Let’s Not Wait for the Next Tragedy

by
  • Hertzberg, Linda, MD, FASA
| Jul 15, 2013

Cardiologists sponsor charity golf tournaments for heart health-related causes. Ophthalmologists, plastic and orthopedic surgeons donate their time and perform surgery in far-flung areas of the globe (which would be impossible without the involvement and care of anesthesiologists). Primary care physicians organize free health screening clinics for school children in underserved areas who might not otherwise obtain those services. These efforts are often well publicized and the specialists involved receive public recognition for their efforts. Anesthesiologists, when involved in these efforts at all, tend to be a quieter group, working behind the scenes to make things happen, such as during those charity surgery efforts by our colleagues.

Anesthesiologists tend to have the “I gave at the office” mentality, because we DO give at the office. Unlike many other physicians, we don’t have a choice of patients and take all comers including charity and uncompensated care, and poorly paid government sponsored cases. In addition, there are the nights available on call, medical staff and other volunteer work at the hospital.

Two weeks ago, CSAOF published a piece about Dr. Ian Chait and his resuscitation of a child who was drowning near him in a pool while on vacation. Since then, I have taken care of a teenager who had a near drowning at age one and now suffers from seizures and a mild developmental delay. Also during that time period, my husband, Dr. David Merzel, pediatric anesthesiologist and intensivist, admitted a child to the pediatric ICU who had suffered a near drowning. His young mother administered CPR and saved the child. When asked where she had learned CPR, she stated she had seen it on TV. Drowning and near drowning are a serious issue in California in the pediatric population, especially here in the hot Central Valley, where those who don’t have access to pools often go swimming in lakes or canals.

A brief Internet search revealed the following statistics on drowning and near drowning, from the CDC website (citations available on CDC website):

  • From 2005-2009, there were an average of 3,533 fatal unintentional drownings (non-boating related) annually in the United States — about ten deaths per day. An additional 347 people died each year from drowning in boating-related incidents.2
  • About one in five people who die from drowning are children 14 and younger.2 For every child who dies from drowning, another five receive emergency department care for nonfatal submersion injuries.1
  • More than 50% of drowning victims treated in emergency departments (EDs) require hospitalization or transfer for further care (compared with a hospitalization rate of about 6% for all unintentional injuries).1,2 These nonfatal drowning injuries can cause severe brain damage that may result in long-term disabilities such as memory problems, learning disabilities, and permanent loss of basic functioning (e.g., permanent vegetative state).3,4

The California Department of Developmental Services reported 58 deaths by drowning in children ages 0-5 alone in 2011.

To be sure, there are many additional resources available, describing multiple measures that can be taken to prevent drowning in the pediatric population. As physicians and anesthesiologists we see the outcomes. But what if we were involved in prevention as something that we can do in our own communities? Relying upon mothers to learn CPR from popular TV programs does not seem like a viable long-term solution. On the other hand, the fact that this actually worked suggests that some barriers to parents learning CPR could be overcome by using accessible and engaging online content such as an instructional YouTube video.

Or we as anesthesiologists we could get involved with local drowning prevention programs such as the one that exists here at Childrens Hospital Central California (CHCC). The pediatric ICU nurses created this outreach program with some assistance from the pediatric anesthesiologists and intensivists at CHCC.

Drowning prevention is just one of many issues that anesthesiologists could potentially take on within our communities. Opportunities surround us to contribute to our communities and to our specialty. There is no reason why we cannot work on community initiatives pertaining to obesity, heart health or diabetes (as our colleagues in other specialties do) — conditions that many of our adult patients have, which directly affect their anesthesia care. Or we could do something in the local high schools to increase awareness of anesthesiology as a medical specialty for those students who might be considering careers in medicine.

Dr. Chait gained well-deserved recognition for his timely rescue and resuscitation of the drowning child. If anesthesiologists can find ways to promote community causes and gain recognition for the specialty for those efforts, wouldn’t that be better than waiting for the next tragedy to strike?  

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