Pediatric Hypothermic Submersion Injury and Protective Factors Associated with Optimal Outcome: A Case Report and Literature Review

Kříž, Daniel; Piantino, Juan; Fields, Devin; Williams, Cydni N.

doi:10.3390/children5010004

Cited by 5 publications

(3 citation statements)

References 24 publications

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“…La evidencia revisada concluye que el recalentamiento extrahospitalario debe comenzar lo antes posible y debe ser lento ya que estos dos factores están directamente relacionados con el aumento de la tasa de supervivencia y la disminución del efecto afterdrop [41]. Se entiende por recalentamiento lento el aumento aproximado de la TCC de unos 2ºC/h en hipotermias leves y moderadas [31,45,51] con métodos de recalentamiento activos externos y entre 0.1-0.7ºC/h con técnicas de recalentamiento pasivo externo.…”

Section: Técnicas De Recalentamientounclassified

Manejo prehospitalario de la hipotermia accidental; Una emergencia sanitaria en el Mediterráneo.

Grima

Deballon

2020

RIECS

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1) Antecedentes: Las diferentes rutas migratorias que atraviesan el Mar Mediterráneo son consideradas las rutas más mortíferas de 2019. Son varios los organismos que recopilan información sobre estos movimientos migratorios, refugiados y migrantes deben ser asistidos cuando se encuentren en peligro según el Derecho Marítimo y trasladados a un puerto seguro en el cual se respeten sus Derechos Humanos. La OMS resalta que la hipotermia se sitúa entre los problemas de salud más frecuentes en el Mediterráneo seguido de quemaduras y lesiones accidentales. Las muertes por ahogamiento e hipotermia representan más del 50% de los casos según la OIM convirtiendo esta patología en una emergencia sanitaria cuyo abordaje prehospitalario definirá los resultados clínico-asistenciales. 2) Métodos: Revisión sistemática de tipo exploratoria para describir el conocimiento sanitario actual sobre la hipotermia accidental tras inmersión y como el correcto triaje, clasificación del grado de hipotermia y tratamiento influyen en los resultados clínicoasistenciales prehospitalarios. 3) Resultados: El triaje debe ser llevado a cabo por profesionales experimentados en el ámbito marítimo. El tratamiento recibido debe ser acorde al grado de hipotermia que presente el paciente, el cuál será definido por la clínica. Los casos de HA severa y PCR por hipotermia cumplen los criterios para una derivación hospitalaria urgente. 4) Conclusión: La hipotermia accidental es una patología ambiental, se considera una emergencia y tiene unos principios básicos de clasificación, tratamiento y reanimación. Conocer estos principios asegurará un buen manejo prehospitalario del paciente hipotérmico.

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Section: Técnicas De Recalentamientounclassified

Manejo prehospitalario de la hipotermia accidental; Una emergencia sanitaria en el Mediterráneo.

Grima

Deballon

2020

RIECS

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“…Understanding the drowning process and related pathophysiology provide a rationale for the management, treatment strategies and interventions that are followed when the child is managed following the drowning incident (Cantwell, 2021; Parenteau et al, 2018). Clear guidelines and protocols exist that directs postdrowning management in the different clinical areas (Cantwell, 2021; Parenteau et al, 2018; Widyantara et al, 2019) as well as clinical pathways for interventions, and managing the effects of the pathophysiological process of drowning (Kritz et al, 2018; Parenteau et al, 2018). However, after exploring the above‐mentioned guidelines, protocols and pathways, it was evident that silos or pockets in care approaches exist in the different clinical areas, the parents or family's inclusion during management is not clearly demarcated, and nor is withdrawing or withholding life sustaining treatment clearly linked between the different clinical areas.…”

Section: Introductionmentioning

confidence: 99%

A quest for an integrated management system of children following a drowning incident: A review of the literature

