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Table 4 Neurological outcome of children with an initial GCS < 8

From: Retrospective evaluation of prehospital triage, presentation, interventions and outcome in paediatric drowning managed by a physician staffed helicopter emergency medical service

Age Asystole first reported rhythm Initial GCS Cardiac output on ED arrival Outcome PCPC score Outcome Comments
5.3 Y 3 N Died ED 6  
1.1 Y 3 N Died ED 6  
1.5 Y 3 N Died ED 6  
3.5 Y 3 N Died ED 6  
2.0 Y 3 N Died ED 6  
2.5 Y 3 N Died day 4 6 MRI- multiple areas of infarction involving brain stem, deep nuclei and cortex
2.8 Y 3 Y Died day 2 6 Bradycardic on ED arrival, MRI- diffusely swollen brain, transtentorial and foramen magnum herniation, no arterial or venous flow
6.4 Y 3 Y Died day 2 6 MRI extensive cerebral and cerebellar oedema with BG and brainstem involvement. Tonsillar herniation. No flow on MRA
7.7 Y 3 Y Died day 2 6 CT complete loss grey- white matter differentiation, herniation of cerebellar tonsils
1.2 Y 3 Y Died day 9 6 MR bilateral globus pallidus, hippocampal and bilateral cortical areas of ischaemic injury. No purposeful movements, occasional breaths, intensive care withdrawn.
3.5 Y 3 Y Died 17 months 6 At 3 months - severe spastic quadriplegia with bulbar palsy, incomprehensible sounds. Died at 17 months
1.3 Y 3 Y Neurological impairment 4 At 6 months - significant dystonia, trunk hypotonia, epilepsy
1.0 Y 3 Y Normal 1 CT - early cerebral oedema, MRI no diffusion restriction. Early seizures on PICU. At 18 months -normal neurological and developmental exam
1.7 N 3 Y Neurological impairment 3 Pre accident diagnosed Aspergers and ADHD. At 1 month – right sided weakness, loss of language. At 3 ½ years - distractible, special help at school
2.2 N 5 Y Normal 1 At 12 months -ahead in development
2.8 N 5 Y Normal 1 At 11 months -Normal function
1.2 N 5 Y Normal 1 Tonic clonic seizures in PICU. At 1 yr 5 months development normal.
2.1 N 6 Y Normal 1 No neurological deficit at discharge
3.9 N 6 Y Normal 1 At 7 months normal behavior and skills
9.9 N 6 Y Baseline*   *Had seizure disorder, autism, ADHD, moderate –severe disability before accident. Returned to baseline state.
1.3 N 7 Y Neurological impairment 3 At 2 yrs - behaviour problems, aggression, repetitive movements/routines
1.9 N 7 Y Normal 1 No neurological deficit at discharge
  1. *Patient not neurologically normal at follow up but had returned to pre-incident baseline