Drowning Classification

Markarian, Thibaut; Loundou, Anderson; Heyer, Vera; Marimoutou, Cyril; Borghese, L; Coulange, Mathieu; Michelet, Pierre

doi:10.1016/j.chest.2020.01.035

Cited by 13 publications

(7 citation statements)

References 14 publications

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“… 3 Drowning may lead to multiple organ damage, and the most immediate threat in drowning is dysfunction of the cardiac and central nervous systems, particularly in cases of severe hypothermia and hypoxemia. 4 Despite improvement in the management of drowning, 5 , 6 the prognosis of serious drowning in patients remains closely associated with the occurrence of drowning-related cardiac injury. 6 During cardiac injury, a series of abnormalities may appear on an electrocardiogram.…”

Section: Introductionmentioning

confidence: 99%

Transient changes in the ST-T waveform mimicking myocardial infarction in a child with near-drowning: a case report

Zhang,

Lv,

Jiang

et al. 2024

J Int Med Res

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Drowning is a common cause of childhood morbidity and mortality worldwide. Anoxia, hypothermia, and metabolic acidosis are mainly responsible for this morbidity. Drowning may lead to multiple organ damage, especially cardiac damage, in cases in which severe hypothermia and hypoxemia occur. We report a case of a 4-year-old girl who was admitted to our hospital’s Emergency Department because of drowning. She had elevated troponin I concentrations and ST-segment elevation with T wave inversion. However, cardiovascular computed tomography showed no obvious abnormalities in the coronary arteries. We suggest that cardiac damage in this situation is caused by coronary artery spasms. To the best of our knowledge, this is the first case of cardiac damage with electrocardiographic changes after drowning in a preschool child.

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Section: Introductionmentioning

confidence: 99%

Transient changes in the ST-T waveform mimicking myocardial infarction in a child with near-drowning: a case report

Zhang,

Lv,

Jiang

et al. 2024

J Int Med Res

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“…This system was derived from data on 1831 drowning cases over a 20-year period (1972–1991) in Brazil. In the 20 plus years since publication there has only been one external validation study of the drowning classification and prognostication systems published 7. Other classification systems for drowning have been described but are not commonly used, such as the system proposed by Simcock8 and later modified by van Berkel et al 9.…”

Section: Introductionmentioning

confidence: 99%

“…Modell et al described a classification system based on conscious state, Grade A awake, Grade B blunted and Grade C comatose 10. All of the classification systems show rising mortality with increasing severity of the grading 6–10…”

Section: Introductionmentioning

confidence: 99%

Addressing gaps in our understanding of the drowning patient: a protocol for the retrospective development of an Utstein style database and multicentre collaboration

et al. 2023

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IntroductionThis retrospective observational study aims to create a comprehensive database of the circumstances of drowning (including care provided and outcomes of care) to report against the Utstein style for drowning (USFD) for patients presenting to the emergency department (ED). Four areas will be examined: a feasibility study of the USFD; a comparison of classification and prognostication systems; examination of indications and efficacy of different ventilation strategies; and differences in the circumstances, severity, treatment and outcomes of drowning by sex and gender.Methods and analysisThis protocol outlines retrospective data collection for all patients presenting to EDs of the Sunshine Coast Hospital and Health Service in Queensland, Australia with the presenting problem or discharge diagnosis of drowning or immersion between 2015 and 2022. Patients computerised health records (emergency medical service record, pathology, radiology results, medical and nursing notes for ED, inpatient units and intensive care units) will be used to extract data for entry into an USFD database. Descriptive (eg, median, IQR) and inferential statistical analyses (eg, analysis of variance) will be used to answer the separate research questions. Development of an International Drowning Registry using the USFD dataset and the Research Electronic Data Capture (REDCap) web application is discussed.Ethics and disseminationThis study has been approved by Metro North Human Research and Ethics Committee (Project No: 49754) and James Cook University Human Research Ethics Committee (H8014). It has been endorsed by national drowning prevention organisations Royal Life Saving Society Australia (RLSSA) and Surf Life Saving Australia (SLSA). Study findings will provide data to better inform clinical management of drowning patients and provide an evidence base on sex and gender differences in drowning. Results will be disseminated through peer review publications, conference presentations and media releases. Results will also be disseminated through RLSSA and SLSA membership of the Australian and New Zealand Resuscitation Council and the Australian Water Safety Council.

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“…In fact, drowning almost certainly never happens even without any degree of aspiration. In addition, hypothermia can develop quickly in people who are swimming or struggling to stay on the surface of cold water, particularly after a catastrophe in open seawater [ 15 , 16 ]. Medico-legal inquiry includes an important component that examines dead bodies collected from the water.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Histological Changes in Tissue Specimens Kept in Tap Water, River Water and Seawater for Different Intervals of Time

Patel¹,

Peyyeti²,

Singh³

et al. 2023

Cureus

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Background: Forensic pathologists find it difficult to ascertain the actual reason for death and the actual mode of death in drowning cases. It is commonly acknowledged that not all people whose dead bodies are found in water perished from drowning. The medico-legal inquiry includes an important component that examines dead bodies collected from the water. The corpse's time in the water continues to be the main concern. This aids in determining the time of death, which is crucial to any medico-legal investigation. The traditional histological analysis of hematoxylin and eosin (H&E)-stained oral soft tissue can be crucial in the assessment of this feature. Hence, this study was done to compare histological changes in the tissue specimens kept in tap water, river water, and seawater for different intervals of time.Materials and methods: One hundred eighty specimens were obtained from 180 dead bodies and divided randomly into three categories. Category A consisted of 60 specimens submerged in tap water, Category B of 60 specimens submersed in river water, and Category C consisted of 60 specimens submerged in seawater. The specimens underwent routine histological processing and H&E staining. The microscopic evaluation of specimens was carried out at two hours and on the first, second, third, fourth, and fifth days of submersion. Details were recorded regarding the structural changes, cellular changes, connective tissue changes, changes in the basement membrane, and intensity of H&E staining. Once the process of routine histological processing and H&E staining was completed for each study specimen, an evaluation of microscopic changes in the tissue was made.Results: The present study revealed that seawater preserved tissue best and for a longer period than river water and tap water. River water preserved tissue better than tap water. In pathologic tissue, details were preserved for much longer. It was noted that in squamous cell carcinoma, connective tissue was destroyed earlier than epithelium, in contrast to normal tissue where epithelium was destroyed before connective tissue.Conclusion: This study indicates that the medium of submersion in drowning victims affects the histopathological features. The time of death is an important aspect of forensic investigation. Considering this, all cases of drowning should be very carefully evaluated, and the medium taken into consideration while determining the time of death, as tissue degrades faster in freshwater than in seawater.

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Drowning Classification

Cited by 13 publications

References 14 publications

Transient changes in the ST-T waveform mimicking myocardial infarction in a child with near-drowning: a case report

Transient changes in the ST-T waveform mimicking myocardial infarction in a child with near-drowning: a case report

Addressing gaps in our understanding of the drowning patient: a protocol for the retrospective development of an Utstein style database and multicentre collaboration

Comparison of Histological Changes in Tissue Specimens Kept in Tap Water, River Water and Seawater for Different Intervals of Time

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