracted observation, particularly for children under 8 years of age. Lifeguards play a critical role in supervision at public swimming pools, yet their presence does not replace the need for attentive personal supervision. When no lifeguard is on duty, or the body of water is in a less controlled environment such as a bath at home, it is crucial that an adult is always actively watching children, without the interference of electronic devices or social distractions.
Water safety education is vital for both children and their guardians. It is important for every child to learn swimming and water survival skills as early as possible. Enrolling children in certified swimming lessons can equip them with necessary techniques to stay safe. Alongside swimming skills, teaching young ones about the dangers of water, and to always wear a life jacket when boating or playing near open waters like rivers or canals, can create a safety-conscious mindset. Adults, in turn, should familiarise themselves with rescue techniques and CPR, so they are prepared to act swiftly and efficiently should an emergency arise.
