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Berger S, Siekmeyer M, Petzold-Quinque S, Kiess W, Merkenschlager A. Drowning and Nonfatal Drowning in Children and Adolescents: A Subsequent Retrospective Data Analysis. CHILDREN (BASEL, SWITZERLAND) 2024; 11:439. [PMID: 38671656 PMCID: PMC11049416 DOI: 10.3390/children11040439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 03/28/2024] [Accepted: 04/04/2024] [Indexed: 04/28/2024]
Abstract
Fatal and nonfatal drowning are among the leading causes of death and lifelong severe neurological impairment among children and adolescents. This study aimed to complement research from Leipzig 1994-2008 to seek trends within risk factors, treatments, and outcomes throughout the last decade. We retrospectively investigated data of 47 inpatients aged 0-18 admitted to Leipzig University Department of Pediatrics who matched ICD-10 code T75.1 from 2008 to 2020 and compared them to a preceding study at the same institution. We also examined the prognostic value of parameters regarding the patients' outcomes. There were three median incidents per annum. The median age was 2.75 years; 76% of incidents happened in males. An accumulation was seen during the summer months and weekends. Most drowning incidents occurred in private ponds or pools (48.9%). Thirty-nine children were discharged without resulting morbidity, four showed neurological impairment, and three died. Risk factors concerning age, sex, and incident characteristics were confirmed. Special supervision needs still apply to 1-3-year-old male children or children with pre-existing health conditions around private pools and ponds. Hospitalization duration shortened, and morbidity and lethality decreased since the previous study. There was structural improvement in primary care and medical documentation. Parameters suggesting good outcomes include a submersion time < 5 min, GCS > 3 points, spontaneous movement upon admission, remaining pupillary light response, the absence of cardiovascular arrest, body temperature ≥ 32 °C, pH > 7, blood glucose < 15 mmol/L, lactate < 14 mmol/L, base excess ≥ -15 mmol/L, and the absence of ARDS. Clear legislation can contribute to improved private home water safety. Further studies should include a broad in- and outpatient spectrum and standardized incident documentation presupposing Utstein-style reporting. Regular reinvestigation of consistent geographical regions facilitates process evaluations of drowning epidemiology and therapy evolution.
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Affiliation(s)
- Sebastian Berger
- Department of Women and Child Health, Hospital for Children and Adolescents, Division of Neuropediatrics, University of Leipzig, Liebigstraße 20a, 04103 Leipzig, Germany;
| | - Manuela Siekmeyer
- Department of Women and Child Health, Hospital for Children and Adolescents, Pediatric Intensive Care Unit, University of Leipzig, Liebigstraße 20a, 04103 Leipzig, Germany
| | - Stefanie Petzold-Quinque
- Department of Women and Child Health, Hospital for Children and Adolescents, Pediatric Intensive Care Unit, University of Leipzig, Liebigstraße 20a, 04103 Leipzig, Germany
| | - Wieland Kiess
- Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research, University Hospital Leipzig, Liebigstraße 20a, 04103 Leipzig, Germany
| | - Andreas Merkenschlager
- Department of Women and Child Health, Hospital for Children and Adolescents, Division of Neuropediatrics, University of Leipzig, Liebigstraße 20a, 04103 Leipzig, Germany;
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Davis CA, Schmidt AC, Sempsrott JR, Hawkins SC, Arastu AS, Giesbrecht GG, Cushing TA. Wilderness Medical Society Clinical Practice Guidelines for the Treatment and Prevention of Drowning: 2024 Update. Wilderness Environ Med 2024; 35:94S-111S. [PMID: 38379489 DOI: 10.1177/10806032241227460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
The Wilderness Medical Society convened a panel to review available evidence supporting practices for acute management of drowning in out-of-hospital and emergency care settings. Literature about definitions and terminology, epidemiology, rescue, resuscitation, acute clinical management, disposition, and drowning prevention was reviewed. The panel graded available evidence supporting practices according to the American College of Chest Physicians criteria and then made recommendations based on that evidence. Recommendations were based on the panel's collective clinical experience and judgment when published evidence was lacking. This is the second update to the original practice guidelines published in 2016 and updated in 2019.
