Selected Podcast
A Deep Dive on Swim Safety
Dr. Graham Snyder discusses water safety.
Featured Speaker:
He is a graduate of the University of North Carolina at Chapel Hill School of Medicine and also holds an undergraduate degree in chemical engineering from North Carolina State University. As the medical director of the Medical Simulation Center, he is able to combine his engineering and medical training to teach all levels of health care providers the art and science of emergency care.
Graham Snyder, MD
Dr. Snyder serves as the Medical Director for the Medical Simulation Center, providing physician oversight and clinical leadership for the SIM Center.He specializes in emergency and critical care medicine and has practiced full-time as an emergency physician at WakeMed Health & Hospitals since 2002. Dr. Snyder also serves as the Associate Program Director for the University Of North Carolina Department Of Emergency Medicine.He is a graduate of the University of North Carolina at Chapel Hill School of Medicine and also holds an undergraduate degree in chemical engineering from North Carolina State University. As the medical director of the Medical Simulation Center, he is able to combine his engineering and medical training to teach all levels of health care providers the art and science of emergency care.
Transcription:
A Deep Dive on Swim Safety
Scott Webb: Keeping our kids safe in the water is a high priority for parents, especially as we head into the summer months and joining me today to discuss the best ways to keep our kids safe in and around the water is Dr. Graham Snyder, Medical Director of the Patient Simulation Center and Emergency Department Physician for Wake Med Health and Hospitals. This is Wake Med Voices, a podcast from Wake Med Health and Hospitals. I'm Scott Webb. So Dr. Snyder, thanks so much for being on today. I am a parent myself and my kids are a little bit older, but of course I worried a lot about them when they were little and tried to watch them as best I could. But let's talk about the importance of teaching our kids to swim. When should we start teaching them?
Dr. Snyder: Teaching children to swim is the most critical intervention you can do to prevent drowning. And you can begin teaching them quite early, a child, even, you know, even as young as a year old can be taught to flip over on their back and float for a little while. And as they get older, they can learn to kind of move around to some degree. Now there's a big, big caveat to that. And the question is not so much. When can you teach a child to swim, but when can you teach a child to swim and they will remember? So any lessons that are done before four years old are fine and can help a child, but before four years old, they're going to forget them even within the same season. So constant re-training is necessary, or those skills will wane as opposed to once you've got a kid, you know, into grade school, then that swimming skill, that swimming proficiency is much more likely to last.
Host: What recommendations do you have for us parents regarding staying vigilant when our kids are in the water? There's just so many distractions, whether it's the doorbell, our phones, whatever it might be.
Dr. Snyder: You're so right. I only have two children. And when they were in the pool, they were notoriously for heading off in opposite directions. And I'm one person watching two children who I love more than my own life. And it's hard to keep my eye on them. Much less what a lifeguard has to do, you know, 20, 30, 40 children. And so watching children while swimming is quite difficult, it is a very vigilant challenge and an awesome responsibility. The times that I worry the most about a kid drowning is not when one parent is watching. It's when 10 parents are watching. And the reason I say that is because when 10 people are supposed to be watching children often, that means nobody is that responsibility is diffused. They say, well, someone's got to be watching. Well someone will notice that's really not good enough. If there are children in the water, you need an adult who is on point.
It is your responsibility. No matter what everybody else is doing, you need one person whose responsibility is to watch the water, to watch the bottom. When you're teaching lifeguards how to guard a pool, you actually don't tell lifeguards to watch the children because the children, you know, the children are carrying on and screaming and yelling and throwing balls and doing that kind of thing. Those aren't the children that need to be watched. The most important thing the lifeguard is doing is watching the bottom. They are scanning the bottom and scanning the bottom and the middle of the top of the water, but not really worth looking for people that are loud and thrashing around and making noise. They're looking for the silent parts of the pool. They're looking for the shadows, the corners. The still places where a child will sink down and not be seen.
Host: What are some of the myths about drowning? I know there are a few, especially that it is always such an event, such a loud thing that everyone's going to notice. That's not really the case is it?
Dr. Snyder: Not at all. We like to say that drowning doesn't look like drowning. As a, you know, even as a college student, as a young parent, I always figured that if a person was drowning, they would, they would wave their hands and say help me. But if you think about it, of course, that doesn't make sense. If you're drowning, that means you can't breathe. And if you can't breathe, all you're doing is sucking in air. You don't have any air left over to yell. And if you've ever treaded water, you know, it's pretty hard to tread water, but tread water with both your arms in the air, you need to be an athlete to do that. And so you're never going to see their hands waving. The way people drown, and one thing that an expert lifeguard is looking for, and a well-trained parent is looking for, is for a child whose eyes are wide open. Their mouth is wide open. They're staring, and they're actually bobbing up and down in the water.
