August 6, 2024 • 24 mins
Join us on this episode of Pediatrics Now as we delve into essential choking, water and heat safety tips as host Holly Wayment interviews a doctor on the front lines of emergency medicine, Priyanka Kandhal, a pediatric emergency medicine doctor. Dr. Kandhal shares her personal experiences as a new parent and provides invaluable advice. From the dangers of choking hazards to the critical importance of water safety, she covers it all. Learn why you should avoid arm floaties for your kids, the significance of wearing bright-colored swimsuits, and the necessity of having multiple layers of protection around pools.
We also discuss heat-related illnesses, the importance of hydration, and the life-saving practice of rapid cooling in cases of heat stroke. Plus, get tips on how to ensure your child's safety in hot cars and the importance of staying up-to-date with vaccinations.
Tune in for practical advice that can help keep your children safe.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
I was like, I should do a quote about being a new parent. Yeah.
But then, other than things like, there's no perfect parent,
because I definitely have fallen into the over-obsessing, over-every-little-thing trap.
And I don't know if being a pediatrician makes that worse.
Possibly. I'm not quite sure.
(00:21):
Welcome to Pediatrics Now.
Music.
Today, we're talking about summer safety, and I'm thrilled today because joining
me here in the podcast studio is Dr.
Priyanka Kondal. She is an emergency medicine doctor who focuses on kids and adults.
(00:47):
Priyanka, thank you so much for being here today in the podcast studio.
Thanks so much for having me. So you did your med school at Medical College
of Georgia and then residency at University of Maryland.
And along the way, you knew you wanted to help, have that feeling of,
hey, I helped someone today.
Yeah, definitely. I went through medical school knowing I really loved kids
(01:11):
and decided to end up pursuing a combined residency in emergency medicine and pediatrics.
Kind of got a little bit of that quick gratification and feeling like I helped
people that day and still pursuing my love of children.
And you just celebrated your son's first birthday.
That's right. It's been definitely a chaotic year, but very,
(01:36):
very rewarding having as my first child.
So experiencing some of the things that I saw from a medical perspective,
from a parental perspective, has been very eye-opening and definitely made me
a better or pediatrician.
And you recently had an experience where you could see how quickly as a parent,
a potential emergency could happen.
(01:58):
Yeah. So my kiddo got into my husband's work bag and found a whole apple,
which we saw and were watching and thought it was funny.
And we didn't really think he'd be able to gnaw off a piece of it,
but it turns out he could.
So he took a big chunk of a bite with his six little teeth and managed to choke.
(02:22):
I did not enjoy being on that side of a medical experience.
I ended up calling my colleague who was working to see what her perspective
was because I definitely felt like I was not completely objective in that time
and I wasn't quite sure which direction I wasn't being objective.
(02:42):
I thought maybe, I don't know if I'm I'm being too concerned or not concerned enough.
And luckily, you know, he was breathing the whole time. He was just coughing a lot.
And we ended up driving him all the way to medical center, got to the hospital,
by which time he had completely come back to normal. And then we drove home without going inside.
Because once you got there, you realized, OK, he's not. Yeah,
(03:04):
and he had been coughing a lot at home.
And then over the course of the drive, he stopped coughing and started talking and smiling again.
So I said, okay, well, he's looking way better.
And now I feel less nervous that something bad is going on.
Is before we dive into the
summer safety is there anything you
(03:25):
want to mention quickly about choking it's kind
of this universal fear where everything
can be going fine and then all of a sudden it's the worst nightmare yeah choking
is very common definitely not exclusive to summer but very common especially
in young children especially when they start moving where they They are snacking
(03:47):
and moving and maybe not being as careful about eating.
And I think in terms of safety, it's really, really important to make sure that
you're serving your child appropriately cut pieces for their age.
And also, ideally, not as much distracted eating.
So trying to be eating when we're eating while we're sitting down and not running around with food.
(04:09):
But especially things like nuts, round fruits like grapes, blueberries, cherries.
Hot dogs are actually a big choking hazard because they're round. Anything round.
So I recommend cutting hot dogs lengthwise. That's a summer barbecue type of food.
And having or quartering grapes, depending on your child's age.
(04:29):
And just being mindful of it because it happens very quickly.
And I also think that every parent could benefit from a quick child CPR course.
They're pretty readily available and can truly help you in that moment where
you know what what to do and how to respond.
And as an emergency medicine doctor, so you work in our new pediatric ER in
(04:52):
the new beautiful Women's and Children's Hospital. What an amazing place.
Yeah, we've really enjoyed the renovation.
And it's been a really nice place to work. And on Monday, I had my first day
volunteering in the NICU.
And I just was blown away of the facility there and how amazing it was.
And what a great place. They've done a really nice job.
