WEBVTT
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Okay, let's get started. So we have covered a
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lot of summer hazards in summer school so far.
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Fireworks, broken bones, extreme heat, bugs,
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bites. But there's one topic we've been saving,
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and it's probably the most important one we're
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going to talk about all summer. And that's drowning.
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And this is a harder episode than some of the
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others we've recorded. It is, because drowning
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isn't a hypothetical risk. It's something that
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changed families forever. And as a pediatric
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emergency physician, it's one of the things I
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worry most about every summer. Drowning is the
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leading cause of death for children ages one
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to four in the United States. And unlike a lot
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of other dangers we've talked about this summer,
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it often doesn't look dramatic. It can happen
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quickly, quietly, and with adults nearby. Which
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is why this is an episode that we really wanted
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to do. So let's get started. Welcome back to
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this week's episode of the Rolin Forward Podcast.
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I'm Dr. Alicia Rolin. And I'm Dr. Stephanie
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Rolin. I'm a pediatrician. And I'm a psychiatrist.
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We're sisters, physicians, researchers, and podcasters.
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And we started this podcast because parents are
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constantly bombarded with health information,
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some of it accurate, much of it confusing, and
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a lot of it actually quite misleading. And our
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goal is to cut through that noise and give you
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some practical evidence -based information that
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you can actually use. And this summer we're doing
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that through summer school lessons from the pediatric
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emergency room. It's a series on injuries and
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illnesses we see predictably every summer and
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what families can do to prevent them. Today's
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lesson is drowning prevention. We're going to
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talk about who is most at risk, what drowning
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actually looks like, why it can be so easy to
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miss, what flotation devices can and can't do,
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swim lessons, life jackets, and the layers of
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protection that make being around water safer
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for kids. This one is serious, but it's also
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incredibly important because drowning is preventable
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and there are concrete things every family can
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do to reduce the risk. So let's start with the
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scope of the problem because I don't think most
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families realize how significant the risk of
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drowning actually is. Drowning is currently the
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leading cause of death for children ages one
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to four in the United States. Unintentional injury
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is the leading cause of death for children age
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five to 14, led by motor vehicle accidents, and
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then drowning. So in the United States, over
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4 ,500 people die from unintentional drowning
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each year, which averages out to about 12 deaths
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daily. That's huge. It is. It truly is. But what
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we know is that nearly half of fatal unintentional
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drownings occur in the summer. And that's why
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this is part of the summer series. When most
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people picture drowning, they imagine a child
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splashing, screaming, waving their arms, yelling
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for help. And that's one of the biggest myths
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we're going to talk about today, because real
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drowning often doesn't look like drowning in
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the movies. Real drowning is quiet. A child may
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simply be struggling to keep their mouth above
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water. They may not be able to call for help
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because all of their energy is being used to
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breathe. which is terrifying. And that's one
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reason adults can be standing nearby and not
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immediately realize that something is wrong.
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So what should parents look for? You should really
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look for someone who isn't making forward progress
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in water. You can look for a child who's vertical
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in the water, but isn't moving or isn't treading
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water. And of course, someone who is motionless
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or face down in the water needs immediate help.
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But I think the larger lesson here is do not
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wait for screaming and dramatic splashing. Kids
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in the pool, they're usually loud. And if someone
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is suddenly quiet, It is time to check and make
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sure that they are okay. And when we think about
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drowning, Alicia, who's at the greatest risk?
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It's toddlers, particularly children age one
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to four. Why? They're mobile, they're curious,
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they have absolutely no fear. None. And they
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don't understand danger. No concept of danger.
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This is a perfect recipe. Many drowning incidents
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occur when a child slips away unnoticed for just
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a few minutes. And that's what makes toddler
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drowning so frightening. It doesn't take a long
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lapse in supervision. Exactly. A toddler can
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slip away incredibly quickly, even in a really
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attentive family. You answer a text, you help
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another child, you grab a towel, you assume another
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adult is watching. We've all done these small
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motions. And that's why drowning prevention can't
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rely on a parent being perfectly vigilant every
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second. We need multiple layers of protection
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so that if one layer fails, another is there.
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And here's one piece of advice we really want
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parents to remember. If all of a sudden your
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young child's missing, it happens. You should
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check the water first. The pool, a hot tub, the
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pond that abuts your property, the lake. Before
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you start searching the neighborhood or checking
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with neighbors or driving around, check the water
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first. That's really chilling, but it's very
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practical advice because drowning can happen
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so quickly that every second matters. How quickly
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does this happen? It's much faster than most
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people realize. We're often talking about seconds
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to a few minutes, not even necessarily long enough
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for another adult to notice that something is
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wrong. And that's one reason that drowning is
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so frightening. It could just happen so quickly
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and quietly. Let's say a child does go underwater
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and then is found and rescued. Are they okay?
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Not necessarily. And this is where things get
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a little more nuanced. If a child has a significant
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water aspiration event, meaning they inhaled
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water, had persistent coughing, or appeared to
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be struggling in the water. The effects aren't
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always immediately obvious. So just because a
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child looks okay immediately afterwards doesn't
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mean that the story is over. Sometimes breathing
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problems can develop over the next several hours
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as the lung becomes irritated or injured. And
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that brings us to one of my least favorite topics
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on the internet. Let me guess. Is it dry drowning?
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Dry drowning! What is this? It's where social
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media takes a real medical concept and turns
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it into something much scarier than it needs
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to be. Because we did just talk about how symptoms
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can develop later. Right. After a significant
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water aspiration event, some children can develop
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breathing problems over the next several hours.
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That is real. What is not real is that a child
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can go swimming, seem completely normal for days,
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and then suddenly die from dry drowning in their
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sleep days later. There's no recognized medical
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diagnosis called dry drowning or secondary drowning.
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So what should parents actually be watching for?
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If your child had a significant water event,
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they likely need to be evaluated and observed
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by a medical professional for at least six to
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eight hours. But if your home thinks to look
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for include persistent coughing, trouble breathing,
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unusual sleepiness, confusion, or just worsening
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of their symptoms. But if your child went swimming,
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like mine did today, was totally fine during
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the swimming, felt fine afterwards, remained
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completely well, and is running around normally
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days later, they are not secretly drowning. They
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are not secretly drowning. All right, some more
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drowning questions. As an emergency pediatrician,
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when you think about drowning, are all bodies
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of water equally dangerous? This is one of the
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things that surprise parents the most. Most people
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hear drowning and they picture the ocean. They
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picture the big waves, the rip currents, and
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these dramatic rescues. So basically Baywatch.
