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Published in: Italian Journal of Pediatrics 1/2023

Open Access 01-12-2023 | Cardiopulmonary Resuscitation | Review

Epidemiology, clinical aspects, and management of pediatric drowning

Authors: Francesco Pellegrino, Irene Raffaldi, Roberta Rossi, Barbara De Vito, Manuela Pagano, Davide Garelli, Claudia Bondone

Published in: Italian Journal of Pediatrics | Issue 1/2023

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Abstract

Drowning is the third leading cause of injury death in the pediatric population worldwide, with incidence peaking among those aged 1–4 years and again in adolescence.
The purpose of this commentary is to review the basic pathophysiology of drowninginjury and factors that affect the outcome, such as submersion and hypothermia. We also discuss principles of prehospital and in-hospital management, comprising resuscitation and stabilization, administration of oxygen and intravenous liquids, and central reheating.
Even though the mortality rate has decreased in recent years, further investments and safety measures are needed to prevent child drowning deaths.
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Literature
1.
go back to reference van Beeck EF, Branche CM, Szpilman D, Modell JH, Bierens JJLM. A new definition of drowning: towards documentation and prevention of a global public health problem. Bull World Health Organ. 2005;83:853–6.PubMedPubMedCentral van Beeck EF, Branche CM, Szpilman D, Modell JH, Bierens JJLM. A new definition of drowning: towards documentation and prevention of a global public health problem. Bull World Health Organ. 2005;83:853–6.PubMedPubMedCentral
2.
go back to reference World Health. Organization Global report on drowning: preventing a leading killer. Switzerland: Geneva; 2014. World Health. Organization Global report on drowning: preventing a leading killer. Switzerland: Geneva; 2014.
3.
go back to reference Franklin RC, Peden AE, Hamilton EB, et al. The burden of unintentional drowning: global, regional and national estimates of mortality from the global burden of Disease 2017. Study Injury Prevention. 2020;26:i83–i95.CrossRefPubMed Franklin RC, Peden AE, Hamilton EB, et al. The burden of unintentional drowning: global, regional and national estimates of mortality from the global burden of Disease 2017. Study Injury Prevention. 2020;26:i83–i95.CrossRefPubMed
5.
go back to reference Driscoll TR, Harrison JA, Steenkamp M. Review of the role of alcohol in drowning associated with recreational aquatic activity. Inj Prev. 2004;10:107–13.CrossRefPubMedPubMedCentral Driscoll TR, Harrison JA, Steenkamp M. Review of the role of alcohol in drowning associated with recreational aquatic activity. Inj Prev. 2004;10:107–13.CrossRefPubMedPubMedCentral
6.
go back to reference Bell GS, Gaitatzis A, Bell CL. Drowning in people with epilepsy: how great is the risk? 8, 2008, Neurology, Vol. 71, pp. 578–582. Bell GS, Gaitatzis A, Bell CL. Drowning in people with epilepsy: how great is the risk? 8, 2008, Neurology, Vol. 71, pp. 578–582.
7.
go back to reference Guan J, Li G. Injury mortality in individuals with autism. 5, 2017, Am J Public Health, Vol. 107, pp. 791–3. 17. Guan J, Li G. Injury mortality in individuals with autism. 5, 2017, Am J Public Health, Vol. 107, pp. 791–3. 17.
8.
go back to reference Guan J, Li G. Characteristics of unintentional drowning deaths in children with autism spectrum disorder. 1, 2017, Inj Epidemiology, Vol. 4, p. 32. Guan J, Li G. Characteristics of unintentional drowning deaths in children with autism spectrum disorder. 1, 2017, Inj Epidemiology, Vol. 4, p. 32.
10.
go back to reference Cenderadewi M, Franklin RC, Peden AE. Fatal intentional drowning in Australia: A systematic literature review of rates and risk factors. 5, 2020,PLOS ONE, Vol. 15. Cenderadewi M, Franklin RC, Peden AE. Fatal intentional drowning in Australia: A systematic literature review of rates and risk factors. 5, 2020,PLOS ONE, Vol. 15.
11.
go back to reference Orlowski JP, Abulleil MM, Phillips JM. The hemodynamic and cardiovascular effects of near-drowning in hypotonic, isotonic, or hypertonic solutions. Ann Emerg Med. 1989;18:1044–9.CrossRefPubMed Orlowski JP, Abulleil MM, Phillips JM. The hemodynamic and cardiovascular effects of near-drowning in hypotonic, isotonic, or hypertonic solutions. Ann Emerg Med. 1989;18:1044–9.CrossRefPubMed