(05:15):
So and I know as a former news reporter,
I came across a lot of emergencies and not even close in the 10 years of doing
that, I'm sure as a doctor, what you see, but just it changed the way where
when I would be in the cul-de-sac,
you know, my kids riding their bikes, I would
see in my head a car coming and hitting them.
(05:36):
It just, for you, it must be like you were saying, and a new experience where
you're now a mom and you have all of this knowledge and experience.
Absolutely. And of course, in the emergency department, I tend to see the bad
things and not the times that everything is fine. Like with news.
Absolutely. So I think I definitely have a little bit of paranoia and especially
(06:00):
in some safety related things.
But I also think when it comes to safety, sometimes you can't be too paranoid. Maybe you can be, but.
Or too safe. Yes. I mean, I think if there are simple and easy things to do
that increase the safety for your children, then they're worth doing.
So tell us, how are things going in the ER? Has it been really busy this summer?
(06:22):
It has been pretty typical, I think, in terms of busyness.
The summer is typically not our busiest season because we have a little bit
fewer of our respiratory viruses going around in the summer,
although we are seeing a big uptick in COVID right now.
I'm sure you might have heard. Yes. But aside from that, we have,
I think, volume that's pretty typical for the summer, but we are definitely
(06:46):
seeing some of those classic summer injuries.
So let's dive into the most common preventable injury that we all know about, drowning.
So recently there was an accident in the water that it was horrible.
Can you, that happened on Monday. Yeah, there was a toddler who fell in the
(07:09):
water and I think just the caregiver had, was distracted for just a minute or
two and that's how fast it happened.
And so the child came into the emergency department and had to be resuscitated.
And it could happen so fast, even just like you said, it's the caregiver just for a few seconds.
(07:31):
Absolutely. It happens so quickly, especially with the younger kids,
that just a couple minutes of being distracted is absolutely enough.
And you've seen kids come into the ER who it was too late by the time they got there.
Absolutely. I've had a couple of drowning cases that we were unfortunately not able to get back.
(07:53):
We see many, a big variety of drowning cases.
So some kids come in and they do okay and they were gotten to in time and some of them get to go home.
Some of them get observed for a while and some of them get resuscitated and
do really well. and some of them unfortunately get resuscitated and either don't
make it or they have long-term neurologic injury from their period of time without oxygen.
(08:18):
You can't be too safe when it comes to water. I absolutely agree.
You cannot be too safe when it comes to water. Multiple layers of protection,
making sure you have eyes on your kid at all times, thinking about the color
of the swimsuit your kid is in because brighter colors are a lot easier to see.
So your reds and your Your yellows and your oranges are far better colors than blues.
(08:39):
Blues can disappear in the water really easily, especially if a kid goes under.
And as we all know, prevention is the best medicine.
Advice from you, from your lens, what you see last year that was an eight-year-old who drowned.
I love what you say about...
Not just have a designated water watcher where that's kind of,
(09:02):
you know, a lot of people know about that, but more of a one-to-one in arm's length adult to child.
Yeah, especially for the younger kids and children who have not learned to swim.
I think it's really crucial to have someone within arm's length because this
happens so quickly and it's not as noticeable as people realize.
So people might watch a movie where they see someone drowning and it involves
(09:25):
a lot of splashing and calling for help and things like that.
But in real life, drowning is much more subtle and is not always appreciable.
And if you're just scanning the water, you might not notice it happening.
There are some very chilling videos out there of children drowning in public
pools surrounded by adults and other children and busy pools.
(09:47):
And it just, it can happen so subtly that no one notices for too long,
unfortunately, and it can happen very, very quickly.
So especially for those younger kids, having someone within arm's length and
a designated person is really, really key to prevention.
And in fact, was it a residency program where there was a video shown recently
(10:09):
at a public pool where, can you tell us about that? It just sounded horrible.
Yeah, we actually had a lecture for our residency didactics where where it was
a public pool and you watch this kid and there are literally people. This pool is packed.
(10:29):
There are people everywhere and you see the kids struggling and trying to come
up for air and then going back down and coming back up and then eventually just
floating face down in the water for several minutes and just floating around
and people are walking past.
On occasion, I think someone even brushes against the kid and no one notices
for a really long period of time And as you're watching it, it feels like eons
(10:52):
before anyone notices and pulls the kid out of the water.
But you can see why it happens because when you're in the pool with your kids,
you're focused on your own children and...
When you just take a quick peek, it might be, oh, this kid is floating.
Everyone does a little bit of floating.
You have to be watching the child for a little bit of a longer period of time to notice.
(11:12):
At just one glance, you don't see that something is wrong. And I think that's
really the key is most people are not trained to know what it looks like,
and they're expecting something very dramatic in a drowning,
and it doesn't always look like that.
In fact, I think it rarely looks like that. It's so silent.
And a lot of neighborhood pools, I'm shocked to see that they don't have lifeguards in the summer.