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Exactly. But for young children, the highest
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risk body of water is often the one that's right
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in your backyard. The pool? The pool. Because
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pools are accessible, they're familiar, they're
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close to home. Many drowning incidents happen
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during everyday moments. A barbecue, a birthday
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party, a family gathering, an afternoon swim.
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It's not necessarily during some dramatic vacation
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accident. Which is actually much scarier. It
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is because familiarity lowers our guard. Parents
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are often appropriately cautious at the beach.
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They might be less cautious around a pool that
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they've seen hundreds of times that their child
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has been in hundreds of times. And what about
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lakes? Lakes have their own challenges, poor
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visibility, drop -offs, docks and boats, and
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currents that people don't always appreciate.
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And unlike a pool, you often can't see what's
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underneath the surface. And then, the ocean.
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The ocean adds the complications of rip currents,
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waves, undertows, and changing conditions. But
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the good news is that people often recognize
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the ocean as dangerous and behave accordingly.
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So the takeaway isn't that pools are more dangerous
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than oceans. It's that parents should be just
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as vigilant around the backyard pool as they
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are at the beach. Water is water, and it needs
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to be respected the same everywhere. And speaking
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about lakes, let's talk about boats, life jackets,
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because some families own life jackets, but not
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every child wears one. As a pediatric emergency
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physician, this is one of the easiest safety
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recommendations I'll ever make. If your child
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is around a natural body of water, lakes, rivers,
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boating, kayaking, paddleboarding, jet skis,
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I strongly recommend a U .S. Coast Guard approved
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life jacket. But what if they know how to swim?
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Especially if they know how to swim. Because
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accidents don't just happen to non -swimmers.
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People get tired, boats capsize, kids get knocked
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into the water unexpectedly. Strong swimmers
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can panic. You can be in an area of water that's
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unsafe. So now this isn't just about toddlers
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anymore. Not at all. Life jackets save lives
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across all age groups. You seem to have some
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pretty strong feelings about this. I do because
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every summer I see families spend hundreds of
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dollars on boats and paddle boards and lake vacations
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and then decide that the $5 life jacket rental
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is optional. And that's exactly backwards. So
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if there's one thing that parents remember? Around
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natural water, wear a life jacket. Okay. Now,
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now let's have some fun. Let's start a fight.
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You ready? I'm ready. Parents love floaties.
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They love them. They're so great. Thoughts? I
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completely understand why. They make kids happy.
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They make parents feel safer. They often allow
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kids to spend more time in the water. But the
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concern is that they create a false sense of
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security. Meaning? Parents sometimes look at
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children wearing floaties and think, great. they
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are going to be safe in the water. But floaties
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are toys. They're not safety devices. They can
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slip off. They can deflate. They can fail. And
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they don't eliminate the need for supervision.
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But what about those really cute pedal jumpers?
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They're certainly better than inflatable arm
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floaties, but they still carry the same risk.
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It creates a false sense of security for both
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kids and parents. It can lead parents to relax
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supervision and give this kid sense that they
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know how to float and swim when they absolutely
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cannot. They also can encourage a vertical body
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position, which some experts worry that this
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may delay the development of independent swimming.
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Meaning? That they keep kids in this very vertical
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upright position in the water. They teach, to
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swim, to float, you have to stay upright and
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kick. But swimming actually requires a horizontal
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body position. And so some instructors worry
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that puddle jumpers can delay the development
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of proper positioning and understanding of how
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to swim. So the issue isn't just whether they
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float. That's correct. It's also about what habits
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they're teaching kids. And what's the biggest
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mistake that parents make with floaties? Thinking
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that a flotation device has replaced supervision.
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A child wearing floaties can still drown. A child
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wearing a puddle jumper can still drown. Does
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that mean that parents should throw these away?
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No, and that's not my message. My message is
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to understand exactly what they're for. They're
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pool toys. They're not a substitute for swim
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lessons. They're not a substitute for supervision
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or life jackets. You just mentioned swim lessons.
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Do swim lessons help? Absolutely. The evidence
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suggests swim lessons reduces drowning risk.
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At what age? The American Academy of Pediatrics
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says swim lessons can begin for many children
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around 12 months of age, depending on readiness.
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But they're only one layer of protection. What
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about for younger babies, like the mommy and
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me or papa and me classes where you hold the
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baby and you sing the song and you go, bop, goes
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the weasel and then they go underwater? You know?
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No, no, you don't know? I know. It's very specific.
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Those can be really wonderful. And parents sometimes
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hear that the AAP says swim lessons shouldn't
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start before age one, and they assume that these
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infant mommy and me classes have no value. And
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that's not true. For babies, the goal isn't teaching
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independent swimming. There's no evidence that
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infant swim lessons before age one reduces drowning
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incidence. Its goal is to help children become
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more comfortable in the water. and helping parents
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learn water safety skills and making water a
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positive experience so that your one -year -old
00:12:45.669 --> 00:12:47.330
doesn't go in the pool for the first time and
00:12:47.330 --> 00:12:50.710
scream their face off. Plus, it can be fun. But
00:12:50.710 --> 00:12:52.929
there's no evidence that these classes reduce
00:12:52.929 --> 00:12:55.710
drowning, not even those infant swim rescue ones?
00:12:56.250 --> 00:12:57.990
No, and that's a really important distinction.
00:12:58.269 --> 00:13:00.250
You've probably seen videos of very young babies
00:13:00.250 --> 00:13:02.149
being taught to roll onto their back and float
00:13:02.149 --> 00:13:04.490
face up. Babies can actually be trained to do
00:13:04.490 --> 00:13:06.889
that reflexively, but the American Academy of
00:13:06.889 --> 00:13:09.549
Pediatrics says that this ability has not been
00:13:09.549 --> 00:13:12.629
shown to reduce infant drowning rates. But there
00:13:12.629 --> 00:13:14.570
are very polarized views on lines, with some
00:13:14.570 --> 00:13:16.330
parents crediting the survival training with
00:13:16.330 --> 00:13:18.549
life -saving skills, and while others worry about
00:13:18.549 --> 00:13:20.909
high stress crying, a potential water trauma
00:13:20.909 --> 00:13:23.210
during these intense conditionings. So it sounds
00:13:23.210 --> 00:13:25.610
like maybe babies could learn this floating response,
00:13:25.669 --> 00:13:27.590
but there's no evidence that this would actually
00:13:27.590 --> 00:13:30.570
prevent drowning. Exactly. Babies under a year
00:13:30.570 --> 00:13:32.950
aren't developmentally capable of the coordinated
00:13:32.950 --> 00:13:36.970
movements for true survival swimming. The AAP's
00:13:36.970 --> 00:13:38.940
latest guidance that came out this summer says
00:13:38.940 --> 00:13:40.659
that they're not yet able to coordinate their
00:13:40.659 --> 00:13:42.639
arms and legs to propel themselves and perform
00:13:42.639 --> 00:13:44.779
most of the motor skills required for survival
00:13:44.779 --> 00:13:47.299
swimming. They also raise a concern about programs
00:13:47.299 --> 00:13:49.440
that use repeated submersions to teach the back
00:13:49.440 --> 00:13:51.539
float response. Repeated submersions can create
00:13:51.539 --> 00:13:53.580
this negative experience with the water, and
00:13:53.580 --> 00:13:56.000
that might interfere with later swimming competency.