12.
go back to reference Grmec S, Strnad M, Podgorsek D. Comparison of the characteristics and outcome among patients suffering from out-of-hospital primary cardiac arrest and drowning victims in cardiac arrest. Int J Emerg Med. 2009;2:7–12.CrossRefPubMedPubMedCentral Grmec S, Strnad M, Podgorsek D. Comparison of the characteristics and outcome among patients suffering from out-of-hospital primary cardiac arrest and drowning victims in cardiac arrest. Int J Emerg Med. 2009;2:7–12.CrossRefPubMedPubMedCentral
13.
go back to reference Evans J, Javaid AA, Scarrott E et al. Fifteen-minute consultation: Drowning in children. 2020, Archives of Disease in Childhood - Education and Practice, pp. 1–6. Evans J, Javaid AA, Scarrott E et al. Fifteen-minute consultation: Drowning in children. 2020, Archives of Disease in Childhood - Education and Practice, pp. 1–6.
14.
go back to reference Sterba JA, Lundgren CE. Diving bradycardia and breath-holding time in man. Undersea Biomed Res. 1985;12:139–50.PubMed Sterba JA, Lundgren CE. Diving bradycardia and breath-holding time in man. Undersea Biomed Res. 1985;12:139–50.PubMed
15.
go back to reference Modell JH, Bellefleur M, Davis JH. Drowning without aspiration: is this an appropriate diagnosis? 1999, J Forensic Sci, Vol. 44, pp. 1119–23. Modell JH, Bellefleur M, Davis JH. Drowning without aspiration: is this an appropriate diagnosis? 1999, J Forensic Sci, Vol. 44, pp. 1119–23.
16.
go back to reference Andrew C, Schmidt DO. MPH et al. 27 wilderness Medical Society Practice Guidelines for the Prevention and treatment of drowning. WILDERNESS & ENVIRONMENTAL MEDICINE; 2016. pp. 236–51. Andrew C, Schmidt DO. MPH et al. 27 wilderness Medical Society Practice Guidelines for the Prevention and treatment of drowning. WILDERNESS & ENVIRONMENTAL MEDICINE; 2016. pp. 236–51.
17.
go back to reference Soar J, Perkins GD, Abbasc G, et al. Section 8. Cardiac arrest in special circumstances: electrolyte abnormalities, poisoning, drowning, accidental hypothermia, hyperthermia, asthma, anaphylaxis, cardiac surgery, trauma, pregnancy, electrocution. Resuscitation. 2010;81:1400–33. European Resuscitation Council Guidelines for Resuscitation 2010. Soar J, Perkins GD, Abbasc G, et al. Section 8. Cardiac arrest in special circumstances: electrolyte abnormalities, poisoning, drowning, accidental hypothermia, hyperthermia, asthma, anaphylaxis, cardiac surgery, trauma, pregnancy, electrocution. Resuscitation. 2010;81:1400–33. European Resuscitation Council Guidelines for Resuscitation 2010.
18.
go back to reference Szpilman D, Soares M. In-water resuscitation — is it worthwhile? Resuscitation 2004;63:25–31. Szpilman D, Soares M. In-water resuscitation — is it worthwhile? Resuscitation 2004;63:25–31.
19.
go back to reference Watson RS, Cummings P, Quan L, Bratton S, Weiss NS. Cervical spine injuries among submersion victims. J Trauma. 2001;51:658–62.CrossRefPubMed Watson RS, Cummings P, Quan L, Bratton S, Weiss NS. Cervical spine injuries among submersion victims. J Trauma. 2001;51:658–62.CrossRefPubMed
20.
go back to reference Orlowski JP, Szpilman D. Drowning: rescue, resuscitation, and reanimation. Pediatr Clin North Am. 2001;48:627–46.CrossRefPubMed Orlowski JP, Szpilman D. Drowning: rescue, resuscitation, and reanimation. Pediatr Clin North Am. 2001;48:627–46.CrossRefPubMed
21.
go back to reference Quan L, et al. Predicting outcome of drowning at the scene: a systematic review and meta-analyses. Resuscitation; 2016. Quan L, et al. Predicting outcome of drowning at the scene: a systematic review and meta-analyses. Resuscitation; 2016.
22.
go back to reference Kieboom JK, Verkade HJ, Burgerhof JG, et al. Outcome after resuscitation beyond 30 minutes in drowned children with cardiac arrest and hypothermia: dutch nationwide retrospective cohort study. BMJ. 2015;350:h418.CrossRefPubMedPubMedCentral Kieboom JK, Verkade HJ, Burgerhof JG, et al. Outcome after resuscitation beyond 30 minutes in drowned children with cardiac arrest and hypothermia: dutch nationwide retrospective cohort study. BMJ. 2015;350:h418.CrossRefPubMedPubMedCentral
