Near Drowning
John G. Brooks MD1
1 Professor of Pediatrics, Department of Pediatrics, The University of Rochester School of Medicine, 601 Elmwood Ave, Rochester, NY 14642
Drowning is the third most common cause of death for children between the ages of 1 and 14 years. Despite increasing understanding of the pathophysiology of drowning and continuing advances in cardiopulmonary resuscitation and support, efforts at cerebral resuscitation have been less successful, and it is estimated that only about half of the children who are apparently lifeless when removed from the water will survive. Prevention, effective on-scene resuscitation, and optimal inpatient care are the keys to reducing the morbidity and mortality of submersion accidents.
EPIDEMIOLOGY
Approximately 8,000 deaths due to drowning occur each year in the United States, and approximately 40% of the victims are less than 4 years of age. Drowning is second only to motor vehicle accidents as a cause of accidental death in children. Within the pediatricage range there are three particularly high-risk groups: toddlers, teenage boys, and children with seizure disorders. Special efforts should be devoted to educating parents of these children and to the older children themselves regarding water safety and their own particular risks. Parents of ambulatory infants and young children must be reminded that continuous, responsible supervision is absolutely essential around water or when the young child might wander away to a nearby body of water.