00:13:57.059 --> 00:13:59.480
So my child's now a year old. They're actually
00:13:59.480 --> 00:14:01.820
three years old. We've been doing swim lessons
00:14:01.820 --> 00:14:05.759
regularly. Has this eliminated drowning risk?
00:14:06.179 --> 00:14:08.889
No. There's a statement in pediatrics, and it's
00:14:08.889 --> 00:14:10.970
that the biggest risk factor for drowning is
00:14:10.970 --> 00:14:12.830
not knowing how to swim, and the second biggest
00:14:12.830 --> 00:14:15.649
risk factor is knowing how to swim. There's no
00:14:15.649 --> 00:14:17.690
winning here. There's no winning. If you know
00:14:17.690 --> 00:14:19.669
how to swim, you're more comfortable around water.
00:14:20.029 --> 00:14:21.690
There's sometimes a little bit more lack of supervision.
00:14:22.269 --> 00:14:24.110
If you don't know how to swim, you don't know
00:14:24.110 --> 00:14:26.830
how to swim. So a child who's had swim lessons
00:14:26.830 --> 00:14:29.129
can drown. A child who's a strong swimmer can
00:14:29.129 --> 00:14:32.129
drown. Adults can drown. Lifeguards can drown.
00:14:32.730 --> 00:14:34.509
Swimming ability lowers the risk of drowning,
00:14:34.649 --> 00:14:37.610
but it does not eliminate the risk. So, let's
00:14:37.610 --> 00:14:40.309
talk about supervision. Because every parent
00:14:40.309 --> 00:14:43.029
thinks that they're supervising. I'm always supervising.
00:14:43.350 --> 00:14:45.129
This is where I introduce one of my favorite
00:14:45.129 --> 00:14:49.889
concepts, the water watcher. Superhero water
00:14:49.889 --> 00:14:52.750
watcher! The idea is that one adult is specifically
00:14:52.750 --> 00:14:54.830
responsible for watching children in the water.
00:14:55.389 --> 00:14:57.129
They don't have a phone, they don't have a book,
00:14:57.309 --> 00:14:58.929
they're not drinking alcohol, they're not scrolling
00:14:58.929 --> 00:15:01.129
Instagram, and they're not assuming that someone
00:15:01.129 --> 00:15:03.940
else is watching. the designated driver, let's
00:15:03.940 --> 00:15:06.379
say, of the pool. Exactly, because one thing
00:15:06.379 --> 00:15:08.820
that we repeatedly see is groups of adults where
00:15:08.820 --> 00:15:11.620
everyone assumes someone else is paying attention,
00:15:11.879 --> 00:15:14.460
and then no one is actually paying attention.
00:15:15.200 --> 00:15:17.200
All right, so let's end with three things that
00:15:17.200 --> 00:15:20.139
parents should remember. Number one, and I think
00:15:20.139 --> 00:15:23.059
this is really important, drowning is often silent.
00:15:23.500 --> 00:15:25.740
Don't look for screaming. Look for kids that
00:15:25.740 --> 00:15:30.120
are vertical and quiet. Check. Number two, no
00:15:30.120 --> 00:15:33.659
flotation device replaces supervision. And what's
00:15:33.659 --> 00:15:36.399
number three? The most effective drowning prevention
00:15:36.399 --> 00:15:39.460
strategy is layers of protection. Having swim
00:15:39.460 --> 00:15:42.879
lessons, having a fence around the pool, always
00:15:42.879 --> 00:15:45.700
having adult supervision, wearing life jackets,
00:15:46.299 --> 00:15:49.120
having designated water watchers. So it's not
00:15:49.120 --> 00:15:52.159
one thing, it's multiple things working together.
00:15:53.279 --> 00:15:55.940
This is really important because drowning isn't
00:15:55.940 --> 00:15:58.320
something that happens to careless families.
00:15:58.879 --> 00:16:01.879
It happens to loving families, attentive families,
00:16:02.419 --> 00:16:05.399
good parents. And drowning prevention, it cannot
00:16:05.399 --> 00:16:08.720
depend on being perfectly vigilant every second.
00:16:08.899 --> 00:16:11.100
So it's using these tips to build these layers
00:16:11.100 --> 00:16:14.360
of protection so that when one layer fails, because
00:16:14.360 --> 00:16:16.620
it will, there's another layer of protection
00:16:16.620 --> 00:16:19.639
there to step in. And if our episode today felt
00:16:19.639 --> 00:16:21.440
a little heavier than our usual summer school
00:16:21.440 --> 00:16:23.950
lessons, That's because this is one of the topics
00:16:23.950 --> 00:16:26.649
where the stakes are really that high. And the
00:16:26.649 --> 00:16:28.809
reason that we talk about it isn't to make families
00:16:28.809 --> 00:16:31.950
afraid of the water. Kids should swim. They should
00:16:31.950 --> 00:16:33.929
go to the lake. They should go to the neighborhood
00:16:33.929 --> 00:16:36.090
pool and have a pool party and spend their summer
00:16:36.090 --> 00:16:38.850
outside. We just want them to do those things
00:16:38.850 --> 00:16:41.509
as safely as possible. And the statistics around
00:16:41.509 --> 00:16:43.909
drowning, they're scary. They're really scary.
00:16:49.579 --> 00:16:52.000
So, thank you for listening to this week's episode
00:16:52.000 --> 00:16:54.679
of the Rolin Forward podcast. I'm Dr. Alicia
00:16:54.679 --> 00:16:57.840
Rolin. I'm Dr. Stephanie Rolin. If you liked
00:16:57.840 --> 00:16:59.899
our episode today, please be sure to follow,
00:17:00.039 --> 00:17:02.399
like, and subscribe. Share it with a friend,
00:17:02.399 --> 00:17:04.480
and then we'll see you next week for another
00:17:04.480 --> 00:17:11.380
episode of Summer School. I'm a pediatrician.