(11:34):
Yeah, unfortunately, I think it is a liability for a lot of pools to have a
lifeguard because if something were to happen, then they become liable.
So ironically, we opt for the option with decreased safety because of liability
reasons. And it makes no sense.
And then so for the parent also, so say if it's one parent or one adult you're
(11:59):
assigned, you're watching this child.
And then to also know to have a plan for a handoff if you have to leave for
even 20 seconds or something. Yeah, absolutely.
So if I'm watching this child and I have to go in and go to the bathroom or
whatever, I need to verbally tell another adult, hey, I am going in.
(12:19):
I need you to watch so-and-so and wait for the response.
And I think waiting for the response is really key. We talk about closed-loop
communication in a healthcare perspective, but that's the same thing externally.
Externally because just because I said, hey, I'm going to the bathroom,
make sure you have eyes on him.
So and so that I was talking to might not have heard or might not have processed.
And that's the period of time when these incidents can end up happening.
(12:42):
So I think making sure that you have a verbal handoff of responsibility is really ideal.
And that closed loop where the person responds back and confirms. Right.
And for adolescents, yes.
We also see drownings, especially when it's on open water and there could be substances involved.
(13:02):
Yeah. So in young kids, we think about pools and small bodies of water.
But in adolescents, we typically see, you know, going out to party with their
friends more often on open bodies of water, like rivers and lakes,
like you said, sometimes involving substances, although not always.
We know that adolescents don't always think through all their actions before
(13:24):
they do them, which is developmentally normal for them.
But you see a lot of diving into unclear surfaces where you don't know the depth.
So things like that, where you could have a head injury at the bottom of a body
of water and then a drowning incident, or we're all tubing and we're all drinking
or whatever other substances.
(13:46):
And so our judgment is impaired and maybe someone can't swim or doesn't swim
as well or is too intoxicated to swim and other people are enjoying themselves
and don't even notice for a while.
So we see another uptick in that age group in the teenagers and young adults.
And the prefrontal cortex not fully developed yet so that judgment of can I
(14:08):
jump off this ledge into the water it looks so fun.
Absolutely and and it's very hard to tell the depth of water when you're just looking at it.
So sometimes things can look deep and it can be really deep until it's not,
or there can be a bunch of rocks, a lot of things.
So not just drowning, but also
paralysis from diving injuries from neck fractures and things like that.
(14:31):
Definitely don't recommend any sort of diving in any body of water that you're
not 100% sure is deep enough.
And it's recommended, is it by the AAP, but nationally it's recommended to wear
life jackets in open water?
Yes, absolutely. On open water
in particular, the recommendation is Coast Guard-approved life jackets.
(14:54):
And then the other danger that can also happen on the water is dehydration.
There was a case, I think it was in Arizona, that you brought up where this
family was out on the water over the holiday in early July and did not realize
that the baby was getting dehydrated. Yeah.
So, you know, especially here in San Antonio with the Texas heat,
(15:19):
but anywhere, dehydration happens pretty quickly and can affect young babies more quickly.
So the very young and the very old are really vulnerable to overheating and dehydration.
And so whenever we're
outside for any extended period of time i always recommend
making sure we're focusing on hydration and focusing on overheating and and
(15:43):
being aware of any if anything seems off it could be the heat and and in this
case this the family was out on the boat and it was really hot and the baby
ended up not making it by the time they got to emergency care Yeah,
I don't know all the details of the case, certainly, but it seems like it was
(16:03):
family out on the lake boating.
And then this child presumably got overheated and dehydrated.
And I don't think they were able to get probably because they were in the middle
of the lake, they weren't able to get care in a timely enough manner.
And again, the younger you are, the more vulnerable.
And let's mention some of the, so the warning signs of heat exhaustion, dehydration.
(16:40):
People can look, there's a varied presentation. So dry or wet skin,
certainly feeling overheated and skin that's hot to touch.
And symptoms can be anywhere from feeling nauseated or dizzy or lightheaded
to being fully confused and altered or even progressing into unconsciousness.
But it can be a varied presentation. But I would say as an observer,
(17:06):
if anything seems at all off to consider that this could be a heat-related issue
and to feel the person's skin because invariably they will feel warmer than they should.
And if there is any concern for heat-related injury, the treatment is rapid
cooling. So as fast, there's no too rapid.
(17:28):
Our really fantastic San Antonio EMS system is actually really,
really advanced in this area.
And they do this rapid cooling with ice water submersion in the field.
And they use body bags, right? They do. I think they prefer to not call them that in that situation.
I think they refer to them as temp bags, but essentially, yes, absolutely.
(17:50):
So they basically fill the bag with ice water and lower the temperature,
and that is ultimately life-saving.
UT Health ER doctors helped with that team developing that?
