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Summer Update from the Pediatric ER · Pediatrics Now: Cases Updates and Discussions for the Busy Pediatric Practitioner

0:00
I was like, I should do a quote about being a new parent. Yeah.
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But then, other than things like, there's no perfect parent,
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because I definitely have fallen into the over-obsessing, over-every-little-thing trap.
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And I don't know if being a pediatrician makes that worse.
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Possibly. I'm not quite sure.
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Welcome to Pediatrics Now, cases, updates, and discussions for the busy practitioner.
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I'm your host, Holly Wayman. I work for UT Health San Antonio's Department of Pediatrics.
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In this podcast, we explore how we can provide the best, most cutting-edge,
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compassionate care for children.
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We hope to give you a unique and behind-the-scenes edge from our expert guests.
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After listening, click on the link on this podcast for free credit that may
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include CME, MOC, or ethics credit, depending on our topic or podcast.
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Today, we're talking about summer safety, and I'm thrilled today because joining
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me here in the podcast studio is Dr.
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Priyanka Kondal. She is an emergency medicine doctor who focuses on kids and adults.
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Priyanka, thank you so much for being here today in the podcast studio.
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Thanks so much for having me. So you did your med school at Medical College
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of Georgia and then residency at University of Maryland.
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And along the way you knew you wanted to help, have that feeling of,
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hey, I helped someone today.
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Yeah, definitely. I went through medical school knowing I really loved kids
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and decided to end up pursuing a combined residency in emergency medicine and pediatrics.
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Kind of got a little bit of that quick gratification and feeling like I helped
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people that day and still pursuing my love of children.
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And you just celebrated your son's first birthday.
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That's right. It's been definitely a chaotic year, but very,
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very rewarding having as my first child.
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So experiencing some of the things that I saw from a medical perspective,
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from a parental perspective, has been very eye-opening and definitely made me a better pediatrician.
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And you recently had Had an experience where you could see how quickly,
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as a parent, a potential emergency could happen.
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Yeah. So my kiddo got into my husband's work bag and found a whole apple,
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which we saw and were watching and thought it was funny.
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And we didn't really think he'd be able to gnaw off a piece of it,
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but it turns out he could.
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So he took a big chunk of a bite with his six little teeth and managed to choke. and we definitely...
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I did not enjoy being on that side of a medical experience.
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I ended up calling my colleague who was working to see what her perspective
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was because I definitely felt like I was not completely objective in that time.
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And I wasn't quite sure which direction I wasn't being objective.
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I thought maybe, I don't know if I'm being too concerned or not concerned enough.
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And luckily, Luckily, you know, he was breathing the whole time.
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He was just coughing a lot.
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And we ended up driving him all the way to medical center, got to the hospital,
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by which time he had completely come back to normal. And then we drove home without going inside.
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Because once you got there, you realized, OK, he's not.
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Yeah. And he had been coughing a lot at home. And then over the course of the
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drive, he stopped coughing and started talking and smiling again.
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So we said, OK, well, he's looking way better. and now I feel less nervous that
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something bad is going on.
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Before we dive into the summer safety for the practitioner, is there anything
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you want to mention quickly about choking?
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It's kind of this universal fear where everything can be going fine and then
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all of a sudden it's the worst nightmare.
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Yeah, choking is very common. Definitely not exclusive to summer,
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but very common, especially in young children, especially when they start moving,
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where they are snacking and moving and maybe not being as careful about eating.
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And I think in terms of safety, it's really, really important to make sure that
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you're serving your child appropriately cut pieces for their age and also ideally
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not as much distracted eating.
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So trying to be eating when we're eating while we're sitting down and not running
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around with food, but especially things like nuts, round fruits like grapes,
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blueberries, cherries.
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Hot dogs are actually a big choking hazard because they're round. Anything round.
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So I recommend cutting hot dogs lengthwise. That's a summer barbecue type of food.
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And having or quartering grapes, depending on your child's age.
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And just being mindful of it because it happens very quickly.
