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Better Groundwork Can Avoid Troubled Waters: A Developing Country Perspective on Drowning
Madhusudan Samprathi1, Ashish Agarwal1, Muralidharan Jayashree1
1Pediatric Emergency and Intensive Care Units, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
Journal of Tropical Pediatrics
|November 15, 2019
Summary
Drowning is a major cause of child death in low-income countries. While hypoxemia, pulseless arrest, and need for ventilation at admission predict poor outcomes, early resuscitation may improve survival rates for pediatric drowning victims.
Area of Science:
- Pediatric Emergency Medicine
- Public Health
- Epidemiology
Background:
- Drowning is a significant cause of unintentional injury-related mortality in low- and middle-income countries (LMICs).
- Understanding the epidemiology and outcomes of childhood drowning is crucial for developing effective prevention and treatment strategies.
Purpose of the Study:
- To investigate the epidemiology, intensive care requirements, and outcome predictors in children experiencing drowning incidents.
- To identify factors associated with unfavorable outcomes in pediatric drowning cases.
Main Methods:
- Retrospective analysis of medical records for children under 12 years old admitted for drowning.
- Inclusion criteria: emergency room and/or pediatric intensive care unit (PICU) admission.
- Outcome assessment: favorable (normal neurological status) vs. unfavorable (death or abnormal neurological status); multivariable analysis for predictors.
Main Results:
- Twenty-seven children were analyzed; median age 18 months, median submersion 4 minutes.
- High rates of hypoxemia (43.7%) and pulseless arrest (22.2%) at admission.
- Ten children (37%) required PICU admission, primarily for hypoxic ischemic encephalopathy (HIE) or ventilation.
Conclusions:
- Hypoxemia, pulseless arrest, HIE, and need for ventilation at admission are associated with unfavorable outcomes in pediatric drowning.
- Effective on-site resuscitation and prompt stabilization are critical for improving outcomes in LMICs.
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