00:17:11.640 --> 00:17:14.119
I'm a forensic psychiatrist. Well, then I'm a
00:17:14.119 --> 00:17:16.319
pediatric emergency physician. Well, I don't
00:17:16.319 --> 00:17:17.460
know. I don't know.
00:00:00.899 --> 00:00:06.339
Okay, let's get started. So we have covered a
00:00:06.339 --> 00:00:09.919
lot of summer hazards in summer school so far.
00:00:10.400 --> 00:00:14.580
Fireworks, broken bones, extreme heat, bugs,
00:00:15.099 --> 00:00:17.800
bites. But there's one topic we've been saving,
00:00:17.980 --> 00:00:19.839
and it's probably the most important one we're
00:00:19.839 --> 00:00:22.359
going to talk about all summer. And that's drowning.
00:00:22.879 --> 00:00:25.019
And this is a harder episode than some of the
00:00:25.019 --> 00:00:27.780
others we've recorded. It is, because drowning
00:00:27.780 --> 00:00:30.510
isn't a hypothetical risk. It's something that
00:00:30.510 --> 00:00:32.689
changed families forever. And as a pediatric
00:00:32.689 --> 00:00:34.590
emergency physician, it's one of the things I
00:00:34.590 --> 00:00:37.609
worry most about every summer. Drowning is the
00:00:37.609 --> 00:00:39.509
leading cause of death for children ages one
00:00:39.509 --> 00:00:42.329
to four in the United States. And unlike a lot
00:00:42.329 --> 00:00:43.990
of other dangers we've talked about this summer,
00:00:44.170 --> 00:00:46.630
it often doesn't look dramatic. It can happen
00:00:46.630 --> 00:00:50.189
quickly, quietly, and with adults nearby. Which
00:00:50.189 --> 00:00:52.810
is why this is an episode that we really wanted
00:00:52.810 --> 00:01:01.329
to do. So let's get started. Welcome back to
00:01:01.329 --> 00:01:03.850
this week's episode of the Rolin Forward Podcast.
00:01:04.409 --> 00:01:06.890
I'm Dr. Alicia Rolin. And I'm Dr. Stephanie
00:01:06.890 --> 00:01:10.469
Rolin. I'm a pediatrician. And I'm a psychiatrist.
00:01:11.170 --> 00:01:14.530
We're sisters, physicians, researchers, and podcasters.
00:01:15.189 --> 00:01:18.010
And we started this podcast because parents are
00:01:18.010 --> 00:01:20.010
constantly bombarded with health information,
00:01:20.450 --> 00:01:23.129
some of it accurate, much of it confusing, and
00:01:23.129 --> 00:01:25.609
a lot of it actually quite misleading. And our
00:01:25.609 --> 00:01:27.469
goal is to cut through that noise and give you
00:01:27.469 --> 00:01:30.200
some practical evidence -based information that
00:01:30.200 --> 00:01:32.980
you can actually use. And this summer we're doing
00:01:32.980 --> 00:01:35.280
that through summer school lessons from the pediatric
00:01:35.280 --> 00:01:38.260
emergency room. It's a series on injuries and
00:01:38.260 --> 00:01:41.120
illnesses we see predictably every summer and
00:01:41.120 --> 00:01:43.760
what families can do to prevent them. Today's
00:01:43.760 --> 00:01:46.000
lesson is drowning prevention. We're going to
00:01:46.000 --> 00:01:48.359
talk about who is most at risk, what drowning
00:01:48.359 --> 00:01:51.859
actually looks like, why it can be so easy to
00:01:51.859 --> 00:01:55.560
miss, what flotation devices can and can't do,
00:01:56.180 --> 00:01:59.120
swim lessons, life jackets, and the layers of
00:01:59.120 --> 00:02:01.219
protection that make being around water safer
00:02:01.219 --> 00:02:04.480
for kids. This one is serious, but it's also
00:02:04.480 --> 00:02:07.560
incredibly important because drowning is preventable
00:02:07.560 --> 00:02:10.159
and there are concrete things every family can
00:02:10.159 --> 00:02:16.939
do to reduce the risk. So let's start with the
00:02:16.939 --> 00:02:19.580
scope of the problem because I don't think most
00:02:19.580 --> 00:02:22.539
families realize how significant the risk of
00:02:22.539 --> 00:02:25.789
drowning actually is. Drowning is currently the
00:02:25.789 --> 00:02:27.590
leading cause of death for children ages one
00:02:27.590 --> 00:02:30.610
to four in the United States. Unintentional injury
00:02:30.610 --> 00:02:32.370
is the leading cause of death for children age
00:02:32.370 --> 00:02:35.689
five to 14, led by motor vehicle accidents, and
00:02:35.689 --> 00:02:39.729
then drowning. So in the United States, over
00:02:39.729 --> 00:02:42.770
4 ,500 people die from unintentional drowning
00:02:42.770 --> 00:02:46.310
each year, which averages out to about 12 deaths
00:02:46.310 --> 00:02:51.469
daily. That's huge. It is. It truly is. But what
00:02:51.469 --> 00:02:54.810
we know is that nearly half of fatal unintentional
00:02:54.810 --> 00:02:57.389
drownings occur in the summer. And that's why
00:02:57.389 --> 00:03:00.270
this is part of the summer series. When most
00:03:00.270 --> 00:03:02.650
people picture drowning, they imagine a child
00:03:02.650 --> 00:03:05.069
splashing, screaming, waving their arms, yelling
00:03:05.069 --> 00:03:07.409
for help. And that's one of the biggest myths
00:03:07.409 --> 00:03:09.150
we're going to talk about today, because real
00:03:09.150 --> 00:03:11.229
drowning often doesn't look like drowning in
00:03:11.229 --> 00:03:15.129
the movies. Real drowning is quiet. A child may
00:03:15.129 --> 00:03:16.870
simply be struggling to keep their mouth above
00:03:16.870 --> 00:03:19.289
water. They may not be able to call for help
00:03:19.289 --> 00:03:21.770
because all of their energy is being used to
00:03:21.770 --> 00:03:24.819
breathe. which is terrifying. And that's one
00:03:24.819 --> 00:03:27.000
reason adults can be standing nearby and not
00:03:27.000 --> 00:03:28.780
immediately realize that something is wrong.