Yeah, we have. I mean, I think it's probably, it's our whole regional STRAC
region, I think, that have worked really closely.
(18:12):
But certainly, several members of the UT Health emergency medicine department
have been very, very involved in the development of that, and they've done a really incredible job.
It's incredible. And then so a lot of these patients aren't needing to come
to the ER, but it's, thank goodness, but it was still an urgent.
Absolutely. Could have been a deadly situation. Absolutely.
(18:33):
So, and then, of course, not leaving kids or babies in the car.
I like the saying of, you know, trying to go fast but not rush,
where it's so easy to forget important things when we're rushing around.
Absolutely. And in terms of the leaving the child in the car,
(18:55):
that's definitely one of the most dangerous ways. we don't realize how fast
the car gets hot and so much hotter than you realize.
It doesn't even have to be that hot outside, especially if the car's in direct sunlight.
It can be 70 degrees outside and the car interior gets hot very quickly.
The other thing to remember is it is sometimes like a negligence,
(19:16):
like let me leave the child in the car while I go grocery shopping.
But more often than not, it is very attentive, concerned parents who just get
busy, something throws them off and they skip the daycare on their normal morning
routine and they go straight to work and they just get out of the car and they
don't realize until they leave the car.
It is so often not, it feels like, oh, that could never happen to me.
(19:37):
How could I forget my child in the car?
And it's one of those things that how could I ever not see my child when we're at the pool?
Of course, I have eyes on them until some little thing throws you off.
You get distracted for a second. That's all it takes. And the same thing with the car.
It's very frequently if something in the day is a little bit
off so your routine gets a little bit off and you don't even
(19:57):
realize one of the safety things I've heard
mentioned is leaving either a shoe or for a woman your purse or your work bag
or something in the back seat so you have to check your back seat before you
get out of the car to make sure but having some sort of mechanism of is there
a child in the car can really really be life-saving even if it seems like something
(20:18):
that could never happen to you,
I guarantee that some of the parents that it's happened to have felt that way
until it happened to them. That's great advice.
Anything else you'd like to talk about, about summer safety that you'd like
the pediatric practitioner to know about or parents?
(20:41):
I think it's always good to do a sunscreen reminder, especially when kids are
outside and it's very, very sunny.
We definitely see a lot of sunburns and sunburn.
Most sunburns are relatively minor and not something I'm so worried about,
but we do know that there are increased skin cancer risk.
The more sunburn you get and certain populations are
(21:02):
really high risk for skin cancer so maybe
not an immediate problem but something far down the line so
i think it's always nice to remember to put that sunscreen
on yes that's a great point which also like wearing a hat and sunscreen apparently
that's not cool if you're a teenager so it's like but these are the battles
we need to fight and teach and lead in in that and then are we missing anything
(21:26):
else or i think those Those are the big things, making sure you check your backseat.
How important is it to stay vaccinated to get the COVID vaccine?
I think we're, I mean, we're definitely seeing periodic upticks the same way.
And I think being vaccinated helps prevent transmission and potentially preventing
(21:47):
a more serious infection.
So I think it's probably going to come, become kind of like our annual flu vaccine,
where where the flu is very dangerous to the vulnerable populations.
Yes, if I get the flu, I'm probably going to be okay, but I'm going to be really miserable.
And maybe getting that flu vaccine is going to help me be a little bit less
(22:08):
miserable if I pick up the flu. And I think COVID is probably going to land
somewhere close to that.
And we started with the most common preventable accident, which is drowning.
So we could end with that. I know you have a great point about floaties,
that it positions the child and gets the child used to things that are not safe.
(22:31):
Can you tell us about that? Yeah, absolutely.
Most, I mean, I know that when I was a kid and my younger sister were a kid,
we used to wear those arm floaties that are just inflatable around your arm.
And especially as toddlers who are not really doing swim lessons yet,
what it does is it teaches a child, first of all, that when I jump in the pool, I float.
(22:55):
And I go in the pool and I float. And they don't have the cognitive ability
to relate that to the floaties that they're wearing.
But the second thing is the natural position when you are wearing those little
arm floaties is a vertical position, which is not the ideal position for you
to be in the water without any sort of flotation device.
So it encourages kids essentially to go into an unnatural position where they're
(23:20):
more likely to sink as opposed to float if the kid jumps in the pool.
And it also increases a little bit of a false sense of security.
I go in the pool all the time. And then, of course, this like two second period
where no one's around and I can run outside and especially for households with
fences, I recommend multiple layers of protection.
So having not just a fenced in backyard, but having a pool fence,
(23:42):
which specifically protects the pool, is only around the pool and prevents anyone
from getting to the pool.
And it should be child safety locks that kids can't get in.
If you are in a place with a pool, like making sure you have an alarm on the
back door, everything you can do because multiple layers of protection dramatically
decreases the risks of drowning.
