Trends in US Pediatric Drowning Hospitalizations, 1993–2008

Bowman, Stephen M.; Aitken, Mary E.; Robbins, James M.; Baker, Susan Pardee

doi:10.1542/peds.2011-2491

Cited by 36 publications

(23 citation statements)

References 15 publications

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“…This finding may be explained by more effective prevention for younger groups than for older age groups [13]. Especially in high-income countries several preventive measures have successfully been implemented for children and have led to a decrease in drowning deaths and hospitalization after drowning incidents [25]. …”

Section: Discussionmentioning

confidence: 99%

Drowning deaths in Sweden with emphasis on the presence of alcohol and drugs – a retrospective study, 1992–2009

2013

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BackgroundDrowning deaths constitute a significant proportion of unnatural deaths globally. In Sweden and other high-income countries, drowning deaths have decreased. This study investigates the epidemiology and current trends of unintentional, intentional, and undetermined drowning deaths with emphasis on the presence of alcohol and other drugs.MethodsDuring an 18-years period, 5,125 drowning deaths were autopsied in Sweden. Data on cases including toxicological analysis on alcohol, pharmaceutical drugs, and illicit drugs were obtained from the National Board of Forensic Medicine.ResultsDuring the study period, the annual incidence of drowning deaths in Sweden was 3.1/100,000 inhabitants and decreased on average by about 2% each year (p<0.001). The highest incidence was found among males and in middle/older age groups. The incidence increased 3% for each year of age. Children/adolescents (≤18 years) constituted 5% of all drowning deaths. Of all drowned females in the study, 55% (847/1,547) committed suicide, which was a significantly higher proportion compared with males (21%, 763/3,578) (p<0.001). In total, 38% (1,656/4,377) of tested drowned persons had alcohol in their blood and the mean concentration was 1.8 g/l. In the unintentional drowning group, intentional drowning group, and the undetermined group, the proportion of alcohol positive was 44%, 24%, and 45%, respectively. One or several psychoactive drugs were present in the blood in 40% (1,688 /4,181) of all tested persons and in 69% (965/1,394) of tested persons who died from suicidal drowning. The most common drug was benzodiazepines (21%, 891/4,181). Illicit drugs were detected in 10% (82/854) of tested persons.ConclusionPresence of alcohol and drugs were frequent and may have contributed to the drowning deaths. The incidence of drowning deaths significantly decreased during the study period. Males and the middle/older age groups had a higher incidence compared to females and children. Suicidal drowning was common especially among women. Alcohol and drugs are significant contributors in drowning deaths in Sweden and should be considered as part of a comprehensive prevention program.

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Section: Discussionmentioning

confidence: 99%

Drowning deaths in Sweden with emphasis on the presence of alcohol and drugs – a retrospective study, 1992–2009

2013

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“…Drowning is an important cause of OHCA in children, and results in approximately 1,100 pediatric deaths in the US annually (10). One multicenter cohort study of children who incurred OHCA with return of circulation reported nearly one-third of cases attributable to drowning (43/138, 31%); drowning outcomes were better than outcomes in non-drowning cases (3).…”

Section: Introductionmentioning

confidence: 99%

Targeted Temperature Management After Pediatric Cardiac Arrest Due To Drowning: Outcomes and Complications*

Moler

Hutchison

Nadkarni

et al. 2016

Pediatric Critical Care Medicine

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Objective To describe outcomes and complications in the drowning subgroup from the Therapeutic Hypothermia After Pediatric Cardiac Arrest Out-of-Hospital (THAPCA-OH) Trial. Design Exploratory post hoc cohort analysis Setting Twenty-four PICUs Patients Pediatric drowning cases Interventions Therapeutic hypothermia versus therapeutic normothermia Measurements and Main Results An exploratory study of pediatric drowning from the THAPCA-OH Trial was conducted. Comatose patients >2 days and <18 years were randomized ≤6 hours following return-of-circulation to hypothermia (n=46) or normothermia (n=28). Outcomes assessed included 12-month survival with a Vineland Adaptive Behavior Scale (VABS-II) score ≥70, 1-year survival rate, change in VABS-II score pre-arrest to 12-months, and select safety measures. Seventy-four drowning cases were randomized. In patients with pre-arrest VABS-II ≥70 (n=65), there was no difference in 12-month survival with VABS-II score ≥70 between hypothermia and normothermia groups [29% vs. 17%; relative risk (RR) 1.74; 95% confidence interval (CI) 0.61 to 4.95; p=0.27]. Among all evaluable patients (n=68), the VABS-II score change from baseline to 12-months did not differ (p=0.46) and one-year survival was similar (49%, hypothermia vs. 42%, normothermia; RR 1.16; 95% CI 0.68 to 1.99; p=0.58). Hypothermia was associated with a higher incidence of positive bacterial culture (any blood, urine or respiratory sample) (67% vs. 43%; p=0.04), however, the rate per 100 days at risk did not differ (11.1 vs. 8.4; p=0.46). Cumulative incidence of blood product use, serious arrhythmias and 28-day mortality were not different. Among patients with CPR durations >30 minutes or epinephrine doses >4, none had favorable Pediatric Cerebral Performance Category (PCPC) outcomes (≤3). Conclusions In comatose survivors of out-of-hospital pediatric cardiac arrest due to drowning, hypothermia did not result in a statistically significant benefit in survival with good functional outcome or mortality at one year, as compared with normothermia. High-risk of culture-proven bacterial infection was observed in both groups.

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“…It is the third leading cause of mortality due to unintentional injury, accounting for 7% of all injury-related deaths [2]. The World Health Organization (WHO) states that every hour more than 40 people die from drowning, which is 372,000 deaths per year [3].…”

Section: Introductionmentioning

confidence: 99%

Accidental Drowning: The Importance of Early Measures of Resuscitation for a Successful Outcome

Sulovic¹,

Pavlović²,

Zivkovic³

et al. 2018

Case Reports in Emergency Medicine

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Case Report The case of a drowning teenager is described involving application of cardiopulmonary resuscitation (CPR) by an untrained rescuer in the field and fast transport to a hospital enabling a positive resuscitation outcome despite an underorganized emergency medical service in a rural area. In our case hypoxia led to extended functional disorders of the cardiovascular system, which fully recovered after adequate therapy. Conclusion Knowledge about BLS measures by ordinary citizens, together with continuous education of health professionals concerning modern techniques of CPR, is crucial for increasing the number of patients surviving after cardiac arrest.

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Trends in US Pediatric Drowning Hospitalizations, 1993–2008

Cited by 36 publications

References 15 publications

Drowning deaths in Sweden with emphasis on the presence of alcohol and drugs – a retrospective study, 1992–2009

Drowning deaths in Sweden with emphasis on the presence of alcohol and drugs – a retrospective study, 1992–2009

Targeted Temperature Management After Pediatric Cardiac Arrest Due To Drowning: Outcomes and Complications*

Accidental Drowning: The Importance of Early Measures of Resuscitation for a Successful Outcome

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