00:03:29.340 --> 00:03:31.879
So what should parents look for? You should really
00:03:31.879 --> 00:03:33.939
look for someone who isn't making forward progress
00:03:33.939 --> 00:03:36.180
in water. You can look for a child who's vertical
00:03:36.180 --> 00:03:38.120
in the water, but isn't moving or isn't treading
00:03:38.120 --> 00:03:40.479
water. And of course, someone who is motionless
00:03:40.479 --> 00:03:42.819
or face down in the water needs immediate help.
00:03:43.180 --> 00:03:45.539
But I think the larger lesson here is do not
00:03:45.539 --> 00:03:48.719
wait for screaming and dramatic splashing. Kids
00:03:48.719 --> 00:03:51.199
in the pool, they're usually loud. And if someone
00:03:51.199 --> 00:03:53.810
is suddenly quiet, It is time to check and make
00:03:53.810 --> 00:03:55.909
sure that they are okay. And when we think about
00:03:55.909 --> 00:03:58.310
drowning, Alicia, who's at the greatest risk?
00:03:59.129 --> 00:04:01.729
It's toddlers, particularly children age one
00:04:01.729 --> 00:04:04.889
to four. Why? They're mobile, they're curious,
00:04:04.990 --> 00:04:08.050
they have absolutely no fear. None. And they
00:04:08.050 --> 00:04:10.389
don't understand danger. No concept of danger.
00:04:10.550 --> 00:04:13.250
This is a perfect recipe. Many drowning incidents
00:04:13.250 --> 00:04:16.009
occur when a child slips away unnoticed for just
00:04:16.009 --> 00:04:18.550
a few minutes. And that's what makes toddler
00:04:18.550 --> 00:04:21.110
drowning so frightening. It doesn't take a long
00:04:21.110 --> 00:04:24.430
lapse in supervision. Exactly. A toddler can
00:04:24.430 --> 00:04:27.269
slip away incredibly quickly, even in a really
00:04:27.269 --> 00:04:29.810
attentive family. You answer a text, you help
00:04:29.810 --> 00:04:31.970
another child, you grab a towel, you assume another
00:04:31.970 --> 00:04:34.509
adult is watching. We've all done these small
00:04:34.509 --> 00:04:37.370
motions. And that's why drowning prevention can't
00:04:37.370 --> 00:04:40.329
rely on a parent being perfectly vigilant every
00:04:40.329 --> 00:04:42.310
second. We need multiple layers of protection
00:04:42.310 --> 00:04:44.430
so that if one layer fails, another is there.
00:04:44.810 --> 00:04:47.269
And here's one piece of advice we really want
00:04:47.269 --> 00:04:49.689
parents to remember. If all of a sudden your
00:04:49.689 --> 00:04:52.769
young child's missing, it happens. You should
00:04:52.769 --> 00:04:56.949
check the water first. The pool, a hot tub, the
00:04:56.949 --> 00:04:59.250
pond that abuts your property, the lake. Before
00:04:59.250 --> 00:05:01.089
you start searching the neighborhood or checking
00:05:01.089 --> 00:05:03.949
with neighbors or driving around, check the water
00:05:03.949 --> 00:05:06.670
first. That's really chilling, but it's very
00:05:06.670 --> 00:05:09.250
practical advice because drowning can happen
00:05:09.250 --> 00:05:12.889
so quickly that every second matters. How quickly
00:05:12.889 --> 00:05:15.839
does this happen? It's much faster than most
00:05:15.839 --> 00:05:18.160
people realize. We're often talking about seconds
00:05:18.160 --> 00:05:21.079
to a few minutes, not even necessarily long enough
00:05:21.079 --> 00:05:22.660
for another adult to notice that something is
00:05:22.660 --> 00:05:24.720
wrong. And that's one reason that drowning is
00:05:24.720 --> 00:05:27.680
so frightening. It could just happen so quickly
00:05:27.680 --> 00:05:31.660
and quietly. Let's say a child does go underwater
00:05:31.660 --> 00:05:34.620
and then is found and rescued. Are they okay?
00:05:35.360 --> 00:05:37.600
Not necessarily. And this is where things get
00:05:37.600 --> 00:05:41.060
a little more nuanced. If a child has a significant
00:05:41.060 --> 00:05:43.199
water aspiration event, meaning they inhaled
00:05:43.199 --> 00:05:45.529
water, had persistent coughing, or appeared to
00:05:45.529 --> 00:05:47.730
be struggling in the water. The effects aren't
00:05:47.730 --> 00:05:50.470
always immediately obvious. So just because a
00:05:50.470 --> 00:05:53.050
child looks okay immediately afterwards doesn't
00:05:53.050 --> 00:05:56.230
mean that the story is over. Sometimes breathing
00:05:56.230 --> 00:05:58.449
problems can develop over the next several hours
00:05:58.449 --> 00:06:01.370
as the lung becomes irritated or injured. And
00:06:01.370 --> 00:06:03.209
that brings us to one of my least favorite topics
00:06:03.209 --> 00:06:06.509
on the internet. Let me guess. Is it dry drowning?
00:06:06.610 --> 00:06:09.959
Dry drowning! What is this? It's where social
00:06:09.959 --> 00:06:11.800
media takes a real medical concept and turns
00:06:11.800 --> 00:06:13.439
it into something much scarier than it needs
00:06:13.439 --> 00:06:16.839
to be. Because we did just talk about how symptoms
00:06:16.839 --> 00:06:20.079
can develop later. Right. After a significant
00:06:20.079 --> 00:06:22.720
water aspiration event, some children can develop
00:06:22.720 --> 00:06:24.699
breathing problems over the next several hours.
00:06:25.120 --> 00:06:28.839
That is real. What is not real is that a child
00:06:28.839 --> 00:06:31.000
can go swimming, seem completely normal for days,
00:06:31.240 --> 00:06:33.459
and then suddenly die from dry drowning in their
00:06:33.459 --> 00:06:37.009
sleep days later. There's no recognized medical
00:06:37.009 --> 00:06:39.649
diagnosis called dry drowning or secondary drowning.
00:06:40.250 --> 00:06:42.110
So what should parents actually be watching for?
