The Turkish Journal of Pediatrics
2013 , Vol 55 , Num 6
Drowning and near-drowning: experience of a university hospital in the Black Sea region
Departments of 1Pediatrics and 2Emergency Medicine, Faculty of Medicine, and 3Department of Industrial Engineering, Faculty of Engineering, Ondokuz Mayıs University, Samsun, Turkey. E-mail: ahmetgzl@yahoo.com
The aim of the study was to describe the characteristics of patients who
applied to the Emergency Department (ED) due to submersion injury; to
recognize the risk factors, complications, causes of death, and the educational
needs of families and caregivers about unsafe environments for submersion;
and to develop preventive strategies. All patients were analyzed retrospectively
according to demographic features, clinical and laboratory findings, association
between clinical variables and submersion injuries, and patient outcomes.
Fifty-five patients with submersion injury were analyzed. The mean age of
patients was 10.9±4.7 years. The most common Szpilman clinical scores were
Grade 1 (24 patients, 43.8%), Grade 2 (15 patients, 27.3%), and Grade 5 (10
patients, 18.2%). The common location of the submersion injuries included the
sea (74.5%), pool (18.4%), bathtub (7.3%), river (3.6%), and lake (3.6%). A
limited swimming ability or exhaustion and suffocation (49.1%) due to unknown
reasons were the most common causes of submersion injury among all patients.
Most complications were due to aspiration pneumonia and hypoxic ischemic
encephalopathy (HIE). Thirty-nine patients (70.9%) were followed in the
ED, while 16 patients (29.1%) were admitted to the pediatric intensive care
unit (PICU); 11 patients (20.0%) died. All of the risk factors of drowning
should be taken into account when designing preventive measures and family
education. In addition, all pediatricians should be trained periodically about
the complications of submersion and the treatment strategies, particularly in
coastal cities and areas where drownings occur frequently.
Keywords :
drowning, children, emergency department, intensive care, risk factors.