24.
go back to reference Zuckerman GB, Gregory PM, Santos-Damiani SM. Predictors of death and neurologic impairment in Pediatric Submersion Injuries: the Pediatric risk of mortality score. rch Pediatr Adolesc Med. 1998;152:134–40. Zuckerman GB, Gregory PM, Santos-Damiani SM. Predictors of death and neurologic impairment in Pediatric Submersion Injuries: the Pediatric risk of mortality score. rch Pediatr Adolesc Med. 1998;152:134–40.
25.
go back to reference Szpilman D, Sempsrott J, Webber J, et al. Dry drowning’ and other myths. Cleve Clin J Med. 2018;85:529–35.CrossRefPubMed Szpilman D, Sempsrott J, Webber J, et al. Dry drowning’ and other myths. Cleve Clin J Med. 2018;85:529–35.CrossRefPubMed
26.
go back to reference Shenoi RP, Allahabadi S, Rubalcava DM, Camp EA. The Pediatric submersion score predicts children at low risk for Injury following submersions. Acad Emerg Med. 2017 Dec;24(12):1491–500. https://doi.org/10.1111/acem.13278. Epub 2017 Sep 23. PMID: 28833853. Shenoi RP, Allahabadi S, Rubalcava DM, Camp EA. The Pediatric submersion score predicts children at low risk for Injury following submersions. Acad Emerg Med. 2017 Dec;24(12):1491–500. https://​doi.​org/​10.​1111/​acem.​13278. Epub 2017 Sep 23. PMID: 28833853.
27.
go back to reference Denny SA, Quan L, Gilchrist J, et al. Council on Injury, Violence, and poison Prevention. Policy statement: Prevention of drowning. Pediatrics. 2019;143(5):e20190850.CrossRefPubMed Denny SA, Quan L, Gilchrist J, et al. Council on Injury, Violence, and poison Prevention. Policy statement: Prevention of drowning. Pediatrics. 2019;143(5):e20190850.CrossRefPubMed
28.
go back to reference Rahman A, Mashreky SR, Chowdhury SM, Giashuddin MS, Uhaa IJ, Shafinaz S, Hossain M, Linnan M, Rahman F. Analysis of the childhood fatal drowning situation in Bangladesh: exploring prevention measures for low-income countries. Inj Prev. 2009;15:75–9.CrossRefPubMed Rahman A, Mashreky SR, Chowdhury SM, Giashuddin MS, Uhaa IJ, Shafinaz S, Hossain M, Linnan M, Rahman F. Analysis of the childhood fatal drowning situation in Bangladesh: exploring prevention measures for low-income countries. Inj Prev. 2009;15:75–9.CrossRefPubMed
29.
go back to reference Bose A, George K, Joseph A. Drowning in childhood: a population-based study. Indian Pediatr. 2000;37:80–3.PubMed Bose A, George K, Joseph A. Drowning in childhood: a population-based study. Indian Pediatr. 2000;37:80–3.PubMed
30.
go back to reference Saluja G, Brenner RA, Trumble AC, Smith GS, Schroeder T, Cox C. Swimming pool drownings among US residents aged 5–24 years: understanding racial/ethnic disparities. Am J Public Health. 2006;96(4):728–33.CrossRefPubMedPubMedCentral Saluja G, Brenner RA, Trumble AC, Smith GS, Schroeder T, Cox C. Swimming pool drownings among US residents aged 5–24 years: understanding racial/ethnic disparities. Am J Public Health. 2006;96(4):728–33.CrossRefPubMedPubMedCentral
31.
go back to reference Thompson DC, Rivara FP. Pool fencing for preventing drowning in children. 26 Jan 1998, Cochrane Database Syst Rev. 2000. Thompson DC, Rivara FP. Pool fencing for preventing drowning in children. 26 Jan 1998, Cochrane Database Syst Rev. 2000.
33.
go back to reference Cummings P, Mueller BA, Quan L. Association between wearing a personal floatation device and death by drowning among recreational boaters: a matched cohort analysis of United States Coast Guard data. Inj Prev. 2011;17(3):156–9.CrossRefPubMed Cummings P, Mueller BA, Quan L. Association between wearing a personal floatation device and death by drowning among recreational boaters: a matched cohort analysis of United States Coast Guard data. Inj Prev. 2011;17(3):156–9.CrossRefPubMed
34.
go back to reference Peden AE, Demant D, Hagger MS, Hamilton K. Personal, social, and environmental factors associated with lifejacket wear in adults and children: A systematic literature review. 5 2018 PLoS ONE, Vol. 13. Peden AE, Demant D, Hagger MS, Hamilton K. Personal, social, and environmental factors associated with lifejacket wear in adults and children: A systematic literature review. 5 2018 PLoS ONE, Vol. 13.
35.