We call that the instinctive drowning response. So what happens is, as a child becomes fatigued and terrified. Obviously eyes open up like dish pans. Their mouth opens up and they kick and kick and kick to stay at the surface, but they're not good swimmers. And so they get fatigued and then they sink, sink, sink under when the water rushes into their mouth and chokes the panic intensifies, and they kick harder bringing their mouth and face to the top again. And then they get fatigued and go down again. And unfortunately that looks like playing. It looks like a kid who's jumping up and down on the bottom, which is a very fun thing to do. But if you focus in on them and go, is that child happy? And you're looking at their face. If they're yelling at their friends, Hey, look at me. That's fine. But if that is a quiet child with a thousand yard stare, then drowning is eminent.
Host: And doctor, I wanted to have you discuss dry drowning and what that means exactly? And what signs we should look for in someone who's inhaled water?
Dr. Snyder: Dry drowning is a real phenomenon, but it's both a rare phenomenon. And the fear surrounding it is grossly disproportionate to the actual incidence of the phenomenon. Dry drowning just means water, Chlorine, salt has rushed into the lungs because the child has aspirated. Then that water has come back out and they've survived. But that influx of water and chlorine has damaged their lungs a little bit. And then over the course of several hours, the lungs begin to weep, begin to secrete extra fluid, and they develop what is very similar to a diffuse pneumonia. And as that pneumonia progresses, they get less and less oxygen into their body. And rarely they can die from it. The reason it's important to know about it is because in the most extreme case, a child sank to the bottom, someone pulls them up, they get mouth to mouth, and then the kid wakes up cries and has a Popsicle and is running around and everyone thinks, Oh, that's wonderful.
It's a great safe. And it is a great say, but you're not done yet. That child must be watched in a hospital for hours and hours to make sure that they don't develop wheezing and then air hunger, and then low oxygenation, because we have all sorts of tricks that we can do to save a person who is going down from that lung injury. Obviously, any child that got mouth to mouth must be observed in an emergency department at a very minimum and probably overnight in the hospital. But even if a child has, I wouldn't say a little choke and sputter, if the child has a significant event where they are rescued and they come up and they're, and you know, true moral terror. And then has, you know, just prolonged coughing, you know, a little wheezing. Let's just bring them by an emergency department and make sure that they're not developing that ARDS, that's the name for acute respiratory distress syndrome from a lung injury
Host: And Dr. Snyder, I know the Seal Swim Safe device and system that you co-founded, hasn't quite worked out as a business, but it's still revolutionary. It's still a great invention. I'd love it if you could tell us all about it.
Dr. Snyder: So I worked with a team for several years at Seals Swim Safe, developing a monitor that kids could wear when they were at the pool, usually in large groups. And if a child was underwater for longer than the limit of pain, longer than the time where it's reasonable for a kid to hold their breath, it would set off a series of strobe lights and sirens, alerting both the lifeguard, the pool owner and parents that, Hey, there's a problem in the pool right now. There's an emergency, in time to initiate a rescue. It's a great invention was used by thousands of children. Mostly at YMCAs around the nation. And unfortunately did not end up being a good economic model for the long-term. And so the business was not able to continue, but we're hopeful that someone else will pick up the technology in the future as manufacturing costs come down so that the children can be safer in pools to come.
Host: Yeah, I hope so, too, Doctor, as we wrap up today, please give us your best advice to help us keep our kiddos safe when they're in the water, whether it's the Lake, the pool, the ocean, wherever it is, how can we keep them safe?
Dr. Snyder: I can reel it off for you. Number one, early and effective swim lessons. It sounds like a cruel joke that the kids had drowned or the kids that don't know how to swim. Well, that's true. 85% of children that drown have never had a single swim lesson. So as soon as they can get children trained to swim so that they'll never even need rescuing. Number two, when it's hard to put one of these things in front of the order in terms of importance, but vigilant parents and lifeguards, we need a person taking sole responsibility for watching the children, washing the bottom, looking for obviously submerged children, but also children in crisis. Children's showing that instinctive drowning response, showing fatigue, showing terror. Number three is I would say you have to focus on a safe pool environment. If you've got kids diving off of docks, where a dock was 10 feet deep last year, but maybe it's four feet deep this year. Then you've got both a neck injury and a drowning waiting to happen. Another thing is you shouldn't be swimming in a pool that's cloudy. Pool water needs to be crystal clear. If it's not crystal clear, someone needs to fix that chemistry. Cause then you can't see if someone is on the bottom. If you cover those three things with those tenants, then you could save the vast, vast majority children from ever drowning. And that's what I would like all parents and pool owners and lakefront property owners to think of.