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Affiliation(s)
- Christopher A Davis
- Department of Emergency Medicine, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Andrew C Schmidt
- Department of Emergency Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, FL
| | | | - Seth C Hawkins
- Department of Emergency Medicine, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Ali S Arastu
- Division of Pediatric Critical Care, Stanford University School of Medicine, Palo Alto, CA
| | - Gordon G Giesbrecht
- Laboratory for Exercise and Environmental Medicine, Faculty of Kinesiology and Recreation, University of Manitoba, Winnipeg, Manitoba, Canada
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Peixoto-Pino L, Barcala-Furelos R, Paz-García B, Varela-Casal C, Lorenzo-Martínez M, Gómez-Silva A, Rico-Díaz J, Rodríguez-Núñez A. The "DrownSafe" Project: Assessing the Feasibility of a Puppet Show in Teaching Drowning Prevention to Children and Parents. CHILDREN (BASEL, SWITZERLAND) 2023; 11:19. [PMID: 38255332 PMCID: PMC10814459 DOI: 10.3390/children11010019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 12/14/2023] [Accepted: 12/20/2023] [Indexed: 01/24/2024]
Abstract
Drowning remains a prominent global pediatric health concern, necessitating preventive measures such as educational initiatives for children and caregivers. In this study, we aimed to assess the feasibility and educational effectiveness of an interactive puppet show centered on teaching water safety to children and parents. A 30 min original theater performance, featuring two actors and three puppets (a girl, a crab, and a lifeguard), was conducted. Subsequently, 185 children (aged 4 to 8) and their 160 parents (134 mothers and 26 fathers) participated in this quasi-experimental study. Pre- and post-show tests were administered to evaluate knowledge and behaviors regarding aquatic environments. Prior to the puppet show, 78% of the children exhibited basic aquatic competency. Only 33% considered swimming alone risky. Following the intervention, 81.6% of the children changed their perception of the risks of solo beach activities, showing improved knowledge regarding contacting an emergency number (from 63.2% to 98.9%, p < 0.001). The intervention increased parents' intention to visit lifeguard-patrolled beaches and improved their CPR knowledge with regard to drowning victims by 58.8%. In conclusion, a drowning prevention puppet show positively impacted children and parents, potentially enhancing safety behaviors during water-related leisure activities, warranting its consideration part of comprehensive drowning prevention strategies.
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Affiliation(s)
- Lucía Peixoto-Pino
- Facultade de Ciencias da Educación, Universidade de Santiago de Compostela, 15706 A Coruña, Spain; (L.P.-P.); (J.R.-D.)
- CLINURSID Research Group, Psychiatry, Radiology, Public Health, Nursing and Medicine Department, Universidade de Santiago de Compostela, 15706 A Coruña, Spain;
| | - Roberto Barcala-Furelos
- REMOSS Research Group, Facultade de Ciencias da Educación e do Deporte, Universidade de Vigo, 36005 Pontevedra, Spain; (B.P.-G.); (C.V.-C.); (M.L.-M.); (A.G.-S.)
| | - Begoña Paz-García
- REMOSS Research Group, Facultade de Ciencias da Educación e do Deporte, Universidade de Vigo, 36005 Pontevedra, Spain; (B.P.-G.); (C.V.-C.); (M.L.-M.); (A.G.-S.)
| | - Cristina Varela-Casal
- REMOSS Research Group, Facultade de Ciencias da Educación e do Deporte, Universidade de Vigo, 36005 Pontevedra, Spain; (B.P.-G.); (C.V.-C.); (M.L.-M.); (A.G.-S.)
| | - Miguel Lorenzo-Martínez
- REMOSS Research Group, Facultade de Ciencias da Educación e do Deporte, Universidade de Vigo, 36005 Pontevedra, Spain; (B.P.-G.); (C.V.-C.); (M.L.-M.); (A.G.-S.)
| | - Adrián Gómez-Silva
- REMOSS Research Group, Facultade de Ciencias da Educación e do Deporte, Universidade de Vigo, 36005 Pontevedra, Spain; (B.P.-G.); (C.V.-C.); (M.L.-M.); (A.G.-S.)
| | - Javier Rico-Díaz
- Facultade de Ciencias da Educación, Universidade de Santiago de Compostela, 15706 A Coruña, Spain; (L.P.-P.); (J.R.-D.)