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And I also think that every parent could benefit from a quick child CPR course.
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They're pretty readily available and can truly help you in that moment where
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you know what what to do and how to respond.
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And as an emergency medicine doctor, so you work in our new pediatric ER in
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the new beautiful Women's and Children's Hospital. What an amazing place.
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Yeah, we've really enjoyed the renovation and it's been a really nice place to work.
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And on Monday, I had my first day volunteering in the NICU and I just was blown
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away of the facility there and how amazing it was.
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And what a great place. They've done a really nice job.
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So and I know as a former news reporter,
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I came across a lot of emergencies and not even close in the 10 years of doing
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that, I'm sure as a doctor, what you see, but just it changed the way where
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when I would be in the cul-de-sac,
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you know, my kids riding their bikes, I would see in my head a car coming and hitting them.
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It just, for you, it must be like you were saying, and a new experience where
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you're now a mom and you have all of this knowledge and experience.
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Absolutely. And of course, in the emergency department, I tend to see the bad
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things and not the times that everything is fine. Like with news.
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Absolutely. So I think I definitely have a little bit of paranoia.
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And especially in some safety related things. But I also think when it comes
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to safety, sometimes you can't be too paranoid.
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Maybe you can be, but. Or too safe. Yes. I mean, I think if there are simple
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and easy things to do that increases safety for your children,
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then they're worth doing.
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So tell us, how are things going in the ER? Has it been really busy this summer?
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It has been pretty typical, I think, in terms of busyness.
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The summer is typically not our busiest season because we have a little bit
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fewer of our respiratory viruses going around in the summer,
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although we are seeing a big uptick in COVID right now. I'm sure you might have heard. Yes.
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But aside from that, we have, I think, volume that's pretty typical for the
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summer, but we are definitely seeing some of those classic summer injuries.
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So and for COVID, is it adults being hospitalized for that or and children right now?
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I haven't seen too many people being hospitalized for it. Most of them are just
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coming in with a bad flu-like illness, feeling pretty miserable.
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But I haven't seen too many people who are ill enough to be hospitalized.
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I don't think I've seen any children ill enough to be hospitalized this season thus far.
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So let's dive into the most common preventable injury that we all know
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about drowning so recently there
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was an accident in the water that
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it was horrible can you
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that happened on monday yeah there was a toddler who fell in the water and and
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i think just the caregiver had was distracted for just a minute or two and that's
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how fast it happened so So the child came into the emergency department and had to be resuscitated.
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And it could happen so fast, even just like you said, it's the caregiver just for a few seconds.
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Absolutely. It happens so quickly, especially with the younger kids,
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that just a couple minutes of being distracted is absolutely enough.
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And you've seen kids come into the ER who it was too late by the time they got there. Absolutely.
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I've had a couple of drowning cases that we were unfortunately not able to get back.
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We see many, a big variety of drowning cases.
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So some kids come in and they do okay and they were gotten to in time and some of them get to go home.
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Some of them get observed for a while, and some of them get resuscitated and
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do really well, and some of them unfortunately get resuscitated and either don't
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make it or they have long-term neurologic injury from their period of time without oxygen.
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And is there anything you want to say directly to the pediatric practitioner
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in general to say to parents about preventing drowning?
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You can't be too safe when it comes to water. I absolutely agree.
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You cannot be too safe when it comes to water. Multiple layers of protection,
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making sure you have eyes on your kid at all times, thinking about the color
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of the swimsuit your kid is in because brighter colors are a lot easier to see.
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So your reds and your yellows and your oranges are far better colors than blues.
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Blues can disappear in the water really easily, especially if a kid goes under.
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And as we all know, prevention is the best medicine.
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There's so much to cover in the exam room visit in that short time that you have.
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With drowning, some of the crucial things, advice from you, from your lens,
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what you see last year that was an eight-year-old who drowned.
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I love what you say about...
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Not just have a designated water watcher where that's kind of,
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you know, a lot of people know about that, but more of a one-to-one in arm's length adult to child.