(24:09):
Music.
I was like, I should do a quote about being a new parent. Yeah.
But then, other than things like, there's no perfect parent,
because I definitely have fallen into the over-obsessing, over-every-little-thing trap.
And I don't know if being a pediatrician makes that worse.
Possibly. I'm not quite sure.
(00:21):
Welcome to Pediatrics Now.
Music.
Today, we're talking about summer safety, and I'm thrilled today because joining
me here in the podcast studio is Dr.
Priyanka Kondal. She is an emergency medicine doctor who focuses on kids and adults.
(00:47):
Priyanka, thank you so much for being here today in the podcast studio.
Thanks so much for having me. So you did your med school at Medical College
of Georgia and then residency at University of Maryland.
And along the way, you knew you wanted to help, have that feeling of,
hey, I helped someone today.
Yeah, definitely. I went through medical school knowing I really loved kids
(01:11):
and decided to end up pursuing a combined residency in emergency medicine and pediatrics.
Kind of got a little bit of that quick gratification and feeling like I helped
people that day and still pursuing my love of children.
And you just celebrated your son's first birthday.
That's right. It's been definitely a chaotic year, but very,
(01:36):
very rewarding having as my first child.
So experiencing some of the things that I saw from a medical perspective,
from a parental perspective, has been very eye-opening and definitely made me
a better or pediatrician.
And you recently had an experience where you could see how quickly as a parent,
a potential emergency could happen.
(01:58):
Yeah. So my kiddo got into my husband's work bag and found a whole apple,
which we saw and were watching and thought it was funny.
And we didn't really think he'd be able to gnaw off a piece of it,
but it turns out he could.
So he took a big chunk of a bite with his six little teeth and managed to choke.
(02:22):
I did not enjoy being on that side of a medical experience.
I ended up calling my colleague who was working to see what her perspective
was because I definitely felt like I was not completely objective in that time
and I wasn't quite sure which direction I wasn't being objective.
(02:42):
I thought maybe, I don't know if I'm I'm being too concerned or not concerned enough.
And luckily, you know, he was breathing the whole time. He was just coughing a lot.
And we ended up driving him all the way to medical center, got to the hospital,
by which time he had completely come back to normal. And then we drove home without going inside.
Because once you got there, you realized, OK, he's not. Yeah,
(03:04):
and he had been coughing a lot at home.
And then over the course of the drive, he stopped coughing and started talking and smiling again.
So I said, okay, well, he's looking way better.
And now I feel less nervous that something bad is going on.
Is before we dive into the
summer safety is there anything you
(03:25):
want to mention quickly about choking it's kind
of this universal fear where everything
can be going fine and then all of a sudden it's the worst nightmare yeah choking
is very common definitely not exclusive to summer but very common especially
in young children especially when they start moving where they They are snacking
(03:47):
and moving and maybe not being as careful about eating.
And I think in terms of safety, it's really, really important to make sure that
you're serving your child appropriately cut pieces for their age.
And also, ideally, not as much distracted eating.
So trying to be eating when we're eating while we're sitting down and not running around with food.
(04:09):
But especially things like nuts, round fruits like grapes, blueberries, cherries.
Hot dogs are actually a big choking hazard because they're round. Anything round.
So I recommend cutting hot dogs lengthwise. That's a summer barbecue type of food.
And having or quartering grapes, depending on your child's age.
(04:29):
And just being mindful of it because it happens very quickly.
And I also think that every parent could benefit from a quick child CPR course.
They're pretty readily available and can truly help you in that moment where
you know what what to do and how to respond.
And as an emergency medicine doctor, so you work in our new pediatric ER in
(04:52):
the new beautiful Women's and Children's Hospital. What an amazing place.
Yeah, we've really enjoyed the renovation.
And it's been a really nice place to work. And on Monday, I had my first day
volunteering in the NICU.
And I just was blown away of the facility there and how amazing it was.
And what a great place. They've done a really nice job.
(05:15):
So and I know as a former news reporter,
I came across a lot of emergencies and not even close in the 10 years of doing
that, I'm sure as a doctor, what you see, but just it changed the way where
when I would be in the cul-de-sac,
you know, my kids riding their bikes, I would
see in my head a car coming and hitting them.
(05:36):
It just, for you, it must be like you were saying, and a new experience where
you're now a mom and you have all of this knowledge and experience.
Absolutely. And of course, in the emergency department, I tend to see the bad
things and not the times that everything is fine. Like with news.
Absolutely. So I think I definitely have a little bit of paranoia and especially
(06:00):
in some safety related things.
But I also think when it comes to safety, sometimes you can't be too paranoid. Maybe you can be, but.
Or too safe. Yes. I mean, I think if there are simple and easy things to do
that increase the safety for your children, then they're worth doing.
