No Pulse, No Breaths, No AED…Drowning prevention with the ABC’s of Pool Safety

The sun was setting on the 4th of July, families across the giant pool lagoon were settling in for fireworks and dessert, when all of a sudden a scream came from the water as a man emerged carrying a blue lifeless little 3yr old body in his arms. No more then 20 feet from me, he drops to the sand yelling for help. My husband pointed at me, told me to go, and in a blink of an eye, I was by his side. Instinct kicked in, years of medical training and information flooded my head. I cleared the scene, and began to breath into his blue unconscious body. After two breaths, and a blocked airway, I began compressions. Shortly after I began CPR on this innocent little guy, another off duty medic came to help me followed seconds later by an off duty fireman and off duty cardiac nurse. The four of us, who by the grace of God just happened to be at the right place at the right time began working so fervently as a team to save this little boy.

Silence ensued across the lagoon as the 700 other observers respectfully stepped back to let us work. We began shouting for an AED (automated external defibrillator) and a pediatric mask, as the only mask provided was an adult mask which was not able to provide adequate breaths and oxygen for his brain. As I was performing the steps of CPR I remember thinking….where are the lifeguards, they should be able to help, or at least let us know that help is coming, find us an AED, provide something to help us…SOMETHING…but there was nothing…and the so called lifeguards, which I now know are just pool monitors, ran away in a panic.

For 15 minutes we worked until finally the paramedics came and did a “swoop and carry” and transported him to the hospital. At the time there was no pulse, no breaths, and the outcome didn’t look good. I know the four of us did all we could do in the midst of what was given to us, but there we stood feeling helpless. It felt as if we were doing our job with one hand tied behind our back. I was astounded at the lack of supplies and readiness that was provided. Here we were at the hub of  our city, near not one but 2 bodies of water, where people exercise on a daily basis and there was no AED??

I have taught CPR classes for 7 years, and have worked in a hospital and pedatric setting for close to 10 years. California law states when lifeguards are present so must an AED, but alas as I have now found out….there were no lifeguards after all…just pool monitors at this lagoon with little training, sitting in high chairs, with the “No lifeguard on Duty sign” taken off the chair, placed to one side, giving a false sense of security. Therefore not a requirement. Which means as parents we have to take the initiative. I replayed the events of that evening over and over again in my head, trying to figure out what more we could do. At this point all we could do was pray.

The next day I learned of  the little boy known as Xavier’s passing. Although they had achieved a heartbeat when he arrived at the hospital, he was brain dead. The mother made the brave decision to pull her fragile son of life support and donate his organs to help the lives of other children. My heart broke….for his family, for his mother, and for all of us in the community who witnessed this horrible tragedy and who worked to try and save him. An event that could have happened to anyone. ANYONE! This happened around hundreds of people and not one person saw him slip silently under the water. Little Xavier wasn’t alone in the water, there were people around, yet he drowned without a sound. An all too familiar story. Most drownings happen in large groups when everyone else assumes the other person is “Watching” the child.

It isn’t a surprise that summer is also nick named “ER” season. More emergencies happen in these short 3 months then any other time of the year. Most of these emergencies are preventable with the proper precautions! As the saying goes, “Children Drown Without a Sound” could not be more haunting and more true. It only takes a few inches of water and few seconds for a child to drown. We as parents can prevent this unfortunate event with a few short safety rules known as the “ABC’S of Pool Safety”. This fabulous article, posted by www.abcpoolsafety.org, is often provided in many First Aid classes, and so as it is the season for swimming… I would like to share these fabulous tips with you.

A- Adult Supervision

Assign an adult to supervise children in and around the swimming pool and spa. This is needed whether there is one parent of guardian present of numerous adults present such as during a family event or party.
Maintain constant eye-to-eye supervision with children in and around the swimming pool and spa
Remove children from the swimming pool and spa area for any distraction such as a telephone call, use of restroom, etc..
Issue the adult supervisor an item such as a whistle, bracelet, etc. to reinforce which adult is in charge of the safety of the children.
Floaties or other inflatable flotation devises care not life jackets and should never be substituted for adult supervision.
Maintain a clear view (no trees, bushes, or other obstacles) from the home to the swimming pool and spa.

Ensure any adult responsible for the children know the emergency services telephone number and also your location address in the event emergency personnel are needed to be called to the scene.

B – Barriers

Have a fence enclosure that isolates your swimming ppl and spa from the home, play areas, front and side yards and the neighbor’s yard.
Make sure all gates in the isolation fence are self-closing and self-latching
Multiple layers of barriers isolating the pool and spa from children should be installed. In addition to an isolation fence, one or more of the following safety features can provide the additional protection necessary:

Approved swimming pool and spa safety cover
Approved swimming pool and spa alarm
Exit alarms on doors providing access to the swimming pool and spa
Keep all doors and windows leading to the swimming pool and spa area locked
Doors providing access to the swimming area should be equipped to be self-closing and self-latching with a release mechanism high enough to be out of the reach of a child.
The main door from the garage should be self-closing and self-latching with a release mechanism high enough to be out of the reach of a child
Perimeter yard fence provided with a self-closing and self-latching gate
Install a device such as the “family turtle” that can be in place to alert adults when children have unintentionally encountered water.

All chairs, tables, large toys of other objects that would allow a child to climb up to reach the gate latch or enable the child to climb over the isolation fence should be removed or kept inside the fenced area.

C – Classes

Learn how to perform Cardiopulmonary Resuscitation (CPR) and AED (automated external defibrillator) use. Visit www.heart.org for a list of local CPR classes. Learning the proper steps of CPR  and AED usage can save a life.

AED’s are easy to use, and are safe for all ages. The machine is portable and will talk you through each step of applying the pads in the appropriate areas, charging the machine, and providing a shock to the heart as needed. The pads are stickers placed upon the chest. Once activated the AED can determine if a heart beat if available, or if the heart is beating at an irregular beat. The machine has both pediatric size pads and adult pads and can determine on its own if an electric shock is needed to start the heart beating again. The machine does not take place of CPR but assists in the procedure. The AED will continue to talk to you during your compressions, tell you when to stop, when to give a charge, and whether or not a shock is needed. Once you know how they are used, you will find them accessible everywhere. They are available in every large store, school, gym, police car, every 50 feet at an airport, and generally at pools where lifeguards are staffed.

The great thing about an AED is that there is very little liability associated with it. The Good Samaritan Law contained in Health and Safety Code section 1799.102, states that “No person who in good faith, and not for compensation, renders emergency care at the scene of an emergency shall be liable for any civil damages resulting from any act or omission…” meaning if you use the AED and it is not successful you are protected from a lawsuit. This code is specific to CPR and AED use. When an AED is purchased, it is recommended to be registered with EMS so that semi-annual maintenance can be performed to protect the city and owners from any malfunction. The truth is, there is more liability associated with not having an AED vs. having one.

Research has shown that CPR alone gives a victim a 30% chance of survival. Adding an AED within the first 10 minutes can jump that survival rate up to 70%. In this case, having an AED could have made a difference in little Xavier’s life, a difference we will never know.

Taking the proper precautions to ensure your child’s safety is one of the most important steps you can take this summer. If ever you can’t find your child, first place you should look is the body of water. Hopefully no one you know will have to encounter such a tragedy as a drowning, but by following these easy steps you can be sure your child will be safe this summer.

Copyright© 2013 Danielle Gauss,IBCLC – JustBreastFeeding.com. All Rights Reserved.