Prognostic indicators in pediatric near-drowning: the Glasgow coma scale

Area of Science:

• Pediatric Emergency Medicine
• Neurology
• Toxicology

Background:

• Drowning is a leading cause of unintentional injury death in children.
• Predicting outcomes in pediatric near-drowning is crucial for guiding medical interventions.
• The Glasgow Coma Scale (GCS) is a standard neurological assessment tool.

Purpose of the Study:

• To evaluate the utility of the Glasgow Coma Scale in predicting outcomes for pediatric near-drowning patients.
• To determine if GCS scores can stratify risk in pediatric near-drowning victims.

Main Methods:

• Retrospective review of 101 pediatric near-drowning admissions to Children's Hospital of Los Angeles (1975-1978).
• Assignment of admission Glasgow Coma Scale scores to 94 patients.
• Correlation of GCS scores with mortality and neurological sequelae.

Main Results:

• A low GCS score (less than 5) was associated with 80% mortality or permanent neurological sequelae.
• A high GCS score (greater than or equal to 6) predicted a low-risk group with no deaths or severe neurological sequelae.
• The GCS demonstrated significant predictive value for patient outcomes.

Conclusions:

• The Glasgow Coma Scale is a valuable tool for predicting outcomes in pediatric near-drowning incidents.
• Early neurological assessment using GCS can aid in risk stratification and management decisions.
• GCS scoring can help identify children at high risk for poor outcomes after near-drowning.