00:06:42.430 --> 00:06:44.509
If your child had a significant water event,
00:06:45.009 --> 00:06:47.250
they likely need to be evaluated and observed
00:06:47.250 --> 00:06:48.970
by a medical professional for at least six to
00:06:48.970 --> 00:06:51.370
eight hours. But if your home thinks to look
00:06:51.370 --> 00:06:53.829
for include persistent coughing, trouble breathing,
00:06:54.350 --> 00:06:56.889
unusual sleepiness, confusion, or just worsening
00:06:56.889 --> 00:06:59.790
of their symptoms. But if your child went swimming,
00:06:59.949 --> 00:07:02.209
like mine did today, was totally fine during
00:07:02.209 --> 00:07:04.470
the swimming, felt fine afterwards, remained
00:07:04.470 --> 00:07:07.069
completely well, and is running around normally
00:07:07.069 --> 00:07:09.850
days later, they are not secretly drowning. They
00:07:09.850 --> 00:07:12.730
are not secretly drowning. All right, some more
00:07:12.730 --> 00:07:17.149
drowning questions. As an emergency pediatrician,
00:07:17.310 --> 00:07:19.930
when you think about drowning, are all bodies
00:07:19.930 --> 00:07:23.269
of water equally dangerous? This is one of the
00:07:23.269 --> 00:07:25.389
things that surprise parents the most. Most people
00:07:25.389 --> 00:07:27.970
hear drowning and they picture the ocean. They
00:07:27.970 --> 00:07:30.110
picture the big waves, the rip currents, and
00:07:30.110 --> 00:07:33.870
these dramatic rescues. So basically Baywatch.
00:07:34.449 --> 00:07:36.790
Exactly. But for young children, the highest
00:07:36.790 --> 00:07:39.149
risk body of water is often the one that's right
00:07:39.149 --> 00:07:41.970
in your backyard. The pool? The pool. Because
00:07:41.970 --> 00:07:44.189
pools are accessible, they're familiar, they're
00:07:44.189 --> 00:07:46.750
close to home. Many drowning incidents happen
00:07:46.750 --> 00:07:49.009
during everyday moments. A barbecue, a birthday
00:07:49.009 --> 00:07:51.170
party, a family gathering, an afternoon swim.
00:07:51.870 --> 00:07:54.170
It's not necessarily during some dramatic vacation
00:07:54.170 --> 00:07:57.170
accident. Which is actually much scarier. It
00:07:57.170 --> 00:08:00.310
is because familiarity lowers our guard. Parents
00:08:00.310 --> 00:08:02.490
are often appropriately cautious at the beach.
00:08:02.930 --> 00:08:04.589
They might be less cautious around a pool that
00:08:04.589 --> 00:08:06.110
they've seen hundreds of times that their child
00:08:06.110 --> 00:08:08.410
has been in hundreds of times. And what about
00:08:08.410 --> 00:08:11.170
lakes? Lakes have their own challenges, poor
00:08:11.170 --> 00:08:14.610
visibility, drop -offs, docks and boats, and
00:08:14.610 --> 00:08:16.290
currents that people don't always appreciate.
00:08:16.850 --> 00:08:18.910
And unlike a pool, you often can't see what's
00:08:18.910 --> 00:08:21.889
underneath the surface. And then, the ocean.
00:08:22.310 --> 00:08:24.550
The ocean adds the complications of rip currents,
00:08:24.810 --> 00:08:27.459
waves, undertows, and changing conditions. But
00:08:27.459 --> 00:08:29.199
the good news is that people often recognize
00:08:29.199 --> 00:08:31.120
the ocean as dangerous and behave accordingly.
00:08:32.139 --> 00:08:34.620
So the takeaway isn't that pools are more dangerous
00:08:34.620 --> 00:08:37.840
than oceans. It's that parents should be just
00:08:37.840 --> 00:08:40.159
as vigilant around the backyard pool as they
00:08:40.159 --> 00:08:42.480
are at the beach. Water is water, and it needs
00:08:42.480 --> 00:08:45.220
to be respected the same everywhere. And speaking
00:08:45.220 --> 00:08:48.799
about lakes, let's talk about boats, life jackets,
00:08:48.799 --> 00:08:53.179
because some families own life jackets, but not
00:08:53.179 --> 00:08:55.860
every child wears one. As a pediatric emergency
00:08:55.860 --> 00:08:57.879
physician, this is one of the easiest safety
00:08:57.879 --> 00:09:00.159
recommendations I'll ever make. If your child
00:09:00.159 --> 00:09:03.100
is around a natural body of water, lakes, rivers,
00:09:03.299 --> 00:09:05.519
boating, kayaking, paddleboarding, jet skis,
00:09:06.000 --> 00:09:09.019
I strongly recommend a U .S. Coast Guard approved
00:09:09.019 --> 00:09:11.179
life jacket. But what if they know how to swim?
00:09:11.659 --> 00:09:14.080
Especially if they know how to swim. Because
00:09:14.080 --> 00:09:16.019
accidents don't just happen to non -swimmers.
00:09:16.580 --> 00:09:19.379
People get tired, boats capsize, kids get knocked
00:09:19.379 --> 00:09:21.750
into the water unexpectedly. Strong swimmers
00:09:21.750 --> 00:09:23.870
can panic. You can be in an area of water that's
00:09:23.870 --> 00:09:26.450
unsafe. So now this isn't just about toddlers
00:09:26.450 --> 00:09:29.210
anymore. Not at all. Life jackets save lives
00:09:29.210 --> 00:09:31.610
across all age groups. You seem to have some
00:09:31.610 --> 00:09:33.830
pretty strong feelings about this. I do because
00:09:33.830 --> 00:09:36.169
every summer I see families spend hundreds of
00:09:36.169 --> 00:09:38.730
dollars on boats and paddle boards and lake vacations
00:09:38.730 --> 00:09:41.590
and then decide that the $5 life jacket rental
00:09:41.590 --> 00:09:45.049
is optional. And that's exactly backwards. So
00:09:45.049 --> 00:09:47.669
if there's one thing that parents remember? Around
00:09:47.669 --> 00:09:51.409
natural water, wear a life jacket. Okay. Now,
00:09:51.809 --> 00:09:54.850
now let's have some fun. Let's start a fight.
00:09:54.929 --> 00:09:58.090
You ready? I'm ready. Parents love floaties.
00:09:58.309 --> 00:10:01.350
They love them. They're so great. Thoughts? I
00:10:01.350 --> 00:10:04.490
completely understand why. They make kids happy.
00:10:04.990 --> 00:10:07.889
They make parents feel safer. They often allow
00:10:07.889 --> 00:10:11.590
kids to spend more time in the water. But the
00:10:11.590 --> 00:10:13.389
concern is that they create a false sense of
00:10:13.389 --> 00:10:16.649
security. Meaning? Parents sometimes look at
00:10:16.649 --> 00:10:19.169
children wearing floaties and think, great. they
00:10:19.169 --> 00:10:21.830
are going to be safe in the water. But floaties
00:10:21.830 --> 00:10:24.309
are toys. They're not safety devices. They can
00:10:24.309 --> 00:10:27.049
slip off. They can deflate. They can fail. And
00:10:27.049 --> 00:10:28.870
they don't eliminate the need for supervision.