Host: Doctor, I appreciate your passion, your expertise today. Thank you so much for your time and stay well. That's Dr. Graham Snyder, for more information, visit wakemed.org. And if you've found this podcast helpful, please share it on your social channels to check out the full podcast library for topics of interest to you. This is Wake Med Voices, a podcast brought to you by Wake Med Health and Hospitals in Raleigh, North Carolina. Thanks for listening.
A Deep Dive on Swim Safety
Scott Webb: Keeping our kids safe in the water is a high priority for parents, especially as we head into the summer months and joining me today to discuss the best ways to keep our kids safe in and around the water is Dr. Graham Snyder, Medical Director of the Patient Simulation Center and Emergency Department Physician for Wake Med Health and Hospitals. This is Wake Med Voices, a podcast from Wake Med Health and Hospitals. I'm Scott Webb. So Dr. Snyder, thanks so much for being on today. I am a parent myself and my kids are a little bit older, but of course I worried a lot about them when they were little and tried to watch them as best I could. But let's talk about the importance of teaching our kids to swim. When should we start teaching them?
Dr. Snyder: Teaching children to swim is the most critical intervention you can do to prevent drowning. And you can begin teaching them quite early, a child, even, you know, even as young as a year old can be taught to flip over on their back and float for a little while. And as they get older, they can learn to kind of move around to some degree. Now there's a big, big caveat to that. And the question is not so much. When can you teach a child to swim, but when can you teach a child to swim and they will remember? So any lessons that are done before four years old are fine and can help a child, but before four years old, they're going to forget them even within the same season. So constant re-training is necessary, or those skills will wane as opposed to once you've got a kid, you know, into grade school, then that swimming skill, that swimming proficiency is much more likely to last.
Host: What recommendations do you have for us parents regarding staying vigilant when our kids are in the water? There's just so many distractions, whether it's the doorbell, our phones, whatever it might be.
Dr. Snyder: You're so right. I only have two children. And when they were in the pool, they were notoriously for heading off in opposite directions. And I'm one person watching two children who I love more than my own life. And it's hard to keep my eye on them. Much less what a lifeguard has to do, you know, 20, 30, 40 children. And so watching children while swimming is quite difficult, it is a very vigilant challenge and an awesome responsibility. The times that I worry the most about a kid drowning is not when one parent is watching. It's when 10 parents are watching. And the reason I say that is because when 10 people are supposed to be watching children often, that means nobody is that responsibility is diffused. They say, well, someone's got to be watching. Well someone will notice that's really not good enough. If there are children in the water, you need an adult who is on point.
It is your responsibility. No matter what everybody else is doing, you need one person whose responsibility is to watch the water, to watch the bottom. When you're teaching lifeguards how to guard a pool, you actually don't tell lifeguards to watch the children because the children, you know, the children are carrying on and screaming and yelling and throwing balls and doing that kind of thing. Those aren't the children that need to be watched. The most important thing the lifeguard is doing is watching the bottom. They are scanning the bottom and scanning the bottom and the middle of the top of the water, but not really worth looking for people that are loud and thrashing around and making noise. They're looking for the silent parts of the pool. They're looking for the shadows, the corners. The still places where a child will sink down and not be seen.
Host: What are some of the myths about drowning? I know there are a few, especially that it is always such an event, such a loud thing that everyone's going to notice. That's not really the case is it?
Dr. Snyder: Not at all. We like to say that drowning doesn't look like drowning. As a, you know, even as a college student, as a young parent, I always figured that if a person was drowning, they would, they would wave their hands and say help me. But if you think about it, of course, that doesn't make sense. If you're drowning, that means you can't breathe. And if you can't breathe, all you're doing is sucking in air. You don't have any air left over to yell. And if you've ever treaded water, you know, it's pretty hard to tread water, but tread water with both your arms in the air, you need to be an athlete to do that. And so you're never going to see their hands waving. The way people drown, and one thing that an expert lifeguard is looking for, and a well-trained parent is looking for, is for a child whose eyes are wide open. Their mouth is wide open. They're staring, and they're actually bobbing up and down in the water.
We call that the instinctive drowning response. So what happens is, as a child becomes fatigued and terrified. Obviously eyes open up like dish pans. Their mouth opens up and they kick and kick and kick to stay at the surface, but they're not good swimmers. And so they get fatigued and then they sink, sink, sink under when the water rushes into their mouth and chokes the panic intensifies, and they kick harder bringing their mouth and face to the top again. And then they get fatigued and go down again. And unfortunately that looks like playing. It looks like a kid who's jumping up and down on the bottom, which is a very fun thing to do. But if you focus in on them and go, is that child happy? And you're looking at their face. If they're yelling at their friends, Hey, look at me. That's fine. But if that is a quiet child with a thousand yard stare, then drowning is eminent.