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Yeah, especially for the younger kids and children who have not learned to swim.
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I think it's really crucial to have someone within arm's length because this
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happens so quickly and it's not as noticeable as people realize.
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So people might watch a movie where they see someone drowning and it involves
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a lot of splashing and calling for help and things like that.
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But in real life, drowning is much more subtle and is not always appreciable.
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And if you're just scanning the water, you might not notice it happening.
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There are some very chilling videos out there of children drowning in public
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pools surrounded by adults and other children and busy pools.
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And it just, it can happen so subtly that no one notices for too long,
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unfortunately, and it can happen very, very quickly.
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So especially for those younger kids, having someone within arm's length and
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a designated person is really, really key to prevention.
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And in fact, was it a residency program where there was a video shown recently
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at a public pool where, can you tell us about that? It just sounded horrible.
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Yeah, we actually had a lecture for our residency didactics where
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a it was a public pool and you
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you watch this kid and there are
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literally people this pool
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is packed there are people everywhere and you see the kids struggling and
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trying to come up for air and then going back down and coming back up and then
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eventually just floating face down in the water for several minutes and just
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floating around and people are walking past on occasion I think I think someone
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even brushes against the kid and no one notices for a really long period of time.
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And as you're watching it, it
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feels like eons before anyone notices and pulls the kid out of the water.
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But you can see why it happens because when you're in the pool with your kids,
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you're focused on your own children and...
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When you just take a quick peek, it might be, oh, this kid is floating.
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Everyone does a little bit of floating.
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You have to be watching the child for a little bit of a longer period of time to notice.
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At just one glance, you don't see that something is wrong. And I think that's
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really the key is most people are not trained to know what it looks like,
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and they're expecting something very dramatic in a drowning,
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and it doesn't always look like that.
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In fact, I think it rarely looks like that. It's so silent.
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And a lot of neighborhood pools i'm shocked
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to see that they don't have lifeguards in the summer yeah unfortunately
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i think it is a liability for a lot of pools to have a lifeguard because if
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something were to happen then they become liable so ironically we opt for the
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option with decreased safety because of liability reasons and it makes no sense
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and then so for the parent Also,
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so say if it's one parent or one adult you're assigned, you're watching this child.
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And then to also know to have a plan for a handoff if you have to leave for
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even 20 seconds or something. Yeah, absolutely.
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So if I'm watching this child and I have to go in and go to the bathroom or
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whatever, I need to verbally tell another adult, hey, I am going in.
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I need you to watch so-and-so and wait for the response.
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And I think waiting for the response is really key. We talk about closed-loop
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communication in a healthcare perspective, but that's the same thing externally.
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Because just because I said, hey, I'm going to the bathroom,
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make sure you have eyes on him.
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So and so that I was talking to might not have heard or might not have processed.
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And that's the period of time when these incidents can end up happening.
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So I think making sure that you have a verbal handoff of responsibility is really ideal.
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And that closed loop where the person responds back and confirms. Right.
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And for adolescents, yes.
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We also see drownings, especially when it's on open water and there could be substances involved.
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Yeah. So in young kids, we think about pools and small bodies of water.
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But in adolescents, we typically see, you know, going out to party with their
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friends more often on open bodies of water, like rivers and lakes,
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like you said, sometimes involving substances, although not always.
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We know that adolescents don't always think through all their actions before
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they do them, which is developmentally normal for them.
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But you see a lot of diving into unclear surfaces where you don't know the depth.
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So things like that, where you could have a head injury at the bottom of a body
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of water and then a drowning incident, or we're all tubing and we're all drinking
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or whatever other substances.
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And so our judgment is impaired and maybe someone can't swim or doesn't swim
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as well or is too intoxicated to swim and other people are enjoying themselves
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and don't even notice for a while.
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So we see another uptick in that age group in the teenagers and young adults.
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And the prefrontal cortex not fully developed yet so that judgment of can I
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jump off this ledge into the water it looks so fun.
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Absolutely and and it's very hard to tell the depth of water when you're just looking at it.