- ESCULCA Knowledge and Educational Action Research Group, Universidade de Santiago de Compostela, 15706 A Coruña, Spain
| | - Antonio Rodríguez-Núñez
- CLINURSID Research Group, Psychiatry, Radiology, Public Health, Nursing and Medicine Department, Universidade de Santiago de Compostela, 15706 A Coruña, Spain;
- Faculty of Nursing, Universidade de Santiago de Compostela, 15782 A Coruña, Spain
- Paediatric Critical, Intermediate and Palliative Care Section, Hospital Clínico Universitario de Santiago de Compostela, 15706 A Coruña, Spain
- Collaborative Research Network Orientated to Health Results (RICORS): Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Developmental Origin, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Simulation and Intensive Care Unit of Santiago (SICRUS) Research Group, Health Research Institute of Santiago, University Hospital of Santiago de Compostela (CHUS), 15706 A Coruña, Spain
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Koon W, Peden AE, Brander RW. Impact of a surfer rescue training program in Australia and New Zealand: a mixed methods evaluation. BMC Public Health 2023; 23:2193. [PMID: 37940894 PMCID: PMC10631059 DOI: 10.1186/s12889-023-17057-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 10/24/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Surfers play a critical role in coastal drowning prevention, conservatively estimated to make as many rescues as beach lifeguards. The Surfer Rescue 24/7 (SR24/7) program is a coastal safety intervention in Australia and New Zealand that teaches surfers safe rescue skills and promotes prevention activities. This multi-part, mixed-methods study aimed to evaluate the impact of the SR24/7 program. METHODS The study consisted of three parts employing quantitative and qualitative methods: a retrospective survey of course participants, in-depth interviews with course participants who had conducted rescues, and an analysis of self-reported skills confidence ratings before and after the program. RESULTS Triangulated results from the three study components indicated that after the course, participants exhibited high levels of satisfaction with their experience in the program and would encourage others to attend, were more observant and aware of safety concerns while surfing, had a better understanding of ocean conditions and hazards, learned new rescue techniques and skills, grasped important course concepts related to their own personal safety, and improved their confidence in responding to an emergency situation. Several participants had conducted rescues in real life and indicated that the course was effective in providing them with the baseline knowledge and skills to keep safe while helping others in the ocean. This study also provides new insight on the role of surfers in coastal safety, specifically that surfers are engaged in a range of prevention activities before rescue is required. CONCLUSIONS Despite persistent challenges in combating coastal drowning rates, the SR24/7 program is an effective intervention that helps save lives. Importantly, this study provides evidence that the course successfully equips surfers with techniques to act responsibly and safely. Expanding coastal safety focus and resources towards surfers, an often-overlooked demographic in beach safety strategies, could substantially enhance community-level capacity to prevent and respond to ocean emergencies.
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Affiliation(s)
- William Koon
- School of Biological Earth and Environmental Sciences, University of New South Wales, Kensington NSW 2052, Sydney, NSW, Australia.
- Beach Safety Research Group, University of New South Wales, Sydney, NSW, Australia.
| | - Amy E Peden
- Beach Safety Research Group, University of New South Wales, Sydney, NSW, Australia
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
| | - Robert W Brander
- School of Biological Earth and Environmental Sciences, University of New South Wales, Kensington NSW 2052, Sydney, NSW, Australia
- Beach Safety Research Group, University of New South Wales, Sydney, NSW, Australia
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De Oliveira J, Lorenzo-Martínez M, Barcala-Furelos R, Queiroga AC, Alonso-Calvete A. Surfers as aquatics rescuers in Portugal and Spain: Characteristics of rescues and resuscitation knowledge. Heliyon 2023; 9:e16032. [PMID: 37234673 PMCID: PMC10205585 DOI: 10.1016/j.heliyon.2023.e16032] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/02/2023] [Accepted: 05/03/2023] [Indexed: 05/28/2023] Open
Abstract
The aim of this study was to analyze the rescues carried out by surfers from Portugal and Spain, their knowledge of rescue and resuscitation and their perception and risk behavior while surfing. An online survey was conducted in 2048 surfers from Portugal and Spain, with questions regarding the demographic characteristics, experience, perception and risk behavior of the surfers; rescues attended by the surfers and surfer's knowledge and experience in rescue and resuscitation. Concerning the number of rescues carried out by surfers, 78.5% of the participants had to carry out at least one rescue in their lifetime. A significant association was found between the years of surfing experience, the surfing level and the number of rescues carried out (p < 0.05). Thirty-five-point eight percent of the surfers never attended a cardiopulmonary resuscitation (CPR) course and 76.2% had no work experience as a lifeguard. Correspondingly, the vast majority of the surfers analyzed did not have the essential knowledge about rescue and resuscitation. This study provides evidence of the important role that surfers play in saving lives on Portuguese and Spanish beaches. The results suggest that the number of rescues conducted by surfers each year in Portugal and Spain is relevant to reducing the number of fatalities that occur along coasts.
