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Inflicted submersion in childhood

J M Gillenwater1, L Quan, K W Feldman

  • 1Department of Family Medicine, University of North Carolina School of Medicine, Chapel Hill, USA.

Archives of Pediatrics & Adolescent Medicine
|March 1, 1996
PubMed
Summary
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A significant portion of pediatric submersion injuries are inflicted, not accidental. Healthcare providers should carefully evaluate bathtub submersions and cases with signs of abuse to identify potential child abuse.

Area of Science:

  • Pediatric Medicine
  • Forensic Pathology
  • Child Abuse and Neglect

Background:

  • Submersion injuries are a leading cause of accidental death in children.
  • Distinguishing between accidental and inflicted submersion injuries is crucial for appropriate intervention.

Purpose of the Study:

  • To enhance the characterization and recognition of inflicted pediatric submersions.
  • To identify factors associated with inflicted versus unintentional submersion events.

Main Methods:

  • Retrospective case series analyzing records from a regional children's hospital and a medical examiner's office.
  • Two pediatricians reviewed cases of children younger than 19 years hospitalized or autopsied for submersion injury between 1983 and 1991.
  • Case scenarios were categorized as inflicted or unintentional based on preestablished criteria, followed by comparative analysis.

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Main Results:

  • Of 205 submersion cases, 16 (8%) were classified as inflicted.
  • Inflicted submersions frequently involved young children (median age 2.1 years) and occurred in bathtubs (56%).
  • Signs of abuse and historical inconsistencies were common in inflicted cases; victims were less likely to be revived and more likely to die.

Conclusions:

  • Inflicted pediatric submersions represent a notable proportion of cases and necessitate careful evaluation.
  • Bathtub submersions and presentations with physical or historical indicators of abuse warrant heightened suspicion for inflicted injury.