Descriptive analysis of triggers, outcomes and the response of the health systems of child drowning in Galicia (Spain). A 17-year retrospective study

e202206048

Authors

  • Patricia Sánchez-Lloria Servicio Médico de Emergencias, Fundación Pública Urxencias Sanitarias de Galicia 061, Cultura. A Estrada (Pontevedra). España. / Grupo de Investigación REMOSS, Facultad de Educación y Ciencias del Deporte, Universidad de Vigo. A Xunqueira (Pontevedra). España.
  • Roberto Barcala-Furelos Grupo de Investigación REMOSS, Facultad de Educación y Ciencias del Deporte, Universidad de Vigo. A Xunqueira (Pontevedra). España. / Grupo de Investigación CLINURSID, Escuela de Enfermería, Universidad de Santiago de Compostela. Santiago de Compostela. España.
  • Martín Otero-Agra Grupo de Investigación REMOSS, Facultad de Educación y Ciencias del Deporte, Universidad de Vigo. A Xunqueira (Pontevedra). España. / Escuela Universitaria de Enfermería de Pontevedra, Universidad de Vigo. Pontevedra. España.
  • Silvia Aranda-García Grupo de Investigación GRAFAIS, Institut Nacional d’Educació Física de Catalunya (INEFC), Universitat de Barcelona. Barcelona. España.
  • Óscar Cosido-Cobos Área de Ciencias de la Computación e Inteligencia Artificial, Departamento de Informática, Universidad de Oviedo. Oviedo. España.
  • Jorge Blanco-Prieto Área de Ciencias de la Computación e Inteligencia Artificial, Departamento de Informática, Universidad de Oviedo. Oviedo. España.
  • Ignacio Muñoz-Barús Departamento de Ciencias Forenses, Patología, Ginecología y Obstetricia, Pediatría; Universidad de Santiago de Compostela. Santiago de Compostela. España. / Instituto de Ciencias Forenses, Universidad de Santiago de Compostela. Santiago de Compostela. España.
  • Antonio Rodríguez-Núñez Grupo de Investigación CLINURSID, Escuela de Enfermería, Universidad de Santiago de Compostela. Santiago de Compostela. España. / Grupo de Investigación en Soporte Vital y Simulación Médica, Instituto de Investigaciones Sanitarias de Compostela (IDIS). Santiago de Compostela. España. / Unidad de Pediatría Crítica, Cuidados Intermedios y Paliativos, Hospital Universitario de Santiago de Compostela. Santiago de Compostela. España.

Keywords:

Drowning prevention, Fatal drowning, Child, Cardiopulmonary resuscitation, Bystander, Oxygen, Pneumonia

Abstract

BACKGROUND // Drowning is one of major public health problem in childhood. The aim of this paper was to describe the characteristics, locations, interventions and outcomes of child drowning in Galicia over 17 years.
METHODS // Retrospective study of 100% of data of drowning amongst children aged 0-14 in the 2004–2020 period who were attended by the 061 emergency services in Galicia (Spain) was made. The characteristics of the incident, the victim’s profile, location, type of medical care given and whether the victim survived or died were analysed using the Chi Square test to compare relative frequencies, and Odds Ratio to estimate the risk.
RESULTS // During the period under study, 100 child drownings were recorded. In 55%, the main cause was lack of supervision. Young children (aged 0-4) primarily drowned in pools, and pre-teens and teenagers (aged 10-14) in the sea. In 42% of the incidents, bystanders performed CPR (37% included ventilation). Emergency services took 12 minutes on average to arrive at the scene. 6% died in situ and of the rest, were taken to hospital and admitted in 47% PICU, 26% ward, 8% discharged from A&E (43% with pulmonary oedema, 41% with supplemental oxygen, 13% with IMV/NIMV [invasive mechanical ventilation/non-invasive]). Pneumonia was the most common complication and survival to discharge was 77%.
CONCLUSIONS // Small children usually drown in pools and water facilities because of lack of supervision, whereas adolescents usually drown in the sea. CPR started by bystanders and the fast response of emergency services contributed to a high rate of survival. A large amount of data was lost during the process: accurate, standardized coding of drowning is necessary.

Downloads

Download data is not yet available.

References

World Health Organization. Preventing drowning: an implementation guide [Internet]. Geneva: World Health Organization; 2017.

Wu Y, Huang Y, Schwebel DC, Hu G. Unintentional Child and Adolescent Drowning Mortality from 2000 to 2013 in 21 Countries: Analysis of the WHO Mortality Database. Int J Environ Res Public Health. 2017;14(8). https://doi.org/10.3390/ijerph14080875

World Health Organization. Global report on drowning: preventing a leading killer [Internet]. World Health Organization. 2014.

Abelairas-Gómez C, Tipton MJ, González-Salvado V, Bierens JJLM. Drowning epidemiology, prevention, pathophysiology, resuscitation, and hospital treatment. Emergencias. 2019;31:270-280.