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So sometimes things can look deep and it can be really deep until it's not,
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or there can be a bunch of rocks, a lot of things.
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So not just drowning, but also
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paralysis from diving injuries from neck fractures and things like that.
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Definitely don't recommend any sort of diving in any body of water that you're
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not 100% sure is deep enough.
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And it's recommended, is it by the AAP, but nationally it's recommended to wear
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life jackets in open water? Yes, absolutely.
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On open water in particular, the recommendation is Coast Guard approved life jackets.
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So and then the other danger that can also happen on the water is dehydration.
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There was a case, I think it was in Arizona, that you brought up that where
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this family was out on the water over the holiday in early July and did not
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realize that the baby was getting dehydrated.
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Yeah. So, you know, especially here in San Antonio with the Texas heat,
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but anywhere, dehydration happens pretty quickly and can affect young babies more quickly.
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So the very young and the very old are really vulnerable to overheating and dehydration.
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And so whenever we're outside for any extended period of time,
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I always recommend making sure we're focusing on hydration and focusing on overheating
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and being aware of if anything seems off,
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it could be the heat. Mm hmm.
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And and in this case, this the family was out on the boat and it was really
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hot and the baby ended up not making it by the time they got to emergency care. care?
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Yeah, I don't know all the details of the case, certainly, but it seems like
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it was family out on the lake boating,
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and then this child presumably got overheated and dehydrated,
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and I don't think they were able to get,
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probably because they were in the middle of the lake, they weren't able to get
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care in a timely enough manner.
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And again, the younger you are, the more vulnerable.
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And let's mention some of the, so the warning signs of heat exhaustion, dehydration.
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Yeah. So the big things is I think there is some classic ideas of,
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oh, if you're sweating, that's early, but later on your skin might be dry,
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but these aren't really cut and dry.
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People can look, there's a varied presentation. So dry or wet skin,
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certainly feeling overheated and skin that's hot to touch.
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And symptoms can be anywhere from feeling nauseated or dizzy or lightheaded
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to being fully confused and altered or even progressing into unconsciousness.
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But it can be a varied presentation. But I would say as an observer,
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if anything seems at all off to consider that this could be a heat-related issue
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and to feel the person's skin because invariably they will feel warmer than they should.
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And if there is any concern for heat-related injury, the treatment is rapid
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cooling. So as fast, there's no too rapid.
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Our really fantastic San Antonio EMS system is actually really,
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really advanced in this area.
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And they do this rapid and cooling with ice water submersion in the field.
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And they use body bags, right? They do. I think they prefer to not call them
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that in that situation. I think they refer to them as temp bags.
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They're saving lives. It's amazing. Yes, absolutely.
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So they basically fill the bag with ice water and lower the temperature,
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and that is ultimately life-saving.
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UT Health ER doctors helped with that team developing that?
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Yeah, we have. I mean, I think it's probably, it's our whole regional STRAC
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region, I think, that have worked really closely.
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But certainly, several members of the UT Health emergency medicine department
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have been very, very involved in the development of that, and they've done a really incredible job.
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It's incredible. And then so a lot of these patients aren't needing to come
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to the ER, but it's, thank goodness, but it was still an urgent.
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Absolutely. Could have been a deadly situation. Absolutely.
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So, and then, of course, not leaving kids or babies in the car.
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I like the saying of, you know, trying to go fast but not rush,
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where it's so easy to forget important things when we're rushing around.
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Absolutely. And in terms of the leaving the child in the car,
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that's definitely one of the most dangerous ways. we don't realize how fast
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the car gets hot and so much hotter than you realize.
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It doesn't even have to be that hot outside, especially if the car's in direct sunlight.
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It can be 70 degrees outside and the car interior gets hot very quickly.
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The other thing to remember is it is sometimes like a negligence,
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like let me leave the child in the car while I go grocery shopping.
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But more often than not, it is very attentive, concerned parents who just get
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busy, something Something throws them off and they skip the daycare on their
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normal morning routine and they go straight to work and they just get out of
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the car and they don't realize until they leave the car.