Host: And doctor, I wanted to have you discuss dry drowning and what that means exactly? And what signs we should look for in someone who's inhaled water?
Dr. Snyder: Dry drowning is a real phenomenon, but it's both a rare phenomenon. And the fear surrounding it is grossly disproportionate to the actual incidence of the phenomenon. Dry drowning just means water, Chlorine, salt has rushed into the lungs because the child has aspirated. Then that water has come back out and they've survived. But that influx of water and chlorine has damaged their lungs a little bit. And then over the course of several hours, the lungs begin to weep, begin to secrete extra fluid, and they develop what is very similar to a diffuse pneumonia. And as that pneumonia progresses, they get less and less oxygen into their body. And rarely they can die from it. The reason it's important to know about it is because in the most extreme case, a child sank to the bottom, someone pulls them up, they get mouth to mouth, and then the kid wakes up cries and has a Popsicle and is running around and everyone thinks, Oh, that's wonderful.
It's a great safe. And it is a great say, but you're not done yet. That child must be watched in a hospital for hours and hours to make sure that they don't develop wheezing and then air hunger, and then low oxygenation, because we have all sorts of tricks that we can do to save a person who is going down from that lung injury. Obviously, any child that got mouth to mouth must be observed in an emergency department at a very minimum and probably overnight in the hospital. But even if a child has, I wouldn't say a little choke and sputter, if the child has a significant event where they are rescued and they come up and they're, and you know, true moral terror. And then has, you know, just prolonged coughing, you know, a little wheezing. Let's just bring them by an emergency department and make sure that they're not developing that ARDS, that's the name for acute respiratory distress syndrome from a lung injury
Host: And Dr. Snyder, I know the Seal Swim Safe device and system that you co-founded, hasn't quite worked out as a business, but it's still revolutionary. It's still a great invention. I'd love it if you could tell us all about it.
Dr. Snyder: So I worked with a team for several years at Seals Swim Safe, developing a monitor that kids could wear when they were at the pool, usually in large groups. And if a child was underwater for longer than the limit of pain, longer than the time where it's reasonable for a kid to hold their breath, it would set off a series of strobe lights and sirens, alerting both the lifeguard, the pool owner and parents that, Hey, there's a problem in the pool right now. There's an emergency, in time to initiate a rescue. It's a great invention was used by thousands of children. Mostly at YMCAs around the nation. And unfortunately did not end up being a good economic model for the long-term. And so the business was not able to continue, but we're hopeful that someone else will pick up the technology in the future as manufacturing costs come down so that the children can be safer in pools to come.
Host: Yeah, I hope so, too, Doctor, as we wrap up today, please give us your best advice to help us keep our kiddos safe when they're in the water, whether it's the Lake, the pool, the ocean, wherever it is, how can we keep them safe?
Dr. Snyder: I can reel it off for you. Number one, early and effective swim lessons. It sounds like a cruel joke that the kids had drowned or the kids that don't know how to swim. Well, that's true. 85% of children that drown have never had a single swim lesson. So as soon as they can get children trained to swim so that they'll never even need rescuing. Number two, when it's hard to put one of these things in front of the order in terms of importance, but vigilant parents and lifeguards, we need a person taking sole responsibility for watching the children, washing the bottom, looking for obviously submerged children, but also children in crisis. Children's showing that instinctive drowning response, showing fatigue, showing terror. Number three is I would say you have to focus on a safe pool environment. If you've got kids diving off of docks, where a dock was 10 feet deep last year, but maybe it's four feet deep this year. Then you've got both a neck injury and a drowning waiting to happen. Another thing is you shouldn't be swimming in a pool that's cloudy. Pool water needs to be crystal clear. If it's not crystal clear, someone needs to fix that chemistry. Cause then you can't see if someone is on the bottom. If you cover those three things with those tenants, then you could save the vast, vast majority children from ever drowning. And that's what I would like all parents and pool owners and lakefront property owners to think of.
Host: Doctor, I appreciate your passion, your expertise today. Thank you so much for your time and stay well. That's Dr. Graham Snyder, for more information, visit wakemed.org. And if you've found this podcast helpful, please share it on your social channels to check out the full podcast library for topics of interest to you. This is Wake Med Voices, a podcast brought to you by Wake Med Health and Hospitals in Raleigh, North Carolina. Thanks for listening.