00:10:29.429 --> 00:10:31.389
But what about those really cute pedal jumpers?
00:10:32.190 --> 00:10:34.250
They're certainly better than inflatable arm
00:10:34.250 --> 00:10:37.049
floaties, but they still carry the same risk.
00:10:37.370 --> 00:10:39.529
It creates a false sense of security for both
00:10:39.529 --> 00:10:42.669
kids and parents. It can lead parents to relax
00:10:42.669 --> 00:10:44.870
supervision and give this kid sense that they
00:10:44.870 --> 00:10:47.250
know how to float and swim when they absolutely
00:10:47.250 --> 00:10:50.440
cannot. They also can encourage a vertical body
00:10:50.440 --> 00:10:52.679
position, which some experts worry that this
00:10:52.679 --> 00:10:55.139
may delay the development of independent swimming.
00:10:55.659 --> 00:10:59.039
Meaning? That they keep kids in this very vertical
00:10:59.039 --> 00:11:01.860
upright position in the water. They teach, to
00:11:01.860 --> 00:11:04.039
swim, to float, you have to stay upright and
00:11:04.039 --> 00:11:06.539
kick. But swimming actually requires a horizontal
00:11:06.539 --> 00:11:08.879
body position. And so some instructors worry
00:11:08.879 --> 00:11:10.820
that puddle jumpers can delay the development
00:11:10.820 --> 00:11:13.080
of proper positioning and understanding of how
00:11:13.080 --> 00:11:16.720
to swim. So the issue isn't just whether they
00:11:16.720 --> 00:11:19.690
float. That's correct. It's also about what habits
00:11:19.690 --> 00:11:22.029
they're teaching kids. And what's the biggest
00:11:22.029 --> 00:11:24.309
mistake that parents make with floaties? Thinking
00:11:24.309 --> 00:11:26.710
that a flotation device has replaced supervision.
00:11:27.610 --> 00:11:30.330
A child wearing floaties can still drown. A child
00:11:30.330 --> 00:11:32.549
wearing a puddle jumper can still drown. Does
00:11:32.549 --> 00:11:34.370
that mean that parents should throw these away?
00:11:35.070 --> 00:11:37.230
No, and that's not my message. My message is
00:11:37.230 --> 00:11:39.570
to understand exactly what they're for. They're
00:11:39.570 --> 00:11:41.769
pool toys. They're not a substitute for swim
00:11:41.769 --> 00:11:43.610
lessons. They're not a substitute for supervision
00:11:43.610 --> 00:11:47.210
or life jackets. You just mentioned swim lessons.
00:11:47.470 --> 00:11:50.610
Do swim lessons help? Absolutely. The evidence
00:11:50.610 --> 00:11:53.269
suggests swim lessons reduces drowning risk.
00:11:53.649 --> 00:11:56.549
At what age? The American Academy of Pediatrics
00:11:56.549 --> 00:11:58.950
says swim lessons can begin for many children
00:11:58.950 --> 00:12:02.090
around 12 months of age, depending on readiness.
00:12:02.470 --> 00:12:04.870
But they're only one layer of protection. What
00:12:04.870 --> 00:12:07.110
about for younger babies, like the mommy and
00:12:07.110 --> 00:12:09.169
me or papa and me classes where you hold the
00:12:09.169 --> 00:12:11.509
baby and you sing the song and you go, bop, goes
00:12:11.509 --> 00:12:13.830
the weasel and then they go underwater? You know?
00:12:14.190 --> 00:12:17.269
No, no, you don't know? I know. It's very specific.
00:12:18.889 --> 00:12:21.929
Those can be really wonderful. And parents sometimes
00:12:21.929 --> 00:12:24.549
hear that the AAP says swim lessons shouldn't
00:12:24.549 --> 00:12:26.570
start before age one, and they assume that these
00:12:26.570 --> 00:12:29.269
infant mommy and me classes have no value. And
00:12:29.269 --> 00:12:32.309
that's not true. For babies, the goal isn't teaching
00:12:32.309 --> 00:12:34.370
independent swimming. There's no evidence that
00:12:34.370 --> 00:12:36.809
infant swim lessons before age one reduces drowning
00:12:36.809 --> 00:12:39.289
incidence. Its goal is to help children become
00:12:39.289 --> 00:12:41.549
more comfortable in the water. and helping parents
00:12:41.549 --> 00:12:43.610
learn water safety skills and making water a
00:12:43.610 --> 00:12:45.669
positive experience so that your one -year -old
00:12:45.669 --> 00:12:47.330
doesn't go in the pool for the first time and
00:12:47.330 --> 00:12:50.710
scream their face off. Plus, it can be fun. But
00:12:50.710 --> 00:12:52.929
there's no evidence that these classes reduce
00:12:52.929 --> 00:12:55.710
drowning, not even those infant swim rescue ones?
00:12:56.250 --> 00:12:57.990
No, and that's a really important distinction.
00:12:58.269 --> 00:13:00.250
You've probably seen videos of very young babies
00:13:00.250 --> 00:13:02.149
being taught to roll onto their back and float
00:13:02.149 --> 00:13:04.490
face up. Babies can actually be trained to do
00:13:04.490 --> 00:13:06.889
that reflexively, but the American Academy of
00:13:06.889 --> 00:13:09.549
Pediatrics says that this ability has not been
00:13:09.549 --> 00:13:12.629
shown to reduce infant drowning rates. But there
00:13:12.629 --> 00:13:14.570
are very polarized views on lines, with some
00:13:14.570 --> 00:13:16.330
parents crediting the survival training with
00:13:16.330 --> 00:13:18.549
life -saving skills, and while others worry about
00:13:18.549 --> 00:13:20.909
high stress crying, a potential water trauma
00:13:20.909 --> 00:13:23.210
during these intense conditionings. So it sounds
00:13:23.210 --> 00:13:25.610
like maybe babies could learn this floating response,
00:13:25.669 --> 00:13:27.590
but there's no evidence that this would actually
00:13:27.590 --> 00:13:30.570
prevent drowning. Exactly. Babies under a year
00:13:30.570 --> 00:13:32.950
aren't developmentally capable of the coordinated
00:13:32.950 --> 00:13:36.970
movements for true survival swimming. The AAP's
00:13:36.970 --> 00:13:38.940
latest guidance that came out this summer says
00:13:38.940 --> 00:13:40.659
that they're not yet able to coordinate their
00:13:40.659 --> 00:13:42.639
arms and legs to propel themselves and perform
00:13:42.639 --> 00:13:44.779
most of the motor skills required for survival
00:13:44.779 --> 00:13:47.299
swimming. They also raise a concern about programs
00:13:47.299 --> 00:13:49.440
that use repeated submersions to teach the back
00:13:49.440 --> 00:13:51.539
float response. Repeated submersions can create
00:13:51.539 --> 00:13:53.580
this negative experience with the water, and
00:13:53.580 --> 00:13:56.000
that might interfere with later swimming competency.