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It is so often not a it feels like, oh, that could never happen to me.
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How could I forget my child in the car?
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And it's one of those things that how could I how could I ever not see my child when we're at the pool?
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Of course, I have eyes on them until some little thing throws you off.
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You get distracted for a second. That's all it takes. And the same thing with the car.
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It's very frequently if something in the day is a
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little bit off so your routine gets a little bit off and you don't
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even realize one of the safety things I've
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heard mentioned is leaving either a shoe or for a woman your purse or your work
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bag or something in the back seat so you have to check your back seat before
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you get out of the car to make sure but having some sort of mechanism of is
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there a child in the car can really really be life-saving even if it seems like
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something that That could never happen to you.
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I guarantee that some of the parents that it's happened to have felt that way
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until it happened to them. That's great advice, Priyanka.
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What would you like pediatric practitioners to be saying about heat and hydration?
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Is there a certain amount of water or...
21:37
Or encouraging water over sodas? Or what would you say there?
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Yeah, I mean, I think in general, we avoid sugary drinks for not necessarily
21:47
hydration reasons, but just general health.
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So I always encourage water over juices and sodas.
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I will say if you are sweating a lot, especially for athletes or people who
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are running outside and things like that, you do want to replete some of those electrolytes as well.
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So that's where you're going to consider things like Pedialyte and Gatorades
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and things like that. But definitely the low sugar alternatives are ideal.
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And you definitely don't need electrolytes if you're just outside hanging out
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by the pool like that. You you are just fine with water.
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It's really more for athletics that we really worry about your electrolytes.
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And I think during the time when we when we are in the pediatrician's office
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talking to parents when it's the right time of year during the summer,
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that is the time to make these reminders of, hey,
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make sure that if you guys are going to the pool, think about these things.
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And if you are outside for a long time, make sure you're pushing fluids.
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I don't think there's a set amount for every child in every age group,
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but I do keep an eye on, especially for the younger kids, making sure they're
22:56
still urinating frequently.
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And I really want a minimum of three or four wet diapers in a baby. be.
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So if we're under that, that's when I start to worry about dehydration.
23:07
Three or four wet diapers in a day? Yeah. Yeah. And if the urine's very dark?
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Yeah. And that could be, or if they're really light. And then most parents will
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know what their kids' diapers are like. They're like, oh, usually I got like three heavy ones.
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And today they're really not that heavy.
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That could be a red flag. So keeping an eye on urine output can be a good way
23:26
to have an idea of like, oh, we're sweating a lot and we're losing a lot of
23:30
fluid even though the drinking is the same maybe.
23:33
Okay. Is there anything else you want to say about heat or hydration before
23:36
we move on? You can just never be too vigilant with some of these things and
23:40
encouraging parents to make sure that they remember these safety tips.
23:45
I'm talking to Priyanka Kondal with the University of Texas Health Science Center
23:49
and University Hospital.
23:51
She's an emergency medicine expert, and we will be right back.
24:00
Coming up next week, an update on surgery for the office-based pediatrician.
24:06
We'll hear from the surgeon-in-chief. That's next week. I'm Holly Wayment,
24:11
and this is Pediatrics Now.
24:15
Our website is pediatricsnowpodcast.com. My email address is on there.
24:21
Some of you have said you'd like to ask a question, you can record a voice memo
24:27
on your phone and email that to me.
24:30
Again, our website is pediatricsnowpodcast.com. That's our podcast for the practitioner.
24:36
Click on the email address on there and send me a question.
24:40
I'm Holly Wayment, and you're listening to Pediatrics Now. Our sister podcast
24:45
is Pediatrics Now for Parents.
24:49
We'll cover summer safety there as well, and we hope it's one less thing you
24:53
have to say in the exam room.
24:55
That's Pediatrics Now for Parents.
24:58
The website is pediatricsnowforparents.com.
25:02
Pediatrics Now for Parents can also be found wherever you get your podcasts.
