Panic at the pool

It only takes a moment for splashy fun to become a parent’s nightmare

Angela Stone Adcock saved her 2-year-old from drowning July 20.

Family members tell her she dropped a glass as she leaped through the air toward curly-haired Rohan, but she doesn't remember that. She remembers hauling him up from the deep end and everyone shouting.

She must have handed him out of the pool, because someone else was holding his sturdy little body as he spat water.

She saved his life. But she doesn't see it that way.

What she sees is moving Ro off her lap and leaving him at the table while she goes inside to get him some cheese crackers. She sees this again and again.

She rewinds the whole scene. It's a blue-sky, happy, usual day around her father-in-law's pool in Camden. Ro's 4 1/2-year-old brother, Darius, is in the shallow end with two friends. One, two, three, four children and one, two, three, four adults watching.

Worn out from bobbing about in his Coast Guard-approved Stearns Puddle Jumper, Rohan crawls into her lap for crackers. He's wet, hungry and done with swimming; he asks her to take off the flotation device. He mashes down the last cracker and asks for more.

She steps inside for crackers. She can't find any.

"So I went back out, counted kids, asked where the crackers were, and went back in to get them," she says. "I found the crackers and stopped to get a cup of water."

Walking out of the house she counted kids again -- a deliberate habit. Her husband, Matthew Adcock, was a lifeguard. They live in Magnolia but spend most summer days enjoying his dad's in-ground pool, where she is watchful.

So she counts. One, two, three, four kids, in the pool. One swimming under water, two in an inner tube, one in a life jacket. "I looked closer and saw it was my 2-year-old under the surface, in the deep end."

The next 24 hours are intense memories: Ro's head nodding to his chest, too sleepy; the decision to call an ambulance and then the foolish feeling when the big truck comes and he perks up; the paramedics saying, no, calling 911 was not overreacting; the fluid in Ro's lungs on X-ray at Ouachita County Medical Center; someone talking about secondary drowning; feeling ashamed to call Matthew; the second ambulance ride to Arkansas Children's Hospital in Little Rock; eyes cutting toward her and away in the ER; the kind doctor who told her, "Listen. This happens to good parents."

And over and over, the memory of Rohan's body beneath the sparkling surface.

"The terrifying part was just how quiet, how quiet it was, how normal," she says.

Just another blue-sky moment with the sun glinting off the pool.

EMERGENCY

"Drowning is swift, and it is silent. It makes no noise," says Karen Lamoreaux, head coach of Safety Before Skill Swim School in central Arkansas (safetybeforeskill.com).

Her business offers private and group pool-safety lessons that teach children age 6 months to 4 years to hold their breath, float on their backs and call for help. She thinks most parents ought to begin water training once kids learn to crawl, but she sees the need as more urgent for families with a pool at home or a neighbor with a pool. (The American Academy of Pediatrics has also endorsed early lessons, although it recommends starting at 1 year old.)

Training helps, Lamoreaux says, because "it buys you time."

But "all it does is buy you time. You cannot drown-proof your child."

Water safety is about layers of protection, she says. Adcock's habit of counting provides a layer. Layers can include fences, gate alarms, adults who know CPR, a landline phone by the pool -- these are items included on a list of water-safety advice from the pediatrics academy (see "A Parent's Guide to Water Safety" at tinyurl.com/p6xmul9).

Also recommended are flotation devices -- but not, Lamoreaux begs, the inflatable arm balloons called "floaties," which create false assurance. They fail easily, she says, deflating gradually as the clueless child sinks.

"If I had my way I would get Congress to ban those floaties, they are just so dangerous. Anything that's inflatable should never be relied upon for safety and survival," she says. "What parents really need to put on their children is a Type II, Coast Guard approved life vest."

Dr. Elizabeth Storm, an emergency medicine specialist at Arkansas Children's Hospital, says the same thing. And her own 21-month-old twins wear those vests anytime and all the time they are near water.

All the layers help, Lamoreaux says, but they will fail. Children are relentlessly naive. The only reliable way to protect them is to stay within arm's reach, all of the time, up to age 14.

SINKING

Why don't babies fight drowning? Why do they sink?

"I think that part of it is when they get dunked under the water, and they're held under, they don't know not to breathe. And so they breathe in that water," Storm says. She pours water over her toddler twins to coax them to hold their breath.

Babies do have an instinct to close their mouths when water hits them in the face, but

then they try to breathe. Rohan knew how to hold his breath and his mother is sure that bought him some time. But holding the breath only goes so far, for anyone. After about a minute, the drive to inhale is too great to resist.

It's also natural to sink when you have a dense body with a large heavy head and small lungs.

"More importantly for us is they never have access to those bodies of water without adult supervision," Storm says.

And not just toddlers. While parents of toddlers are right to be vigilant as hawks at the lake or the pool, statistically speaking, the youngest children are somewhat less likely to drown in those places than are children ages 5 to 14.

SECONDARY DROWNING?

A review article on drowning appeared May 31, 2012, in The New England Journal of Medicine. It notes that the majority of people rescued from drowning "aspirate only small amounts of water, if any, and will recover spontaneously. Less than 6 percent of all persons who are rescued by lifeguards need medical attention in a hospital."

But for every one person who drowns, four others require emergency room support to recover from "nonfatal drowning." The process of drowning was interrupted, but it includes lung injury, which can continue to impair respiration after rescue. That can cause brain damage.

Not counting three drowned children in July, Storm says, Children's Hospital's emergency department has seen five drowning deaths in the last five years and 21 submersion injuries with survival. "Survival doesn't mean intact survival," she says. "Some of the children will have long-term neurological issues from being without oxygen."

Adcock understands that Children's Hospital's emergency team had Rohan taken to Little Rock for assessment and kept overnight out of concern about such lung impairment. She has heard it called "secondary drowning."

But emergency room doctors like Storm don't like that term or the term "dry drowning" because both terms tend to scare people. After past media reports on so-called secondary drowning, worried parents in Little Rock sought ER attention for kids who coughed a bit after being dunked at the pool. They feared their child -- who seemed fine -- might actually be getting ready to die.

Storm stresses that if a child had lung damage after being submerged, parents would know something was wrong. There would be no doubt.

"They're going to have symptoms -- and symptoms that we would be concerned about in general. A child that's having respiratory problems, a child that's not acting like himself, having altered mental status. A child that is coughing a lot more," she says. "I don't think it's something that parents are going to miss, the 'secondary drowning.'

"There's not some hidden, secret, concerning symptom that a child with secondary drowning is going to have."

Meanwhile, she says, illness that comes on after submersion, a situation in which a person appears to be OK for a while but then isn't, is "super, super rare." None of the ER doctors she asked had ever seen it.

ONWARD

Rohan is A-OK -- no ill effects from submersion other than his lingering questions about those cheese crackers he never got to eat. What happened to them?

Adcock took her boys back to their grandfather's pool the next week, wiser and warier. "He went right back in the water. He couldn't wait to go swimming," she says.

She's going to need a while longer to recover.

"I told my husband it's like I'm living two lives ... like I'm living this life where I have my baby, and it's wonderful, and then the entire time I'm thinking, 'What would that week have been like if ... what if I didn't have him?" She struggles for composure.

"Problems just don't seem like a big deal," she says. "What do I want more than anything in the world? I want those kids to be healthy. And I have it."

ActiveStyle on 08/24/2015

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