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Berger S, Siekmeyer M, Petzold-Quinque S, Kiess W, Merkenschlager A. Drowning and Nonfatal Drowning in Children and Adolescents: A Subsequent Retrospective Data Analysis. CHILDREN (BASEL, SWITZERLAND) 2024; 11:439. [PMID: 38671656 PMCID: PMC11049416 DOI: 10.3390/children11040439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 03/28/2024] [Accepted: 04/04/2024] [Indexed: 04/28/2024]
Abstract
Fatal and nonfatal drowning are among the leading causes of death and lifelong severe neurological impairment among children and adolescents. This study aimed to complement research from Leipzig 1994-2008 to seek trends within risk factors, treatments, and outcomes throughout the last decade. We retrospectively investigated data of 47 inpatients aged 0-18 admitted to Leipzig University Department of Pediatrics who matched ICD-10 code T75.1 from 2008 to 2020 and compared them to a preceding study at the same institution. We also examined the prognostic value of parameters regarding the patients' outcomes. There were three median incidents per annum. The median age was 2.75 years; 76% of incidents happened in males. An accumulation was seen during the summer months and weekends. Most drowning incidents occurred in private ponds or pools (48.9%). Thirty-nine children were discharged without resulting morbidity, four showed neurological impairment, and three died. Risk factors concerning age, sex, and incident characteristics were confirmed. Special supervision needs still apply to 1-3-year-old male children or children with pre-existing health conditions around private pools and ponds. Hospitalization duration shortened, and morbidity and lethality decreased since the previous study. There was structural improvement in primary care and medical documentation. Parameters suggesting good outcomes include a submersion time < 5 min, GCS > 3 points, spontaneous movement upon admission, remaining pupillary light response, the absence of cardiovascular arrest, body temperature ≥ 32 °C, pH > 7, blood glucose < 15 mmol/L, lactate < 14 mmol/L, base excess ≥ -15 mmol/L, and the absence of ARDS. Clear legislation can contribute to improved private home water safety. Further studies should include a broad in- and outpatient spectrum and standardized incident documentation presupposing Utstein-style reporting. Regular reinvestigation of consistent geographical regions facilitates process evaluations of drowning epidemiology and therapy evolution.
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Affiliation(s)
- Sebastian Berger
- Department of Women and Child Health, Hospital for Children and Adolescents, Division of Neuropediatrics, University of Leipzig, Liebigstraße 20a, 04103 Leipzig, Germany;
| | - Manuela Siekmeyer
- Department of Women and Child Health, Hospital for Children and Adolescents, Pediatric Intensive Care Unit, University of Leipzig, Liebigstraße 20a, 04103 Leipzig, Germany
| | - Stefanie Petzold-Quinque
- Department of Women and Child Health, Hospital for Children and Adolescents, Pediatric Intensive Care Unit, University of Leipzig, Liebigstraße 20a, 04103 Leipzig, Germany
| | - Wieland Kiess
- Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research, University Hospital Leipzig, Liebigstraße 20a, 04103 Leipzig, Germany
| | - Andreas Merkenschlager
- Department of Women and Child Health, Hospital for Children and Adolescents, Division of Neuropediatrics, University of Leipzig, Liebigstraße 20a, 04103 Leipzig, Germany;
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Morgan ER, Sakamoto I, Ardelean A, Diaz-Rohena A, Falk A, Starnes C, Rivara FP, Vavilala M. Caregiver perspectives on a water safety toolkit for child supervision. Health Promot J Austr 2024; 35:345-354. [PMID: 37277112 DOI: 10.1002/hpja.757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/11/2023] [Accepted: 05/30/2023] [Indexed: 06/07/2023] Open
Abstract
ISSUE ADDRESSED Drowning is one of the leading causes of unintentional deaths among children and adolescents globally. Adult supervision is one method to decrease the risk of drowning among youth. METHODS We sought to assess the acceptability of a Water Watcher toolkit among children's caregivers. The toolkit consists of a badge-to designate the adult(s) responsible for supervision during water activities-and a smartphone application. When activated, the application blocks incoming calls, text messages and other applications, for example, mobile games and social media, as well as providing a button to quickly dial 911 and information for guided cardiopulmonary resuscitation. We conducted online and in-person semi-structured interviews of 16 adults residing in Washington State, United States and providing supervision to a child under 18 years of age for at least 20 h per week. Interview guides were developed based on the Health Belief Model and we performed content analysis on interview transcripts using an inductive approach. RESULTS When asked about Water Watcher tools, respondents generally reacted favourably towards the intervention, citing benefits of formally delegating a responsible party during group activities and elimination of distractions. Primary challenges to using the toolkit were social acceptability, competence with technology, and the independence of older children (i.e., those 13- to 17-years-old). CONCLUSIONS Caregivers recognized the importance of minimizing distractions, and many liked the strategy to formally designate responsibility for child supervision during aquatic recreation. SO WHAT?: Interventions such as the Water Watcher toolkit are generally considered acceptable and expanding access to these resources could reduce the burden of unintentional drownings.
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Affiliation(s)
- Erin R Morgan
- Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
- College of Medicine, Institute for Research and Education to Advance Community Health, Washington State University, Seattle, Washington, USA
| | | | - Alan Ardelean
- Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington, USA
- Department of Public Health, University of Rochester, Rochester, New York, USA
| | - Alejandra Diaz-Rohena
- Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington, USA
- College of Natural Sciences, University of Puerto Rico, Rio Piedras, Puerto Rico
| | - Allison Falk
- Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington, USA
- Department of Biological Sciences, University of Idaho, Moscow, Idaho, USA
| | - Cara Starnes
- Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington, USA
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Frederick P Rivara
- Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington, USA
- Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | - Monica Vavilala
- Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington, USA
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Affiliation(s)
- Deborah C Girasek
- From the Uniformed Services University of the Health Sciences, Bethesda, MD (D.C.G.); and the Medical College of Wisconsin, Milwaukee (S.H.)
| | - Stephen Hargarten
- From the Uniformed Services University of the Health Sciences, Bethesda, MD (D.C.G.); and the Medical College of Wisconsin, Milwaukee (S.H.)
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