UMEM Educational Pearls

Title: Pediatric Drownings

Posted: 6/8/2009 by Rose Chasm, MD (Updated: 6/9/2009)
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Rates are highest for children <5yrs and between 15-24 yrs old.
Most of pathology is related to duration of asphyxia from time of submersion until adequate respiration is restored.
The brain and heart are most vulnerable to anoxic and ischemic injury.
Prognosis for near-drowning depends primarily on the degree of brain anoxia.
Prolonged submersion (>25 min); apnea or coma at presentation to ED; and initial arterial pH <7.0 are all poor prognostic indicators.
96% of victims who require <10min of CPR survive with no or only mild neurologic impariment.

DeNicola LK, Falk JL, Swanson ME, Gayle MO, Kissoon N. Submersion injuries in children and adults. Crit Care Clin. 1997;13:477-502.

Fisher DH. Near-drowning. Pediatr Rev. 1993;14:148-151.

Shaw KN, Briede CA. Submersion injuries: drowning and near-drowning. Emerg Med Clin North Am. 1989;7:355-370.