go back to reference Chung C, Quan L, Bennett E, Kernic MA, Ebel BE. Informing policy on open water drowning prevention: an observational survey of life jacket use in Washington State. Inj Prev. 2014;20(4):238–43.CrossRefPubMed Chung C, Quan L, Bennett E, Kernic MA, Ebel BE. Informing policy on open water drowning prevention: an observational survey of life jacket use in Washington State. Inj Prev. 2014;20(4):238–43.CrossRefPubMed
36.
go back to reference Kyriacou DN, Arcinue EL, Peek C, et al. Effect of immediate resuscitation on children with submersion injury. Volume 94. Pediatrics; 1994. 137 – 42. 8036063. Kyriacou DN, Arcinue EL, Peek C, et al. Effect of immediate resuscitation on children with submersion injury. Volume 94. Pediatrics; 1994. 137 – 42. 8036063.
37.
go back to reference Fernández-Méndez F, Otero-Agra M, Abelairas-Gómez C, Sáez-Gallego NM, Rodríguez-Núñez A, Barcala-Furelos R. ABCDE approach to victims by lifeguards: how do they manage a critical patient? A cross sectional simulation study 4. PLOS ONE; 2019. p. 14. Fernández-Méndez F, Otero-Agra M, Abelairas-Gómez C, Sáez-Gallego NM, Rodríguez-Núñez A, Barcala-Furelos R. ABCDE approach to victims by lifeguards: how do they manage a critical patient? A cross sectional simulation study 4. PLOS ONE; 2019. p. 14.
38.
go back to reference Cody B, Quraishi A, Dastur M, Mickalide A, Clear Danger. A National Study of Childhood drowning and related attitudes and behaviors. Washington, DC: National Safe Kids Campaign; 2004. Cody B, Quraishi A, Dastur M, Mickalide A, Clear Danger. A National Study of Childhood drowning and related attitudes and behaviors. Washington, DC: National Safe Kids Campaign; 2004.
39.
go back to reference Quan L, Pilkey D, Gomez A, Bennett E. Analysis of paediatric drowning deaths in Washington State using the child death review (CDR) for surveillance: what CDR does and does not tell us about lethal drowning injury. Inj Prev. 2011;17(Suppl 1):i28–i33.CrossRefPubMed Quan L, Pilkey D, Gomez A, Bennett E. Analysis of paediatric drowning deaths in Washington State using the child death review (CDR) for surveillance: what CDR does and does not tell us about lethal drowning injury. Inj Prev. 2011;17(Suppl 1):i28–i33.CrossRefPubMed
40.
go back to reference Wang M et al. Social and environmental risk factors for the accidental drowning of children under five in China. 1553, 2020, BMC Public Health, Vol. 20. Wang M et al. Social and environmental risk factors for the accidental drowning of children under five in China. 1553, 2020, BMC Public Health, Vol. 20.
42.
go back to reference Megan C, Sandomierski. et. Al S.A.F.E.R. Near Water: An Intervention Targeting Parent Beliefs About Children’s Water Safety. 9, October 2019, J Pediatr Psychol, Vol. 44, pp. 1034–45.]. Megan C, Sandomierski. et. Al S.A.F.E.R. Near Water: An Intervention Targeting Parent Beliefs About Children’s Water Safety. 9, October 2019, J Pediatr Psychol, Vol. 44, pp. 1034–45.].
43.
go back to reference Parker HE, Blanksby BA. Starting age and aquatic skill learning in young children: mastery of prerequisite water confidence and basic aquatic locomotion skills. Aust J Sci Med Sport. 1997;29(3):83–7.PubMed Parker HE, Blanksby BA. Starting age and aquatic skill learning in young children: mastery of prerequisite water confidence and basic aquatic locomotion skills. Aust J Sci Med Sport. 1997;29(3):83–7.PubMed
44.
go back to reference Brenner RA, Taneja GS, Haynie DL, et al. Association between swimming lessons and drowning in childhood: a case-control study. Arch Pediatr Adolesc Med. 2009;163(3):203–10.CrossRefPubMedPubMedCentral Brenner RA, Taneja GS, Haynie DL, et al. Association between swimming lessons and drowning in childhood: a case-control study. Arch Pediatr Adolesc Med. 2009;163(3):203–10.CrossRefPubMedPubMedCentral
Metadata
Title
Epidemiology, clinical aspects, and management of pediatric drowning
Authors
Francesco Pellegrino
Irene Raffaldi
Roberta Rossi
Barbara De Vito
Manuela Pagano
Davide Garelli
Claudia Bondone
Publication date
01-12-2023
Publisher
BioMed Central
Published in
Italian Journal of Pediatrics / Issue 1/2023
Electronic ISSN: 1824-7288
DOI
https://doi.org/10.1186/s13052-023-01464-1

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