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Online ISSN 1827-1596
Barbieri S. 1, Feltracco P. 1, Delantone M. 2, Spagna A. 1, Michieletto E. 1, Bortolato A. 1, Ori C. 1
1 Department of Pharmacology and Anesthesiology, University Hospital of Padua, Padua, Italy;
2 Department of Emergency, Emergency Medical Service 118 of Mestre, Venice, Italy
Background. Drowning is the second leading cause of unintentional injury-related death in children <14 years of age and is one of the most important causes of accidental injury between the ages of 1 and 4 years. In this study, the characteristics of non-fatal unintentional drownings in a small series of pediatric victims were examined.
Methods. We retrospectively analyzed data collected by the rescue team from May to October in two consecutive years (2006, 2007).
Results. Nine accidents occurred in public waters, while 5 occurred in lakes and rivers. The submersion time reported ranged from approximately 5 to 15 min. The ground emergency service with basic life support rescue experts intervened within a mean of 12 min. Advanced cardiac life support maneuvers were implemented by the helicopter medical crew for all victims. Ten of the 14 children remained in cardiocirculatory arrest despite cardiopulmonary resuscitation (CPR). The Glasgow Coma Scale (GCS) was <8 in all cases. Field resuscitation ultimately proved successful for every child. Thus, none was transported by the helicopter with ongoing CPR. All submersion-injured children survived. No postanoxic cerebral injury or major neurological complications were detected.
Conclusion. Assuring safe tracheal ventilation, achieving intravenous access, and stabilizing both respiratory and hemodynamic disturbances on the ground before transferring the patient are the keys to out-of-hospital management. Our 100% survival rate likely results from adequate primary out of-hospital care. Promptly dispatching a helicopter with a specialized medical crew is very expensive, but is worth the cost because it offers a better chance of survival.