25:12
We're back now, so let's move on to bike accidents.
25:17
Accidents i have a teenage son i have
25:20
three teenagers actually now and while my
25:23
i think my youngest daughter wears her helmet always
25:26
while riding my son does not and bike
25:30
accidents can i mean it can be mean the difference
25:33
between life and death whether you're wearing a helmet
25:36
absolutely i think whether it's bikes
25:39
or scooters or skateboards or any of
25:42
we see a lot of accidents during the summer because of course kids
25:45
are not in school and protective equipment I think
25:48
especially at a certain age is not cool
25:51
perhaps but from my perspective it
25:55
is always cool yes how can we make it cool again it's so it's it's so important
25:59
yeah and and I think for for one thing some I've heard kids tell me like oh
26:06
I wasn't wearing my helmet I'm really good at riding my bike and the issue is
26:09
not whether you're good at riding your bike in the same way that when you're driving the car,
26:13
it's not about how good of a driver you are. It's about how everyone else is on the road.
26:17
So you can have someone else come bump into you, or there can be just a rock
26:21
on the road that you hit, or someone, a car can hit the bike.
26:26
So I think emphasizing to kids that it's not about how good at the activity that they are.
26:32
It's about all the other circumstances.
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And especially for head injuries, you know, we talk about life and death, but also So, yeah.
26:41
Debilitating brain injuries that will impact the rest of someone's life.
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And those can be really, really devastating.
26:50
A bad head injury can be really, really devastating and it doesn't take much.
26:54
So I try and make sure that whenever I see someone, especially for any sort
27:00
of injury, I fell and I broke my arm while I was riding a bike.
27:05
It's a good opportunity to talk about helmets too even if they didn't get a
27:09
head injury that time because I think people are more apt to listen at those
27:14
periods where there's maybe a near miss yes and I was riding my bike the other.
27:19
Evening before it was dark and it was and I came upon this man who had fallen
27:23
he was not moving he was on top of his bike and and he was I helped him up of
27:29
course and helped him and he was had you you know,
27:31
skinned elbow and was dizzy,
27:34
but he basically, and I asked if he had a head injury and we got off to the
27:37
side, but, and he pointed to where he hit his head on, on the helmet.
27:42
And like, if he had not, I mean, going really fast on a road bike,
27:45
if he had not had his helmet on, I know it would have been so different.
27:50
And he said this little tiny dog just came out of nowhere and ran like right
27:55
in front of the wheel. No one would expect that, right? Absolutely.
27:58
That's exactly the sort of thing that can happen to any sort of well-seasoned
28:02
bicycler or whatever the sport is.
28:07
So you just never know what you're... You can't have 100% control of your surroundings,
28:11
even if you are the best biker in the world.
28:15
And I don't see a lot of skateboarders with helmets on, kids on skateboards
28:19
with helmets on the street, maybe at the skate park.
28:21
But what are your thoughts there? Yeah.
28:25
Encourage it is i i'm all for encouraging it
28:28
i think you're typically not going quite as fast on a skateboard as
28:31
you are on a bike so maybe slightly lower risk but
28:34
it's not zero yeah and there's and you can't there's no brakes exactly and and
28:39
you it's not necessarily about the speed although that certainly increases the
28:44
risk you can fall badly i mean you can fall badly from standing realistically
28:48
but the faster you're going and depending on what the surface is there's so many other factors.
28:55
Yes. Anything else about helmets and safety there you want to mention?
28:59
Electric scooters that people ride around is another one that people don't think
29:03
about, but certainly you see plenty of people on those without helmets.
29:07
And though we see a lot of bad scooter accidents, so not just for recreation,
29:12
but even just getting around when you rent those downtown or the rent electric bikes,
29:19
all those sorts of things are also high risk. So I recommend of men's helmets for all of the above.
29:24
Okay, that's great advice and great to mention.
29:27
Anything else you'd like to talk about, about summer safety that you'd like
29:31
the pediatric practitioner to know about or parents?
