From: Review of 14 drowning publications based on the Utstein style for drowning
USFD parameters (Core/Supplemental) | Total use (n) | Overall conclusions |
---|---|---|
Victim Information | ||
Victim identifier (Core) | 6 | Not related to a conclusion |
Gender (Core) | 14 | Most drowning victims are male (57–100%) in 12 publications [3,4,5,6, 8,9,10,11,12,13, 15, 16]. In one publication 35% of the victims are male [7]. In one publication the distribution is unclear due to a contradiction in the reporting of this parameter [14]. |
Precipitating event (Core) | 10 | The most frequently reported precipitating events are motor vehicle or boating accidents, and swimming [6, 8, 12,13,14]. |
Pre-existing illness (Supplemental) | 5 | Pre-existing illness is either not reported or not linked to outcome in any of the publications [3, 5, 6, 8, 12]. |
Scene information | ||
Body of water (Core) | 13 | Drowning occurs mostly (66–100%) in natural bodies of water such as rivers, lakes and canals in eight publications [3, 5,6,7,8, 10, 12,13,14, 16]. Two publications report that drowning occur predominantly (52 and 95%) in private or public pools [9, 15]. Another publication has only included drowning in swimming pools [11]. |
Water/liquid type (Supplemental) | 11 | Seven publications predominantly (84–100%) report fresh water drownings [3, 5,6,7,8, 10, 16]. In one publication drowning in roadside ditches, canals and retention ponds are reported as the predominant water sources, however salinity was not determined [12]. In one publication all drownings occurred in salt water [14]. In the two publications where most drownings occurred in pools, the salinity of these pools was not specified [9, 15]. |
Unconscious when removed from water (Core) | 8 | Four publications report that 83–100% of the victims were unconscious when removed from the water [3, 5, 9, 16]. In two publications a minority were unconscious [6, 13]. Two publications show an equal distribution [12, 14]. |
Method of CPR (Supplemental) | 6 | One publication only reported that the victims were resuscitated according to guidelines [16]. Five publications described in more detail how resuscitation was performed, based on which it seems that international guidelines were followed [4,5,6, 11, 14]. One of these publications reported that in 10% resuscitation was not performed according to guidelines (tapping on back, rubbing abdomen, pressing water out of lungs etc.) [6]. Another one of these publications described the use of abdominal trusts in and outside the water [11]. |
EMS called (Core) | 11 | Calling the EMS is directly or indirectly reported in 11 publications but as such provides no relevant information. |
EMS vehicle dispatched (Supplemental) | 10 | Dispatch of the EMS is directly or indirectly reported in ten publications but as such provides no relevant information. |
Initial vital signs (Core) | 5 | Two publications directly or indirectly reported that all victims were in cardiac arrest [3, 16]. One publication reported that all victims had a Glasgow Coma Scale of 3 [5]. One publication reported that 53% of the victims were in cardiac arrest [14]. One publication described that the information was available in 0.3% of the victims but made no further specifications [6]. |
Neurological status (Core) | 5 | Two publications reported that all victims had a Glasgow Coma Scale of 3 [3, 5]. One of these publications also reported fixed dilated pupils for all patients [3]. One publication reported that 16% of the victims were unconscious and 84% were conscious [6]. One publication reported that four patients (50%) were comatose of which two had fixed dilated pupils with diffuse flaccid paralysis. This same publication also reported a mean initial Glasgow Coma Scale of 10.4 [12]. In one publication this information was indirectly available because all were in cardiac arrest [16]. |
Hospital Course | ||
Airway and ventilation requirements (Core) | 7 | All seven publications that reported this parameter only globally described it, which provided no real relevant information [3, 7, 8, 12, 14,15,16]. |
Complicating illnesses (Supplemental) | 6 | Six publications report complicating illnesses such as pneumonia, acute respiratory distress syndrome, pancreatitis, rhabdomyolysis, disseminated intravascular coagulation acute renal failure, multiple organ failure and septic shock [3, 5, 7, 9, 12, 16]. In one of these publications extubation stridor, minor neurologic deficits and corneal ulceration are reported which all are resolved at the time of discharge [9]. |
Disposition | ||
Alive or dead (Core) | 14 | Survival is good (16–93%) in most studies [3,4,5,6,7,8,9,10,11,12, 14, 15]. In one study only 5% of the victims survived [16]. One publication only reports non-fatal drowning [13]. |
Neurological outcome at hospital discharge (Core) | 10 | In four publications 7–20% had a (Paediatric) Cerebral Performance Scale/Category (P)CPC score of one to two [3, 5, 7, 8]. In one publication 85% of the patients had a CPC score of one to two [4]. In one publication 84% of the patients do not have any neurological complications, while 5.3% have irreversible neurological sequellae [9]. In one publication 11% of the patients have a (P)CPC score of three or less 1 year after the drowning incident [10]. In one publication hypoxic encephalopathy is reported in one victim (13%) [12]. One publication described a median Functional Independence Measure of 115 (range 51–121) and a median extended Glasgow Coma Scale score of 4 (range 3–7) after 6 months [14]. In one publication two victims (5%) survived to hospital discharge of which one had a CPC score (at discharge and at 6 months later) of one and one had a CPC score of three [16]. |
Cause of death (Supplemental) | 5 | Five publications described causes of death such as multi organ failure, septic shock, cardiac arrest, respiratoy failure, severe brain injury and brain death [3, 7, 10, 12, 16]. |