Near Drowning in Pedriatric Department, Surin Hospital in 2006-2008
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Abstract
Objective: To study characteristics, treatment and outcome of near-drowning patients in Pediatric ward, Surin Hospital
Research design: Retrospective descriptive study
Methods: Retrospective reviewed the chart and OPD card of 60 near-drowning patients admitted at Pediatric ward Surin Hospital during Jan. 1, 2006-Dec. 31, 2008
Results: There were 60 cases of near drowning, Male : female ratio was 1.4:1 The average age of admitted patients was 3 year 8 months ( ranged from 9 months to 14 year 8 months). Seventy percent of the patients were under 5 years of age. Seventy-one percent of the patients were left alone when near- drowning occurred. The sites of occurrence were around their houses in 85% of cases. Bystander resuscitation was documented in 40 %. Common complication were pneumonia (76%) seizure (58.3% ) and neurological sequelae (23.33%). Groups of patients with poor outcome were children without spontaneous purposeful movement within 24 hours after submersion (100%), comatose when arrived hospital (60%) and being classified in class 6 of ND/D classification by Szpilman (60%). Neurological sequelae was found in 60% of the patients Mortality rate was 45% (23 due to severe brain hypoxia 2 due to severe pneumonia from prolonged intubation and 2 due to ARDS)
Conclusion: The high incidence (60%) of poor outcome (death 45%, or neurological sequelae 15%) is observed in this study. Prevention of submersion injury is the most important and cost-effective measure. However, if near-drowning happens, effective immediate resuscitation is crucial for the best outcome.
Key words: Near drowning. ARDS
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References
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