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Drowning and near-drowning--some lessons learnt
Annals of the Academy of Medicine, Singapore
|September 25, 1999
Summary
Early bystander cardiopulmonary resuscitation significantly improves survival rates for drowning victims. Prompt medical intervention is crucial for preventing complications like pulmonary edema in submersion injuries.
Area of Science:
- Emergency Medicine
- Public Health
Background:
- Submersion injuries, including drowning and near-drowning, pose a significant public health concern.
- This study examines cases managed at Changi General Hospital over sixteen months.
Observation:
- 17 cases of submersion injury were treated, predominantly affecting young, inexperienced recreational swimmers.
- Most incidents occurred in unsupervised urban swimming pools, with adults over fifteen years old comprising two-thirds of cases.
- Associated conditions like seizures, spinal injuries, and intoxication were often initially unsuspected.
Findings:
- Early bystander cardiopulmonary resuscitation (CPR) was associated with recovery without severe morbidity in 6 cases.
- Non-cardiogenic pulmonary edema leading to chest infection was the most common complication in survivors.
- Key determinants of survival included early CPR, pupil reactivity, palpable pulse, and cardiac sinus rhythm.
Implications:
- Highlights the critical role of immediate CPR in improving outcomes for submersion victims.
- Emphasizes the need for thorough assessment to identify underlying conditions and associated injuries.
- Underscores the importance of supervision and safety measures in recreational water environments.
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