So tell us, how are things going in the ER? Has it been really busy this summer?
(06:22):
It has been pretty typical, I think, in terms of busyness.
The summer is typically not our busiest season because we have a little bit
fewer of our respiratory viruses going around in the summer,
although we are seeing a big uptick in COVID right now.
I'm sure you might have heard. Yes. But aside from that, we have,
I think, volume that's pretty typical for the summer, but we are definitely
(06:46):
seeing some of those classic summer injuries.
So let's dive into the most common preventable injury that we all know about, drowning.
So recently there was an accident in the water that it was horrible.
Can you, that happened on Monday. Yeah, there was a toddler who fell in the
(07:09):
water and I think just the caregiver had, was distracted for just a minute or
two and that's how fast it happened.
And so the child came into the emergency department and had to be resuscitated.
And it could happen so fast, even just like you said, it's the caregiver just for a few seconds.
(07:31):
Absolutely. It happens so quickly, especially with the younger kids,
that just a couple minutes of being distracted is absolutely enough.
And you've seen kids come into the ER who it was too late by the time they got there.
Absolutely. I've had a couple of drowning cases that we were unfortunately not able to get back.
(07:53):
We see many, a big variety of drowning cases.
So some kids come in and they do okay and they were gotten to in time and some of them get to go home.
Some of them get observed for a while and some of them get resuscitated and
do really well. and some of them unfortunately get resuscitated and either don't
make it or they have long-term neurologic injury from their period of time without oxygen.
(08:18):
You can't be too safe when it comes to water. I absolutely agree.
You cannot be too safe when it comes to water. Multiple layers of protection,
making sure you have eyes on your kid at all times, thinking about the color
of the swimsuit your kid is in because brighter colors are a lot easier to see.
So your reds and your Your yellows and your oranges are far better colors than blues.
(08:39):
Blues can disappear in the water really easily, especially if a kid goes under.
And as we all know, prevention is the best medicine.
Advice from you, from your lens, what you see last year that was an eight-year-old who drowned.
I love what you say about...
Not just have a designated water watcher where that's kind of,
(09:02):
you know, a lot of people know about that, but more of a one-to-one in arm's length adult to child.
Yeah, especially for the younger kids and children who have not learned to swim.
I think it's really crucial to have someone within arm's length because this
happens so quickly and it's not as noticeable as people realize.
So people might watch a movie where they see someone drowning and it involves
(09:25):
a lot of splashing and calling for help and things like that.
But in real life, drowning is much more subtle and is not always appreciable.
And if you're just scanning the water, you might not notice it happening.
There are some very chilling videos out there of children drowning in public
pools surrounded by adults and other children and busy pools.
(09:47):
And it just, it can happen so subtly that no one notices for too long,
unfortunately, and it can happen very, very quickly.
So especially for those younger kids, having someone within arm's length and
a designated person is really, really key to prevention.
And in fact, was it a residency program where there was a video shown recently
(10:09):
at a public pool where, can you tell us about that? It just sounded horrible.
Yeah, we actually had a lecture for our residency didactics where where it was
a public pool and you watch this kid and there are literally people. This pool is packed.
(10:29):
There are people everywhere and you see the kids struggling and trying to come
up for air and then going back down and coming back up and then eventually just
floating face down in the water for several minutes and just floating around
and people are walking past.
On occasion, I think someone even brushes against the kid and no one notices
for a really long period of time And as you're watching it, it feels like eons
(10:52):
before anyone notices and pulls the kid out of the water.
But you can see why it happens because when you're in the pool with your kids,
you're focused on your own children and...
When you just take a quick peek, it might be, oh, this kid is floating.
Everyone does a little bit of floating.
You have to be watching the child for a little bit of a longer period of time to notice.
(11:12):
At just one glance, you don't see that something is wrong. And I think that's
really the key is most people are not trained to know what it looks like,
and they're expecting something very dramatic in a drowning,
and it doesn't always look like that.
In fact, I think it rarely looks like that. It's so silent.
And a lot of neighborhood pools, I'm shocked to see that they don't have lifeguards in the summer.
(11:34):
Yeah, unfortunately, I think it is a liability for a lot of pools to have a
lifeguard because if something were to happen, then they become liable.
So ironically, we opt for the option with decreased safety because of liability
reasons. And it makes no sense.
And then so for the parent also, so say if it's one parent or one adult you're
(11:59):
assigned, you're watching this child.
And then to also know to have a plan for a handoff if you have to leave for
even 20 seconds or something. Yeah, absolutely.
So if I'm watching this child and I have to go in and go to the bathroom or
whatever, I need to verbally tell another adult, hey, I am going in.
(12:19):
I need you to watch so-and-so and wait for the response.
And I think waiting for the response is really key. We talk about closed-loop
communication in a healthcare perspective, but that's the same thing externally.
