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Childhood submersion injuries
1Phoenix Children's Hospital, Arizona 85006, USA.
Insights
Near-drowning outcomes in children depend on submersion length and initial health status. Aggressive resuscitation is crucial for improving survival and neurologic recovery in near-drowning incidents.
Area of Science:
- Pediatric Emergency Medicine
- Nephrology
- Cardiology
Background:
- Submersion incidents pose significant risks to children, with outcomes influenced by various factors.
- Near-drowning resuscitation efforts face challenges in predicting neurologically intact survival.
Purpose of the Study:
- To identify key variables affecting prognosis in pediatric near-drowning.
- To emphasize the importance of aggressive resuscitation and management strategies.
Main Methods:
- Analysis of prognostic variables in pediatric near-drowning cases.
- Review of resuscitation success rates and predictive factors for neurologic outcome.
Main Results:
- Prognosis is linked to submersion duration, initial neurologic assessment, time to first breath, and initial pH.
- Approximately 30% of treated children experience mortality or neurologic deficit post-near-drowning.
Conclusions:
- Predicting intact neurologic survival in comatose children post-near-drowning remains challenging.
- Understanding drowning pathophysiology guides aggressive interventions to enhance recovery likelihood.
Abstract:
The overall prognosis for children who sustain a submersion incident is directly related to several variables including length of submersion, initial neurologic evaluation, time to first breath, initial pH, and others. Resuscitation after near-drowning is unsuccessful in terms of death and neurologic deficit in 30% of those children who are treated at our institution. Despite the fact that we have been able to present variables that are somewhat predictive of outcome, it is almost impossible to identify 100% of the time which particular comatose child will survive neurologically intact. Therefore skilled attempts at resuscitation and management are mandatory. The understanding of the sequence of events that occur during the drowning process and the pathophysiologic consequence make it possible for health care personnel to provide aggressive therapeutic interventions that will enhance the likelihood of a normal recovery.