Water safety: What to do during a diving accident

Welcome back. A recent near drowning of a six-year-old boy here in the D.C. area is a reminder of just how quickly a fun day at the pool can turn into an emergency with families spending more and more time in and around water this summer. We're talking about how to prevent these tragedies and what to do when the unthinkable happens. Joining us now is Jennifer Rock, a pediatric nurse practitioner with the Kennedy Krieger Institute. Jennifer, thank you so much for being with us today. Thank you for having me. Absolutely. We hear so much about drownings and diving accidents every single summer. From your perspective, are these tragedies more common than people realize? And what are you seeing year after year? So I would say they're probably a lot more common than people realize or people just take swimming and diving into bodies of water for granted. Every year there are about 18,000 new spinal cord injuries every year and about five to ten percent of those injuries are a result of diving accidents. And are these diving accidents happening in pools, lakes, backyards, where? Everywhere. So the biggest issue is people diving into water that is too shallow. So these are happening in pools, backyard pools, neighborhood pools. It's also happening in lakes, the ocean as well. And the biggest people don't think about lakes or ponds or other bodies of water as being that dangerous. But there can be things under the surface of the water that you don't know about that you can hit. And so yeah, this is something a lot of people don't think about. I think when we talk about water safety, drowning is usually the issue, but you know, you're talking about diving and this being a problem. What should people know then? If it's happening everywhere, what should they know? The biggest thing is just be aware that it can happen and it can happen in a split second. A very brief lapse of judgment can can bring on a tragedy. I think the biggest thing people need to do to know is to have like a safe plan surrounding the water. So with kids it's really important that they always ask permission from an adult before going into the water. And then if they are going to go into the water, they need to have an adult who is aware, alert, and paying attention. Those two things are really, really important. And so are we talking about these diving incidents? Is it happening more to kids and teenagers or adults? What's the age group that you're seeing more of these injuries occurring? The age group that we see the most often, especially in our center, is teenagers and young adults. And it does seem to be a little bit more skewed to males than females. So walk us through, if you can, what happens to the body when they have one of these injuries? Yeah, so first of all, when you are diving into the water, what you're doing is you're basically going into the water head first. And when you go in head first, your body kind of acts like a torpedo coming after it. And your body is relying on the depth of the water to slow you down. And if there is not enough water, you are not able to slow down enough. And your head hits either the bottom or an object in the water. And your head stops moving, but your body keeps going. And when your body keeps going, it results in injury to the neck bones, the vertebrae in the neck. So they can buckle or they can break and that will cause injury to the spinal cord that runs through them. And so is the person able to function or do they just sort of become like a ball and just sink to the bottom? What happens? It varies. It depends on how much injury there is. So a person that has a spinal cord injury from diving, the range can be from just signs of like numbness and tingling to the arms and legs all the way to not being able to breathe. Most often what we see like our telltale sign is they can't move their arms or legs. That is a number one telltale sign. Or shooting pain down their back or down their neck or their back. Or even loss of bladder control. And so people around, what should they do? What's the first thing that someone who's around someone who's gone into water and now they come up they can't feel their legs or something terrible has happened. What should they do? Those people surrounding and around? Well, the first thing anybody should do is always call 9-1-1. Get emergency responders to the scene as soon as possible. The next thing that's really important I guess it depends on the presentation, but the best thing is to not move the person. If the person's able to breathe, their head's above water, just keep them still. So don't pull them out? No, if they're breathing and a lot of times people will be talking, do not pull them out. Do not move them. You do not want to shift anything in the body to cause more injury. So you're like don't try to stabilize their head. I'm imagining if someone, you know, nothing. Oh goodness. Well now if you know, again, if they're breathing, if somebody, if a person's breathing or if they're talking to you, just tell them to stay still and try to keep them as still as possible. You don't want any of those broken bones to shift and cause more injury. And so I guess that if you you're inclined to say, okay, they're not breathing, give them CPR. Even that in of itself I'm hearing can be, that could be dangerous. Yeah, so it can be, but if they're not breathing, they don't have a pulse, that takes priority over the spinal cord injury. You need to, you need to administer CPR. You have to, you do have to get them out of the water and start CPR. Why is it that we don't know this? I've done so many stories and it's always about pool safety, water safety, drowning, but I've not heard this before. If someone goes in and there's a diving accident, don't, you know, and they're breathing, talking, don't move them. I've never heard this before. Should this be more widely talked about? I, yeah, I think it should. I mean, you know, and this is all with the caveat, bystanders should not move the person, but of course when emergency personnel arrives, then they can take over and do everything. They have all the equipment that they need to keep the person safe. But I think it's just people want to do something and they want to help, but that can result in more, more injury. And the best thing you can do is stay calm, have the person stay calm, stay with them. But yeah, you don't want to move the person. Is there some sort of a checklist or something that you, that people should be aware of? Maybe there isn't, but just I'm wondering, is there some sort of a checklist? A checklist. Like a safety checklist when it comes to this? I know you mentioned, no, it could happen in any sort of body of water, but is there some sort of a checklist or something people should be aware of when it comes to preventing diving accidents? I mean, honestly, as far as a checklist, I wouldn't, I don't know of a specific checklist. But I think the things to keep in mind are you definitely need to know your water. And again, things can shift and change minute to minute. You need to know how deep it is. But even then, it's hard to tell how deep the water is. You can't really tell by looking at it. And as far as like a checklist, it's just having your, being safe around the water, having safe activities. And honestly, the best thing you can do is go into the water feet first. And that would be, you know, walking into the water, wading into the water. If you have to jump, jump with feet first. Yeah. You work with children recovering from spinal cord injuries. I want to kind of wrap it up with the hope and recovery. So tell us a little bit something about the children you work with and their recovery that can at least give us some hope that this is not just a doom and gloom of this topic. Yeah, and I mean, I don't want it to be doom and gloom. It's the summer. We want to have fun in the water and we just have to be smart and safe about it. But the children we work with are amazing. They do therapy with us and it's very intensive therapy. It's called activity-based restorative therapy. And we really see in the children, we really see a lot of improvement in skills. Again, it depends on the child and the degree of injury, but we really, really do see improvements in children. They do seem to have a little bit more what we call neuroplasticity. But again, you know, from an initial injury to several months later, we can't predict with the course immediately. I would imagine that treatment has gotten much better as the years go on. Is there research being done in this regard with spinal cord injuries? And is there anything you can share with us from a layperson's perspective that we'd understand? Yeah, and our center participates in a lot of research and there are studies. We are participating in several studies right now, but there are studies across the board looking at ways to improve recovery from a therapy standpoint, but also from a medical standpoint. There are things in the pipeline that are being developed, but right now there's more and more things are making recovery. They are improving chances of recovery, but there is no like magic, you know, cure right now. But we are seeing a lot more recovery than we did even five or ten years ago. If every viewer remembered just one thing from our interview today, what would you want that to be? The biggest thing I would want people to remember is when you're going into water, have fun, but go feet first. The only safe dive you do is the one you don't do. Feet first always. Jennifer Roth, the pediatric nurse practitioner with the Kennedy Krieger Institute. Thank you so much for this eye-opening conversation. Certainly something that maybe people had been thinking about, but we certainly have put it on their radar and they will go feet first, which is the lesson of the day. We appreciate it. Thank you so much. Thanks for having me. Absolutely.