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Affiliation(s)
- Joel De Oliveira
- REMOSS Research Group, Facultade de Ciencias da Educación e do Deporte, Universidade de Vigo, Spain
- Escola Superior De Educação Do Instituto Politécnico Do Porto, Porto, Portugal
| | - Miguel Lorenzo-Martínez
- REMOSS Research Group, Facultade de Ciencias da Educación e do Deporte, Universidade de Vigo, Spain
| | - Roberto Barcala-Furelos
- REMOSS Research Group, Facultade de Ciencias da Educación e do Deporte, Universidade de Vigo, Spain
| | - Ana Catarina Queiroga
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - Alejandra Alonso-Calvete
- REMOSS Research Group, Facultade de Ciencias da Educación e do Deporte, Universidade de Vigo, Spain
- Facultade de Fisioterapia, Universidade de Vigo, Campus A Xunqueira s/n, 36005, Pontevedra, Spain
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Affiliation(s)
- Deborah C Girasek
- From the Uniformed Services University of the Health Sciences, Bethesda, MD (D.C.G.); and the Medical College of Wisconsin, Milwaukee (S.H.)
| | - Stephen Hargarten
- From the Uniformed Services University of the Health Sciences, Bethesda, MD (D.C.G.); and the Medical College of Wisconsin, Milwaukee (S.H.)
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Velasco B, Galanis DJ, Bronstein AC, Downs M. Public rescue tube deployment in Hawaii: protective association with rescuer drownings. Inj Prev 2022; 28:330-334. [DOI: 10.1136/injuryprev-2021-044467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 01/10/2022] [Indexed: 11/05/2022]
Abstract
ObjectiveTo describe the association between public rescue tube (PRT) flotation devices and fatal rescuer drownings in Kauai, Hawaii.MethodsWe reviewed Hawaii death certificate data from 1993 to 2017, sometimes supplemented with autopsy and emergency medical service reports, to identify fatal rescuer drownings. Incidents were analysed in relation to the initial 2008 deployment of PRT.ResultsOver the 25-year period, only 13% (228) of the 1750 identified drownings occurred in Kauai, but nearly half (46%, or 13) of the 28 rescuer deaths occurred there. However, only 1 of the 13 rescuer deaths in Kauai occurred after the 2008 deployment of PRT. The state-wide proportion of rescuer deaths in Kauai decreased significantly from 60% (12 of 20) from 1993 to 2007 to 13% (1 of 8) from 2008 to 2017. There were no apparent changes in the proportions of rescuer drownings in the other three counties of the state, where PRTs were essentially non-existent.ConclusionDespite valid concerns, we found no fatal rescuer drownings related to PRT use after their 2008 introduction in the county of Kauai. Instead, we observed a reduction in the number of rescuer drownings, and in their proportion of total drownings in association with the deployment of PRT. The findings of this study have the potential to directly impact ocean and other open water environment-related fatal drowning prevention policy and practice.
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Queiroga AC, Szpilman D, Sempsrott J. Management of a Drowned Person After Low-Voltage Electrocution While Attempting a Rescue on a River. Am Surg 2021; 88:317-318. [PMID: 33847175 DOI: 10.1177/00031348211011147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Ana Catarina Queiroga
- IDRA - International Drowning Researchers Alliance, Kuna, ID, USA.,EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
| | - David Szpilman
- IDRA - International Drowning Researchers Alliance, Kuna, ID, USA.,Sociedade Brasileira de Salvamento Aquático - SOBRASA, Rio de Janeiro, Brazil
| | - Justin Sempsrott
- IDRA - International Drowning Researchers Alliance, Kuna, ID, USA
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