Szpilman D, Bierens JJLM, Handley AJ, Orlowski JP. Drowning. N Engl J Med. 2012 May 31;366(22):2102-2110. https://doi.org/10.1056/NEJMra1013317

Schyllander J, Janson S, Nyberg C, Eriksson UB, Stark Ekman D. Case analyses of all children’s drowning deaths occurring in Sweden 1998-2007. Scand J Public Health. 2013 Mar;41(2):174-179. https://doi.org/10.1177/1403494812471156

Dirlik M, Bostancıoğlu B. Child drowning deaths in Aydin province, western Turkey, 2002-2012. Eur J Trauma Emerg Surg. 2015 Dec 1;41(6):683-688. https://doi.org/10.1007/s00068-015-0493-0

Yang L, Nong QQ, Li CL, Feng QM, Lo SK. Risk factors for childhood drowning in rural regions of a developing country: A case-control study. Inj Prev. 2007 Jun;13(3):178-182. https://doi.org/10.1136/ip.2006.013409

Ya F, Long D, Jaung MS, Xiaoxuan C, Songlin Y, Huiyun X. Child drowning deaths in Xiamen city and suburbs, People’s Republic of China, 2001-2005. Inj Prev. 2007 Oct;13(5):339-343. https://doi.org/10.1136/ip.2007.016683

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 Nov;83(11):853-856. https://doi.org//S0042-96862005001100015

Loux T, Mansuri F, Brooks SE, Slye N, Lewis B, Lu Y et al. Factors associated with pediatric drowning admissions and outcomes at a trauma center, 2010-2017. Am J Emerg Med. 2021 Jan;39:86-91.

Cohen N, Scolnik D, Rimon A, Balla U, Glatstein M. Childhood Drowning: Review of Patients Presenting to the Emergency Departments of 2 Large Tertiary Care Pediatric Hospitals Near and Distant From the Sea Coast. Pediatr Emerg Care. 2020 May;36(5):e258-262.

De Oliveira J, Piñeiro-Pereira L, Padrón-Cabo A, Alonso-Calvete A, García-Crespo O, Varela-Casal C et al. Percepciones, conocimientos y educación para la prevención del ahogamiento en adolescentes. Rev Esp Salud Publica. 2021, 95, 11 de noviembre: e202111148.

Denny SA, Quan L, Gilchrist J, McCallin T, Shenoi R, Yusuf S et al. Prevention of Drowning. Pediatrics. 2019;143(5). https://doi.org/10.1542/peds.2019-0850

Raess L, Darms A, Meyer-Heim A. Drowning in Children: Retrospective Analysis of Incident Characteristics, Predicting Parameters, and Long-Term Outcome. Child (Basilea, Suiza). 2020 Jul;7(7).

Rahman F, Bose S, Linnan M, Rahman A, Mashreky S, Haaland B et al. Cost-effectiveness of an injury and drowning prevention program in Bangladesh. Pediatrics. 2012 Dec;130(6):e1621-8. https://doi.org/10.1542/peds.2012-0757

Barcala-Furelos R, Carbia-Rodríguez P, Peixoto-Pino L, Abelairas-Gómez C, Rodríguez-Núñez A. Implantación de programas educativos para prevenir ahogamientos. ¿Qué se puede hacer desde la escuela infantil? Med Intensiva. 2019 Apr;43(3):180-182. https://doi.org/10.1016/j.medin.2017.08.005

Gaida FJ, Gaida JE. Infant and toddler drowning in Australia: Patterns, risk factors and prevention recommendations. J Paediatr Child Health. 2016 Oct;52(10):923-927. https://doi.org/10.1111/jpc.13325

Szpilman D, Webber J, Quan L, Bierens J, Morizot-Leite L, Langendorfer SJ et al. Creating a drowning chain of survival. Resuscitation. 2014. Sep;85(9):1149-1152. https://doi.org/10.1016/j.resuscitation.2014.05.034

Rubio B, Yagüe F, Benítez MT, Esparza MJ, González JC, Sánchez F et al. Recomendaciones sobre la prevención de ahogamientos. An Pediatría. 2015 Jan;82(1):43.e1-43.e5. https://doi.org/10.1016/j.anpedi.2014.06.010

Petrass LA, Blitvich JD. A Lack of Aquatic Rescue Competency: A Drowning Risk Factor for Young Adults Involved in Aquatic Emergencies. J Community Health. 2018;43(4):688-693. https://doi.org/10.1007/s10900-018-0472-6

Szpilman D, Tipton M, Sempsrott J, Webber J, Bierens J, Dawes P et al. Drowning timeline: a new systematic model of the drowning process. Am J Emerg Med. 2016 Nov;34(11):2224-2226. https://doi.org/10.1016/j.ajem.2016.07.063

Lawes JC, Rijksen EJT, Brander RW, Franklin RC, Daw S. Dying to help: Fatal bystander rescues in Australian coastal environments. PLoS One. 2020 Sep 1;15(9). https://doi.org/10.1371/JOURNAL.PONE.0238317