Rossouw,

Maree,

Latour

2023

Specialist Pediatric Nursing

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PurposeManagement of children following a drowning incident is based on specific interventions which are used in the prehospital environment, the emergency department (ED) and the Paediatric Intensive Care Unit (PICU). This paper presents a review of the literature to map and describe the management and interventions used by healthcare professionals when managing a child following a drowning incident. Of specific interest was to map, synthesise and describe the management and interventions according to the different clinical domains or practice areas of healthcare professionals.Design and MethodsA traditional review of the literature was performed to appraise, map and describe information from 32 relevant articles. Four electronic databases were searched using search strings and the Boolean operators AND as well as OR. The included articles were all published in English between 2010 and 2022, as it comprised a timeline including current guidelines and practices necessary to describe management and interventions.ResultsConcepts and phrases from the literature were used as headings to form a picture or overview of the interventions used for managing a child following a drowning incident. Information extracted from the literature was mapped under management and interventions for prehospital, the ED and the PICU and a figure was constructed to display the findings. It was evident from the literature that management and interventions are well researched, evidence‐informed and discussed, but no clear arguments or examples could be found to link the interventions for integrated management from the scene of drowning through to the PICU. Cooling and/or rewarming techniques and approaches and termination of resuscitation were found to be discussed as interventions, but no evidence of integration from prehospital to the ED and beyond was found. The review also highlighted the absence of parental involvement in the management of children following a drowning incident.Practice ImplicationsMapping the literature enables visualisation of management and interventions used for children following a drowning incident. Integration of these interventions can collaboratively be done by involving the healthcare practitioners to form a link or chain for integrated management from the scene of drowning through to the PICU.

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“…Drowning is the third leading cause of unintentional injury death worldwide, with the highest rates of fatality among young children [1]. Out of hospital it can sometimes be challenging to decide how to treat these patients, but inhospital extracorporeal life support (ECLS) has revolutionized the management of hypothermic cardiac arrest, with greatly improved survival rates [2].…”

Section: Introductionmentioning

confidence: 99%

Pediatric hypothermic submersion incident – should we do chest compressions on a beating heart?

Einvik

Krüger

Gisvold

2020

Scand J Trauma Resusc Emerg Med

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Background: Drowning is the third leading cause of unintentional injury death worldwide, with the highest rates of fatality among young children. To decide how to treat these patients prehospitally could be challenging in certain situations when uncertain about the adequacy of the patent's circulation. Methods/case report: We describe a 2 year old boy surviving a 15 min hypothermic submersion in a cold river. In spite of the presence of some vital signs, we decided to do full cardiopulmonary resuscitation to the hospital. The main reason was that we were uncertain about the adequacy of the spontaneous circulation, and the transport to hospital was fairly long. The patient suffered no obvious harm and the outcome was good. Discussion: What is regarded as adequate circulation when accidentally hypothermic between 24 and 25 0 C? A weak pulse was felt in the femoral artery with a rate of about 40-50 per minute. There were shallow, but regular respiration, and point of care ultrasound revealed a slightly dilated left ventricle and weak, but organised cardiac contractions. Despite these findings a decision was made to continue ventilations and chest compressions during helicopter transport to the University hospital. Conclusion: In an accidentally hypothermic pediatric submersion incident we decided to do full cardiopulmonary resuscitation to the hospital despite there were signs of circulation. We did no harm to the patient. Future guideline revisions should try to clarify how to handle situations with severly accidentally hypothermic patients like this, so the good outcome that is often seen in these patients could be even better.

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Pediatric Hypothermic Submersion Injury and Protective Factors Associated with Optimal Outcome: A Case Report and Literature Review

Cited by 5 publications

References 24 publications

Manejo prehospitalario de la hipotermia accidental; Una emergencia sanitaria en el Mediterráneo.

Manejo prehospitalario de la hipotermia accidental; Una emergencia sanitaria en el Mediterráneo.

A quest for an integrated management system of children following a drowning incident: A review of the literature

Pediatric hypothermic submersion incident – should we do chest compressions on a beating heart?

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