00:13:57.059 --> 00:13:59.480
So my child's now a year old. They're actually
00:13:59.480 --> 00:14:01.820
three years old. We've been doing swim lessons
00:14:01.820 --> 00:14:05.759
regularly. Has this eliminated drowning risk?
00:14:06.179 --> 00:14:08.889
No. There's a statement in pediatrics, and it's
00:14:08.889 --> 00:14:10.970
that the biggest risk factor for drowning is
00:14:10.970 --> 00:14:12.830
not knowing how to swim, and the second biggest
00:14:12.830 --> 00:14:15.649
risk factor is knowing how to swim. There's no
00:14:15.649 --> 00:14:17.690
winning here. There's no winning. If you know
00:14:17.690 --> 00:14:19.669
how to swim, you're more comfortable around water.
00:14:20.029 --> 00:14:21.690
There's sometimes a little bit more lack of supervision.
00:14:22.269 --> 00:14:24.110
If you don't know how to swim, you don't know
00:14:24.110 --> 00:14:26.830
how to swim. So a child who's had swim lessons
00:14:26.830 --> 00:14:29.129
can drown. A child who's a strong swimmer can
00:14:29.129 --> 00:14:32.129
drown. Adults can drown. Lifeguards can drown.
00:14:32.730 --> 00:14:34.509
Swimming ability lowers the risk of drowning,
00:14:34.649 --> 00:14:37.610
but it does not eliminate the risk. So, let's
00:14:37.610 --> 00:14:40.309
talk about supervision. Because every parent
00:14:40.309 --> 00:14:43.029
thinks that they're supervising. I'm always supervising.
00:14:43.350 --> 00:14:45.129
This is where I introduce one of my favorite
00:14:45.129 --> 00:14:49.889
concepts, the water watcher. Superhero water
00:14:49.889 --> 00:14:52.750
watcher! The idea is that one adult is specifically
00:14:52.750 --> 00:14:54.830
responsible for watching children in the water.
00:14:55.389 --> 00:14:57.129
They don't have a phone, they don't have a book,
00:14:57.309 --> 00:14:58.929
they're not drinking alcohol, they're not scrolling
00:14:58.929 --> 00:15:01.129
Instagram, and they're not assuming that someone
00:15:01.129 --> 00:15:03.940
else is watching. the designated driver, let's
00:15:03.940 --> 00:15:06.379
say, of the pool. Exactly, because one thing
00:15:06.379 --> 00:15:08.820
that we repeatedly see is groups of adults where
00:15:08.820 --> 00:15:11.620
everyone assumes someone else is paying attention,
00:15:11.879 --> 00:15:14.460
and then no one is actually paying attention.
00:15:15.200 --> 00:15:17.200
All right, so let's end with three things that
00:15:17.200 --> 00:15:20.139
parents should remember. Number one, and I think
00:15:20.139 --> 00:15:23.059
this is really important, drowning is often silent.
00:15:23.500 --> 00:15:25.740
Don't look for screaming. Look for kids that
00:15:25.740 --> 00:15:30.120
are vertical and quiet. Check. Number two, no
00:15:30.120 --> 00:15:33.659
flotation device replaces supervision. And what's
00:15:33.659 --> 00:15:36.399
number three? The most effective drowning prevention
00:15:36.399 --> 00:15:39.460
strategy is layers of protection. Having swim
00:15:39.460 --> 00:15:42.879
lessons, having a fence around the pool, always
00:15:42.879 --> 00:15:45.700
having adult supervision, wearing life jackets,
00:15:46.299 --> 00:15:49.120
having designated water watchers. So it's not
00:15:49.120 --> 00:15:52.159
one thing, it's multiple things working together.
00:15:53.279 --> 00:15:55.940
This is really important because drowning isn't
00:15:55.940 --> 00:15:58.320
something that happens to careless families.
00:15:58.879 --> 00:16:01.879
It happens to loving families, attentive families,
00:16:02.419 --> 00:16:05.399
good parents. And drowning prevention, it cannot
00:16:05.399 --> 00:16:08.720
depend on being perfectly vigilant every second.
00:16:08.899 --> 00:16:11.100
So it's using these tips to build these layers
00:16:11.100 --> 00:16:14.360
of protection so that when one layer fails, because
00:16:14.360 --> 00:16:16.620
it will, there's another layer of protection
00:16:16.620 --> 00:16:19.639
there to step in. And if our episode today felt
00:16:19.639 --> 00:16:21.440
a little heavier than our usual summer school
00:16:21.440 --> 00:16:23.950
lessons, That's because this is one of the topics
00:16:23.950 --> 00:16:26.649
where the stakes are really that high. And the
00:16:26.649 --> 00:16:28.809
reason that we talk about it isn't to make families
00:16:28.809 --> 00:16:31.950
afraid of the water. Kids should swim. They should
00:16:31.950 --> 00:16:33.929
go to the lake. They should go to the neighborhood
00:16:33.929 --> 00:16:36.090
pool and have a pool party and spend their summer
00:16:36.090 --> 00:16:38.850
outside. We just want them to do those things
00:16:38.850 --> 00:16:41.509
as safely as possible. And the statistics around
00:16:41.509 --> 00:16:43.909
drowning, they're scary. They're really scary.
00:16:49.579 --> 00:16:52.000
So, thank you for listening to this week's episode
00:16:52.000 --> 00:16:54.679
of the Rolin Forward podcast. I'm Dr. Alicia
00:16:54.679 --> 00:16:57.840
Rolin. I'm Dr. Stephanie Rolin. If you liked
00:16:57.840 --> 00:16:59.899
our episode today, please be sure to follow,
00:17:00.039 --> 00:17:02.399
like, and subscribe. Share it with a friend,
00:17:02.399 --> 00:17:04.480
and then we'll see you next week for another
00:17:04.480 --> 00:17:11.380
episode of Summer School. I'm a pediatrician.
00:17:11.640 --> 00:17:14.119
I'm a forensic psychiatrist. Well, then I'm a
00:17:14.119 --> 00:17:16.319
pediatric emergency physician. Well, I don't
00:17:16.319 --> 00:17:17.460
know. I don't know.