McCarroll RJ, Brander RW, MacMahan JH, Turner IL, Reniers AJHM, Brown JA et al. Evaluation of swimmer-based rip current escape strategies. Nat Hazards. 2014 Apr 25;71(3):1821-1846. https://doi.org/10.1007/s11069-013-0979-1

Quan L, Bierens JJLMLM, Lis R, Rowhani-Rahbar A, Morley P, Perkins GD. Predicting outcome of drowning at the scene: A systematic review and meta-analyses. Resuscitation. 2016;104:63-75. https://doi.org/10.1016/j.resuscitation.2016.04.006

Gräsner J-T, Wnent J, Herlitz J, Perkins GD, Lefering R, Tjelmeland I et al. Survival after out-of-hospital cardiac arrest in Europe-Results of the EuReCa TWO study. Resuscitation. 2020 Mar;148:218-226.

Bierens J, Abelairas-Gomez C, Barcala Furelos R, Beerman S, Claesson A, Dunne C et al. Resuscitation and emergency care in drowning: A scoping review. Resuscitation. 2021 May 4;162:205-217. https://doi.org/10.1016/j.resuscitation.2021.01.033

Idris AH, Bierens JJLM, Perkins GD, Wenzel V, Nadkarni V, Morley P et al. 2015 revised Utstein-style recommended guidelines for uniform reporting of data from drowning-related resuscitation: An ILCOR advisory statement. Resuscitation. 2017 Sep 1;118:147-158. https://doi.org/10.1016/J.RESUSCITATION.2017.05.028

Davey M, Callinan S, Nertney L. Identifying Risk Factors Associated with Fatal Drowning Accidents in the Paediatric Population: A Review of International Evidence. Cureus. 2019 Nov 19;11(11). https://doi.org/10.7759/cureus.6201

Peden AE, Willcox-Pidgeon S. Autism spectrum disorder and unintentional fatal drowning of children and adolescents in Australia: an epidemiological analysis. Arch Dis Child. 2020;105(9):869-874. https://doi.org/10.1136/archdischild-2019-318658

Guan J, Li G. Injury Mortality in Individuals With Autism. Am J Public Health. 2017;107(5):791–3. https://doi.org/10.2105/AJPH.2017.303696

Franklin RC, Pearn JH, Peden AE. Drowning fatalities in childhood: the role of pre-existing medical conditions. Arch Dis Child. 2017;102(10):888-893. https://doi.org/10.1136/archdischild-2017-312684

Aagaard SK, Dreier JW, Sun Y, Laursen TM, Christensen J. Accidental deaths in young people with epilepsy and psychiatric comorbidity-A Danish nationwide cohort study. Epilepsia. 2020;61(3):479-488. https://doi.org/10.1111/epi.16453

Diekema DS, Quan L, Holt VL. Epilepsy as a risk factor for submersion injury in children. Pediatrics. 1993 Mar;91(3):612-616.

Kemp AM, Sibert JR. Epilepsy in children and the risk of drowning. Arch Dis Child. 1993 May;68(5):684-685. https://doi.org/10.1136/adc.68.5.684

Bradley T, Dixon J, Easthope R. Unexplained fainting, near drowning and unusual seizures in childhood: screening for long QT syndrome in New Zealand families. N Z Med J. 1999 Aug 13;112(1093):299-302.

Choi G, Kopplin LJ, Tester DJ, Will ML, Haglund CM, Ackerman MJ. Spectrum and frequency of cardiac channel defects in swimming-triggered arrhythmia syndromes. Circulation. 2004 Oct 12;110(15):2119-2124. https://doi.org/10.1161/01.CIR.0000144471.98080.CA

Kieboom JK, Verkade HJ, Burgerhof JG, Bierens JJ, Rheenen PF van, Kneyber MC et al. Outcome after resuscitation beyond 30 minutes in drowned children with cardiac arrest and hypothermia: Dutch nationwide retrospective cohort study. BMJ. 2015 Feb;350:h418.

Suominen PK, Vähätalo R. Neurologic long term outcome after drowning in children. Scand J Trauma Resusc Emerg Med. 2012 Aug 15;20:55. https://doi.org/10.1186/1757-7241-20-55

Published

2022-06-22

How to Cite

1.
Sánchez-Lloria P, Barcala-Furelos R, Otero-Agra M, Aranda-García S, Cosido-Cobos Óscar, Blanco-Prieto J, et al. Descriptive analysis of triggers, outcomes and the response of the health systems of child drowning in Galicia (Spain). A 17-year retrospective study: e202206048. Rev Esp Salud Pública [Internet]. 2022 Jun. 22 [cited 2024 Sep. 27];96:15 páginas. Available from: https://ojs.sanidad.gob.es/index.php/resp/article/view/299

Issue

Section

Originales

Categories

Most read articles by the same author(s)