Part 10.3: Drowning

Wilkins, Lippincott Williams

doi:10.1161/circulationaha.105.166565

Cited by 2 publications

(5 citation statements)

References 25 publications

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“…Our study confirms the findings of studies by Claesson et al and Kuisma et al that drowning patients are younger and more of them are found in a nonshockable rhythm [asystole/pulseless electrical activity (PEA)] compared to OHPCA patients [1, 4, 8]. Younger patients have a lower incidence of comorbidity and/or greater potential for recovery [4, 5, 9].…”

Section: Discussionsupporting

confidence: 91%

“…Ten intoxicated patients drowned by accident. The share of intoxicated patients is relatively high in comparison with other reports about drowning [1, 12, 13]. In Slovenia suicide and alcohol intoxication are the leading causes of drowning.…”

Section: Discussionmentioning

confidence: 84%

“…Younger patients have a lower incidence of comorbidity and/or greater potential for recovery [4, 5, 9]. DCA patients usually have a nonshockable initial rhythm (asystole/PEA) due to asphyxia after drowning that leads to myocardial hypoxia, which results in progressive bradycardia, finally deteriorating to asystole [1, 4, 9], or prolonged response time resulting in the disappearance of a shockable rhythm [4]. …”

Section: Discussionmentioning

confidence: 99%

“…Drowning is one of the leading preventable causes of unintentional morbidity and mortality [1]. The most important and detrimental consequence of submersion is hypoxia.…”

Section: Introductionmentioning

confidence: 99%

“…The Utstein definition and style of data reporting were created to ensure the use of consistent terminology and the uniform reporting of data from drowning and were published as recommended guidelines in October 2003 (“Utstein Style for Drowning,” USFD) [2]. Patients with cardiac arrest caused by drowning present a specific problem and recent guidelines [1] suggest that basic and advanced cardiac life support used in patients with primary cardiac arrest should be modified for the use in patients with cardiac arrest caused by drowning. The aim of this study was to compare the characteristics and outcome between patients suffering from out-of-hospital primary cardiac arrest (OHPCA) and drowning victims in cardiac arrest (DCA) by analysis of variables based on the USFD.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of the characteristics and outcome among patients suffering from out-of-hospital primary cardiac arrest and drowning victims in cardiac arrest

2009

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BackgroundIn 2003, the International Liaison Committee on Resuscitation (ILCOR) published the Recommended Guidelines for Uniform Reporting of Data from Drowning: the “Utstein style” (“Utstein Style for Drowning,” USFD) to improve the understanding of epidemiology, treatment, and outcome prediction after drowning.AimsThe aim of this study was to compare the characteristics and outcome between patients suffering from out-of-hospital primary cardiac arrest (OHPCA) and drowning victims in cardiac arrest (DCA) by analysis of variables based on the USFD.MethodsAll cases of OHPCA and DCA from February 1998 to February 2007 were included in the research and analysis. Data on OHPCA and DCA patients were collected using the Utstein method. Data on DCA patients were then compared with data of OHPCA patients.ResultsDuring the study period 788 cardiac arrests with resuscitation attempts were identified: 528 of them were OHPCA (67%) and 32 (4%) were DCA. The differences between DCA and OHPCA patients were: the DCA patients were younger (46.5 ± 21.4 vs 62.5 ± 15.8; p = 0.01), suffered a witnessed cardiac arrest less frequently (9/32 vs 343/528; p = 0.03), were more often found in a nonshockable rhythm (29/32 vs 297/528; p < 0.0001), had a prolonged ambulance response time (11 vs 6 min; p = 0.001), had a relatively better (but not statistically significant) return of spontaneous circulation (ROSC) in the field [22/32 (65%) vs 301/528 (57%); p = 0.33], more of them were admitted to hospital [19/32 (60%) vs 253/528 (48%); p = 0.27], and also had a significantly higher survival rate (discharge from hospital) [14/32 (44%) vs 116/528 (22%); p = 0.01]. DCA patients had higher values of initial PETCO2 (53.2 ± 16.8 vs 15.8 ± 8.3 mmHg; p < 0.0001) and average PETCO2 (43.5 ± 13.8 vs 23.5 ± 8.2; p = 0.002). These values of PETCO2 suggest an asphyxial mechanism of cardiac arrest. The analysis showed that DCA patients who survived were younger, had more bystander cardiopulmonary resuscitation (CPR), shorter call-arrival interval, higher values of PETCO2 after 1 min of CPR, higher average and final values of PETCO2, lower value of initial serum K+, and more of them received vasopressin (p < 0.05) in comparison with DCA patients who did not survive.ConclusionDCA patients had a better survival rate (discharge from hospital), higher initial and average PETCO2 values, and more of them had nonshockable initial rhythm. Survival (discharge from hospital) in DCA patients is associated with the PETCO2 values, initial serum K+ values, administration of vasopressin, and ambulance response time.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

“…Drowning is one of the leading preventable causes of unintentional morbidity and mortality [1]. The most important and detrimental consequence of submersion is hypoxia.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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