Drowning in Arizona

Firefighters have experienced blazing house fires. Fatal heart attacks. Toxic gas leaks. Crews are dispatched to a scene, follow the basic protocols and return home to the station for dinner, relatively unscathed.

But in Arizona, there’s one call that makes even the toughest first responders anxious: Drowning involving a child.

“They are horrible,” said Kelly Liebermann, engineer paramedic for the Phoenix Fire Department. “Mom could be running out there with a purple baby in her arms, dangling, throwing it in your hands, like, ‘Do something.’ ”

The state’s constant warm climate keeps pools open year-round, the most common environment for drownings involving toddlers; in fact, toddlers in the Grand Canyon state are far more likely to drown compared with rates of childhood drownings from around the nation — and authorities say they’re nearly all preventable.

For those who survive, recovery could last a lifetime. Victims may experience brain trauma, the inability to speak, walk or even feed themselves.

Drowning rates in the state have flattened, tapering off after a steady decline that followed a push from fire departments and hospitals to educate families on water safety, as well as state ordinances to keep pools more secure.

But with drowning continuing to be a leading cause of death for toddlers, the state has more work to do.

Experts say drownings involving children follow a similar pattern.

An unattended child wanders off, falls into a pool. Submerged, he begins to panic and doesn’t think to hold his breath. His lungs begin to fill with water. Oxygen stops flowing to his brain. Brain cells begin to die. The brain swells against the skull. The child loses consciousness.

That was the story of Stryder Grub, now 4, who was found unconscious in his backyard pool at 11 months old. His dad found him. Panicked, he raced to a neighbor, who began administering CPR until first responders arrived.

“When I got (to the hospital), there was a team working on him and he was breathing, but he was kind of unresponsive,”

Phoenix Fire Department officials say they average about four minutes response time to a drowning call. Medical experts say even with that speed, damage is already done.

“By the time they get to us, they can already have some significant problems,” said Dr. Laura Wilner, who specializes in physical medicine and rehabilitation at Phoenix Children’s Hospital.

Some children will succumb to their injuries shortly after being pulled from a pool or bath. Others begin to recover.

While in the intensive care unit, drowning victims can begin seeing the immediate effects on the body, struggling with regulating blood pressure or losing flexibility in their joints, becoming stiff.

Arizona regularly ranks in the top five states for drowning, according to Phoenix Children’s Hospital Water Safety Coordinator Tiffaney Isaacson. The state rate is more than twice the national average. Drowning is a particular problem for young children.

In 2016, there were 157 drowning-related incidents across Maricopa and Pinal counties, which account for roughly 60 percent of Arizona’s total population, according to Children’s Safety Zone. Of these incidents, 90 involved toddlers and infants. Sixteen died as an immediate result of injuries.

In the first three months of 2017, three children died from drowning, according to Phoenix Fire’s Liebermann.

“It’s an ongoing issue and battle,” he said. “We don’t have a large ocean next to us, yet we have one of the highest population drownings in the country, and why is because we have so many pools.”

For fire crews, a drowning involving a child is emotionally taxing.

Fire departments administer mock drowning simulations to expose new crew members to the atmosphere, as well as inform the public of proper steps to take: Call 911 immediately and administer CPR.

Tension lingers in the air, even when the crew returns to the station. Anger boils in the group, hitting home especially for those who have small children of their own, like Liebermann.

“You can’t justify a drowning,” he

Between 5 and 20 percent of drowning survivors will likely suffer lifelong disabilities, according to research by Phoenix Children’s Hospital.

Recovery can be unpredictable, Wilner said. Some may regain most, if not all, abilities. Others may never get back what was lost.

The physical impact on toddlers and infants is hard to measure, as victims in this age group have yet to learn everyday skills. This makes rehabilitation more difficult for doctors like Wilner.

“The challenge is being able to predict where they are going to be in the future, because we can’t just rehab them back to what they were able to do, because there are so many things that have yet to do,” she said.

Younger victims are also more likely to suffer from major swelling of the brain, which can lead to secondary complications. These deficits can cause infants and toddlers to rely more heavily on their families, Wilner said, making it challenging for them to grow independent of their injuries.

Older victims pose their own challenges, as they have loss to account for. Wilner said a drowning victim can lose learned skills immediately and get pushed back in school.

Most survivors will need to create a new sense of normalcy, Isaacson said.

Miracles are possible. Children have walked away with little to no lingering