Predictors of safe discharge for pediatric drowning patients in the emergency department

Brennan, Courtney; Hong, Travis K.F.; Wang, Vincent J.

doi:10.1016/j.ajem.2018.01.050

Cited by 19 publications

(24 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Five studies were identified for final data abstraction, 70,71,100–102 all of which were retrospective observational studies, including 1 with both derivation and validation arms. 102 Four studies were performed in the United States, 70,100–102 and 1 was performed in Israel. 71 In total, 834 patients were analyzed, all of whom were <18 years of age.…”

Section: Basic Life Supportmentioning

confidence: 99%

“…71,100–102 Three studies evaluated specific safe discharge times, specifically 6 hours 71,100 and 8 hours, 102 with the remaining studies solely comparing discharged patients to admitted patients. Additional objective factors that were analyzed were chest radiography (341 patients) 70,71,101 and arterial blood gas results (161 patients). 70,71…”

Section: Basic Life Supportmentioning

confidence: 99%

“…All studies correlated objective clinical findings to determine factors that could predict safe discharge early in the clinical phase. These factors include pulmonary examination (744 patients), 71,[100][101][102] oxygen saturation in air (834 patients), 70,71,[100][101][102] pulse rate (673 patients), [100][101][102] blood pressure (673 patients), [100][101][102] mental status (744 patients), 71,[100][101][102] need for airway support (535 patients), 70,102 and dyspnea (744 patients). 71,[100][101][102] Three studies evaluated specific safe discharge times, specifically 6 hours 71,100 and 8 hours, 102 with the remaining studies solely comparing discharged patients to admitted patients.…”

Section: Summary Of Evidencementioning

confidence: 99%

See 2 more Smart Citations

2021 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Neonatal Life Support; Education, Implementation, and Teams; First Aid Task Forces; and the COVID-19 Working Group

Wyckoff¹,

Singletary²,

Soar³

et al. 2022

Circulation

View full text Add to dashboard Cite

The International Liaison Committee on Resuscitation initiated a continuous review of new, peer-reviewed published cardiopulmonary resuscitation science. This is the fifth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations; a more comprehensive review was done in 2020. This latest summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscitation task force science experts. Topics covered by systematic reviews in this summary include resuscitation topics of video-based dispatch systems; head-up cardiopulmonary resuscitation; early coronary angiography after return of spontaneous circulation; cardiopulmonary resuscitation in the prone patient; cord management at birth for preterm and term infants; devices for administering positive-pressure ventilation at birth; family presence during neonatal resuscitation; self-directed, digitally based basic life support education and training in adults and children; coronavirus disease 2019 infection risk to rescuers from patients in cardiac arrest; and first aid topics, including cooling with water for thermal burns, oral rehydration for exertional dehydration, pediatric tourniquet use, and methods of tick removal. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, according to the Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations or good practice statements. Insights into the deliberations of the task forces are provided in Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces listed priority knowledge gaps for further research.

show abstract

Section: Basic Life Supportmentioning

confidence: 99%

Section: Basic Life Supportmentioning

confidence: 99%

Section: Summary Of Evidencementioning

confidence: 99%

See 1 more Smart Citation

2021 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Neonatal Life Support; Education, Implementation, and Teams; First Aid Task Forces; and the COVID-19 Working Group

Wyckoff¹,

Singletary²,

Soar³

et al. 2022

Circulation

View full text Add to dashboard Cite

show abstract

“…162 In addition, a recent study identified that low-risk patients had normal vital signs and pulse oximetry at the time of arrival to the ED. 163 Despite the common belief that young age is protective, a meta-analysis found that young age did not correlate with better outcome. 161 The strongest predictor of poor outcome (death or survival with moderate or severe neurologic sequelae) appears to be increased submersion duration of 6 minutes or longer, with a low likelihood of good outcome after submersion greater than 10 minutes.…”

Section: Outcome Predictorsmentioning

confidence: 99%

Prevention of Drowning

et al. 2021

View full text Add to dashboard Cite

show abstract

“… 2 Pulse oximetry is recommended as part of the decision algorithm for discharging patients recovering from drowning. 3 Existing literature addressing pulse oximetry in drowned patients is sparse.…”

Section: Introductionmentioning

confidence: 99%

Feasibility of pulse oximetry after water immersion

et al. 2021

View full text Add to dashboard Cite

Objective This study aimed to determine if pulse oximetry could reliably be used after immersion in water, and if so, which of the finger, earlobe or nose most reliably produced a functional waveform. Method Pulse oximetry data was recorded from the ear, nose and finger before and after 30 min of immersion in water. The primary outcome was the ability to measure pulse oximetry at any of the sites. Results A total of 119 participants were enrolled (with a median age of 16 years, 55% male). A useful pulse oximetry waveform was obtained after immersion from at least one of the measurement sites in 118 (99.2%) participants. Waveforms were usable after immersion in 96% of participants at the nostril, compared to 92% at the finger, and 41% at the ear lobe. The likelihood of success at the ear was significantly lower than either the finger or the nose (41% vs 92% and 96% respectively, p < 0.0001 for both comparisons). The finger and nostril were similar. Oxygen saturations were not significantly different after immersion at the nostril (100% vs 100%, p = 0.537) and finger (100% vs 100%, p = 0.032) sites but were different at the ear (100% vs 96%, p < 0.0001). Conclusion This study demonstrates that pulse oximetry is feasible and reliable in a large cohort of participants who have been immersed in water for 30 min. The results support the nostril as the most reliable location. Only pulse oximeters registered for clinical use should be employed for patient care.

show abstract

Predictors of safe discharge for pediatric drowning patients in the emergency department

Cited by 19 publications

References 11 publications

Prevention of Drowning

Feasibility of pulse oximetry after water immersion

Contact Info

Product

Resources

About