Externally because just because I said, hey, I'm going to the bathroom,
make sure you have eyes on him.
So and so that I was talking to might not have heard or might not have processed.
And that's the period of time when these incidents can end up happening.
(12:42):
So I think making sure that you have a verbal handoff of responsibility is really ideal.
And that closed loop where the person responds back and confirms. Right.
And for adolescents, yes.
We also see drownings, especially when it's on open water and there could be substances involved.
(13:02):
Yeah. So in young kids, we think about pools and small bodies of water.
But in adolescents, we typically see, you know, going out to party with their
friends more often on open bodies of water, like rivers and lakes,
like you said, sometimes involving substances, although not always.
We know that adolescents don't always think through all their actions before
(13:24):
they do them, which is developmentally normal for them.
But you see a lot of diving into unclear surfaces where you don't know the depth.
So things like that, where you could have a head injury at the bottom of a body
of water and then a drowning incident, or we're all tubing and we're all drinking
or whatever other substances.
(13:46):
And so our judgment is impaired and maybe someone can't swim or doesn't swim
as well or is too intoxicated to swim and other people are enjoying themselves
and don't even notice for a while.
So we see another uptick in that age group in the teenagers and young adults.
And the prefrontal cortex not fully developed yet so that judgment of can I
(14:08):
jump off this ledge into the water it looks so fun.
Absolutely and and it's very hard to tell the depth of water when you're just looking at it.
So sometimes things can look deep and it can be really deep until it's not,
or there can be a bunch of rocks, a lot of things.
So not just drowning, but also
paralysis from diving injuries from neck fractures and things like that.
(14:31):
Definitely don't recommend any sort of diving in any body of water that you're
not 100% sure is deep enough.
And it's recommended, is it by the AAP, but nationally it's recommended to wear
life jackets in open water?
Yes, absolutely. On open water
in particular, the recommendation is Coast Guard-approved life jackets.
(14:54):
And then the other danger that can also happen on the water is dehydration.
There was a case, I think it was in Arizona, that you brought up where this
family was out on the water over the holiday in early July and did not realize
that the baby was getting dehydrated. Yeah.
So, you know, especially here in San Antonio with the Texas heat,
(15:19):
but anywhere, dehydration happens pretty quickly and can affect young babies more quickly.
So the very young and the very old are really vulnerable to overheating and dehydration.
And so whenever we're
outside for any extended period of time i always recommend
making sure we're focusing on hydration and focusing on overheating and and
(15:43):
being aware of any if anything seems off it could be the heat and and in this
case this the family was out on the boat and it was really hot and the baby
ended up not making it by the time they got to emergency care Yeah,
I don't know all the details of the case, certainly, but it seems like it was
(16:03):
family out on the lake boating.
And then this child presumably got overheated and dehydrated.
And I don't think they were able to get probably because they were in the middle
of the lake, they weren't able to get care in a timely enough manner.
And again, the younger you are, the more vulnerable.
And let's mention some of the, so the warning signs of heat exhaustion, dehydration.
(16:40):
People can look, there's a varied presentation. So dry or wet skin,
certainly feeling overheated and skin that's hot to touch.
And symptoms can be anywhere from feeling nauseated or dizzy or lightheaded
to being fully confused and altered or even progressing into unconsciousness.
But it can be a varied presentation. But I would say as an observer,
(17:06):
if anything seems at all off to consider that this could be a heat-related issue
and to feel the person's skin because invariably they will feel warmer than they should.
And if there is any concern for heat-related injury, the treatment is rapid
cooling. So as fast, there's no too rapid.
(17:28):
Our really fantastic San Antonio EMS system is actually really,
really advanced in this area.
And they do this rapid cooling with ice water submersion in the field.
And they use body bags, right? They do. I think they prefer to not call them that in that situation.
I think they refer to them as temp bags, but essentially, yes, absolutely.
(17:50):
So they basically fill the bag with ice water and lower the temperature,
and that is ultimately life-saving.
UT Health ER doctors helped with that team developing that?
Yeah, we have. I mean, I think it's probably, it's our whole regional STRAC
region, I think, that have worked really closely.
(18:12):
But certainly, several members of the UT Health emergency medicine department
have been very, very involved in the development of that, and they've done a really incredible job.
It's incredible. And then so a lot of these patients aren't needing to come
to the ER, but it's, thank goodness, but it was still an urgent.
Absolutely. Could have been a deadly situation. Absolutely.
(18:33):
So, and then, of course, not leaving kids or babies in the car.
I like the saying of, you know, trying to go fast but not rush,
where it's so easy to forget important things when we're rushing around.
Absolutely. And in terms of the leaving the child in the car,
(18:55):
that's definitely one of the most dangerous ways. we don't realize how fast
the car gets hot and so much hotter than you realize.
