Primary Care

Primary care physicians should counsel parents of young children about drowning prevention

Cost-consciousness has shrunk patient visit time, forcing doctors to choose which injury prevention topics to address during typical immunization or well-child visits. Even though drowning is the second most common cause of accidental death among U.S. children 5 years of age and younger, primary care providers (PCPs) don't put drowning prevention high on the list of injury prevention topics to be discussed with parents.

A recent study shows that only one-third of PCPs in Los Angeles County counseled parents about drowning prevention. About two-thirds of PCPs did not know that injury deaths due to drowning were more common than those due to ingesting poisons and firearm injuries in young children. This is particularly striking since Los Angeles County has a high incidence of drowning injuries (3.7/100,000).

If families with young children are to receive drowning prevention education, their PCPs must get the message about the high number of drowning deaths among children, note Shari Barkin, M.D., M.S.H.S., and Lillian Gelberg, M.D., M.S.P.H., of the University of California, Los Angeles. In a study supported by the Agency for Healthcare Research and Quality (National Research Service Award training grant T32 HS00046), they analyzed 325 responses from a random sample of Los Angeles County pediatricians, family physicians, and pediatric nurse practitioners who serve families with young children.

Female providers were nearly twice as likely to counsel parents about drowning prevention as male providers. However, clinician specialty, age, years out of training, proportion of well-child examinations in a typical week, having children, practice setting, and personal knowledge of drowning-injury deaths made no significant difference in drowning prevention counseling.

See "Sink or swim: Clinicians don't often counsel on drowning prevention," by Drs. Barkin and Gelberg, in the November 1999 Pediatrics 104(5), pp. 1217-1219.

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