29:34
I think it's always good to do a sunscreen reminder, especially when kids are
29:41
outside and it's very, very sunny.
29:43
We definitely see a lot of sunburns and sunburn.
29:46
Most sunburns are relatively minor and not something I'm so worried about,
29:49
but we do know that there are increased skin cancer risk, the more sunburn you
29:54
get and certain populations are really high risk for skin cancer.
29:58
So maybe not an immediate problem, but something far down the line.
30:02
So I think it's always nice to remember to put that sunscreen on.
30:05
Yes, that's a great point, which also like wearing a hat and sunscreen,
30:09
apparently that's not cool if you're a teenager.
30:12
So it's like, but these are the battles we need to fight and teach and lead in that.
30:18
So it's sunscreen, helmets.
30:22
Going over with parents, swim safety, and then are we missing anything else?
30:26
I think those are the big things, making sure you check your back seat.
30:30
And how important is it to stay vaccinated to get the COVID vaccine?
30:37
I think we're definitely seeing periodic upticks the same way,
30:41
and I think being vaccinated helps prevent transmission and potentially preventing
30:47
a more serious infection.
30:49
So I think it's probably going to become kind of like our annual flu vaccine,
30:54
where the flu is very dangerous to the vulnerable populations.
31:00
Yes, if I get the flu, I'm probably going to be okay, but I'm going to be really miserable.
31:04
And maybe getting that flu vaccine is going to help me be a little bit less
31:08
miserable if I pick up the flu. And I think COVID is probably going to land
31:10
somewhere close to that.
31:12
And we started with the most common preventable accident, which is drowning.
31:19
So we could end with that. I know you have a great point about floaties,
31:25
that it positions the child and gets the child used to things that are not safe.
31:31
Can you tell us about that? Yeah, absolutely.
31:33
So most, I mean, I know that when I was a kid and my younger sister were a kid,
31:38
we used to wear those arm floaties that are just inflatable around your arm.
31:47
And what it does is it teaches a child, first of all, that when I jump in the
31:54
pool, I float and I go in the pool and I float and they don't have the cognitive
31:58
ability to relate that to the floaties that they're wearing.
32:01
The second thing is the natural position when you're wearing those little arm
32:05
floaties is a vertical position, which is not the ideal position for you to
32:10
be in the water without any sort of flotation device.
32:14
So it encourages kids essentially to go into an unnatural position where they're
32:20
more likely to sink as opposed to float if the kid jumps in the pool.
32:24
And it also increases a little bit of a false sense of security.
32:27
I go in the pool all the time. And then, of course, this like two second period
32:32
where no one's around and I can run outside and especially for households with
32:35
fences, I recommend multiple layers of protection.
32:38
So having not just a fenced in backyard, but having a pool fence,
32:42
which specifically protects the pool, is only around the pool and prevents anyone
32:47
from getting to the pool.
32:48
And it should be child safety locks that kids can't get in.
32:52
If you are in a place with a pool, like making sure you have an alarm on the
32:56
back door, everything you can do because multiple layers of protection dramatically
33:01
decreases the risks of drowning.
33:04
Thank you for all of this advice and reminders. And as we know,
33:08
pediatric practitioners have power in the exam rooms,
33:12
you know, that where kids may not be listening to certain things their parents
33:16
are saying, but when their doctor says it, their pediatrician says it,
33:20
hey, that has even, you know, has a lot more weight.
33:23
Absolutely. I think especially in those moments where you're a little bit of
33:27
an authority figure and parents might not be cool, but other adults might still
33:32
be okay. hey, it might be a real opportunity.
33:37
Yes, as a mom of three teenagers, I know what you're talking about.
33:42
Dr. Priyanka Kondal, thank you so much for being here today on Pediatrics Now.
33:47
Thank you so much for having me.
33:50
Click on the link in this podcast for a free credit that may include CME,
33:53
MOC, or ethics credit, depending on our topic or podcast.
33:58
I'm Holly Wayment. I'll see you next time.