Outcome in children who nearly drown: a British Isles study.

Abstract

Objective-To determine the outcome in nearly drowned children in the British Isles and identify factors that might predict a poor prognosis. Design Results-All of the children who were conscious on admission fully recovered. Of the 64 children unconscious on admission, 31 had normally reactive pupils and all but three (all of whom had severe preexisting neurological disease) recovered fully. Of the 33 children with fixed dilated pupils on admission, 10 fully recovered, 13 died, and 10 had severe neurological deficit. Spontaneous respiratory effect on admission was associated with normal survival. Pupils that remained dilated six hours after admission and fits continuing 24 hours after admission predicted a poor outcome.

Cardiopulmonary resuscitation of a near-drowned child with a combination of epinephrine and vasopressin

“…Whether CPR should be performed in these patients over a long period in time is the subject of an ongoing debate; some data suggest that the chance of survival with neurologic recovery is relatively high, especially in cases of submersion in cold water (17)(18)(19), whereas others argue that we should be not so aggressive (20). However, neurologic outcome in our case is not satisfying but may improve over time.…”

Neurodevelopmental outcome for extended cold water drowning: A longitudinal case study

“…Most available research focuses on gross neurologic outcome, as opposed to more subtle neuropsychological deficits. Pediatric victims are typically described as forming a bimodal distribution (e.g., severely impaired vs. seemingly spared; Kemp & Sibert, 1991;Pearn et al, 1979). Statistical probability would instead, however, suggest a bellcurve distribution, given the variety of individual differences and general applicability of normal distribution to a variety of mental and physical traits (Minium, 1978).…”

Reply letter: Rescue and resuscitation or body retrieval

“…One such example is the survival of a 7 month old after submersion for an estimated 60 minutes in a cold bath. 3 How cold cold is, is not defined and could plausibly include a water temperature above 6⁰C. Whilst the relationship between water temperature and duration of submersion is undoubtedly more complex than a linear relationship, linear regression analysis of the data in figure one of the paper provides 95% confidence intervals at a water temperature of 6⁰C that exceed 30 minutes submersion time.…”