It doesn't even have to be that hot outside, especially if the car's in direct sunlight.
It can be 70 degrees outside and the car interior gets hot very quickly.
The other thing to remember is it is sometimes like a negligence,
(19:16):
like let me leave the child in the car while I go grocery shopping.
But more often than not, it is very attentive, concerned parents who just get
busy, something throws them off and they skip the daycare on their normal morning
routine and they go straight to work and they just get out of the car and they
don't realize until they leave the car.
It is so often not, it feels like, oh, that could never happen to me.
(19:37):
How could I forget my child in the car?
And it's one of those things that how could I ever not see my child when we're at the pool?
Of course, I have eyes on them until some little thing throws you off.
You get distracted for a second. That's all it takes. And the same thing with the car.
It's very frequently if something in the day is a little bit
off so your routine gets a little bit off and you don't even
(19:57):
realize one of the safety things I've heard
mentioned is leaving either a shoe or for a woman your purse or your work bag
or something in the back seat so you have to check your back seat before you
get out of the car to make sure but having some sort of mechanism of is there
a child in the car can really really be life-saving even if it seems like something
(20:18):
that could never happen to you,
I guarantee that some of the parents that it's happened to have felt that way
until it happened to them. That's great advice.
Anything else you'd like to talk about, about summer safety that you'd like
the pediatric practitioner to know about or parents?
(20:41):
I think it's always good to do a sunscreen reminder, especially when kids are
outside and it's very, very sunny.
We definitely see a lot of sunburns and sunburn.
Most sunburns are relatively minor and not something I'm so worried about,
but we do know that there are increased skin cancer risk.
The more sunburn you get and certain populations are
(21:02):
really high risk for skin cancer so maybe
not an immediate problem but something far down the line so
i think it's always nice to remember to put that sunscreen
on yes that's a great point which also like wearing a hat and sunscreen apparently
that's not cool if you're a teenager so it's like but these are the battles
we need to fight and teach and lead in in that and then are we missing anything
(21:26):
else or i think those Those are the big things, making sure you check your backseat.
How important is it to stay vaccinated to get the COVID vaccine?
I think we're, I mean, we're definitely seeing periodic upticks the same way.
And I think being vaccinated helps prevent transmission and potentially preventing
(21:47):
a more serious infection.
So I think it's probably going to come, become kind of like our annual flu vaccine,
where where the flu is very dangerous to the vulnerable populations.
Yes, if I get the flu, I'm probably going to be okay, but I'm going to be really miserable.
And maybe getting that flu vaccine is going to help me be a little bit less
(22:08):
miserable if I pick up the flu. And I think COVID is probably going to land
somewhere close to that.
And we started with the most common preventable accident, which is drowning.
So we could end with that. I know you have a great point about floaties,
that it positions the child and gets the child used to things that are not safe.
(22:31):
Can you tell us about that? Yeah, absolutely.
Most, I mean, I know that when I was a kid and my younger sister were a kid,
we used to wear those arm floaties that are just inflatable around your arm.
And especially as toddlers who are not really doing swim lessons yet,
what it does is it teaches a child, first of all, that when I jump in the pool, I float.
(22:55):
And I go in the pool and I float. And they don't have the cognitive ability
to relate that to the floaties that they're wearing.
But the second thing is the natural position when you are wearing those little
arm floaties is a vertical position, which is not the ideal position for you
to be in the water without any sort of flotation device.
So it encourages kids essentially to go into an unnatural position where they're
(23:20):
more likely to sink as opposed to float if the kid jumps in the pool.
And it also increases a little bit of a false sense of security.
I go in the pool all the time. And then, of course, this like two second period
where no one's around and I can run outside and especially for households with
fences, I recommend multiple layers of protection.
So having not just a fenced in backyard, but having a pool fence,
(23:42):
which specifically protects the pool, is only around the pool and prevents anyone
from getting to the pool.
And it should be child safety locks that kids can't get in.
If you are in a place with a pool, like making sure you have an alarm on the
back door, everything you can do because multiple layers of protection dramatically
decreases the risks of drowning.
(24:09):
Music.
Popular Podcasts
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com
On Purpose with Jay Shetty
I’m Jay Shetty host of On Purpose the worlds #1 Mental Health podcast and I’m so grateful you found us. I started this podcast 5 years ago to invite you into conversations and workshops that are designed to help make you happier, healthier and more healed. I believe that when you (yes you) feel seen, heard and understood you’re able to deal with relationship struggles, work challenges and life’s ups and downs with more ease and grace. I interview experts, celebrities, thought leaders and athletes so that we can grow our mindset, build better habits and uncover a side of them we’ve never seen before. New episodes every Monday and Friday. Your support means the world to me and I don’t take it for granted — click the follow button and leave a review to help us spread the love with On Purpose. I can’t wait for you to listen to your first or 500th episode!