Prevention of Drowning

Denny, Sarah; Quan, Linda; Gilchrist, Julie; McCallin, Tracy; Shenoi, Rohit; Yusuf, Shabana; Weiss, Jeffrey A.; Hoffman, Benjamin

doi:10.1542/peds.2021-052227

Cited by 53 publications

(51 citation statements)

References 127 publications

(159 reference statements)

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“…Early and effective bystander CPR has been shown to improve outcomes in drowning victims. 8,14 In our study, more patients who received CPR from a professional died compared with those who received CPR from a nonprofessional (22% vs 8%). This likely speaks to the higher level of illness of those receiving professional CPR rather than to the quality of the CPR being performed.…”

Section: Discussionmentioning

confidence: 61%

Descriptive Epidemiology of Pediatric Drowning Patients Presenting to a Large Southern US Children’s Hospital

Webb¹,

Wheeler²,

Ricci³

et al. 2021

Southern Medical Journal

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Objectives: Drowning is the leading cause of death for children ages 1 to 4, and it is among the leading causes of death for children of all ages. National data show disparities in drowning risk for certain racial groups. This study aimed to describe characteristics of patients presenting after a drowning event to guide focused drowning prevention outreach efforts.Methods: This was a retrospective chart review study designed to analyze the epidemiologic and demographic characteristics of drowning-related injuries and deaths that presented to a large, urban, southern US pediatric hospital from 2016 to 2019. All patients aged 0 to 19 years were identified using International Classification of Diseases, Ninth Revision and Tenth Revision codes for drowning or submersion injuries.Results: One hundred sixty-two patients met the inclusion criteria for the study. Submersion injuries were most common in the 1-to 5-year-old age group. Fifty-eight percent of patients were male. The analysis of race showed that 65% of patients were White and 33% of patients were Black. Pools were the setting for 78% of drowning events. Fifty-four percent of patients received cardiopulmonary resuscitation. Sixty-four percent of patients required hospitalization after the injury.Conclusions: Characteristics of drowning victims may vary significantly from national data, depending on the area involved. This finding highlights the need for assessing local data to better inform local outreach. Further research is necessary to understand why such variance exists. Drowning prevention education, tailored toward pool safety and preschool-age children, should be a focus of injury prevention efforts.

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Section: Discussionmentioning

confidence: 61%

Descriptive Epidemiology of Pediatric Drowning Patients Presenting to a Large Southern US Children’s Hospital

Webb¹,

Wheeler²,

Ricci³

et al. 2021

Southern Medical Journal

View full text Add to dashboard Cite

show abstract

“…Given that drowning risk is ubiquitously present in home and recreational settings, the drowning-related question focused on caregivers' past exposure to cardiopulmonary resuscitation (CPR) training as early CPR has been associated with survival in drowning events. 13,14 Additional information was gathered regarding the participant's relationship to the patient, the number and ages of children younger than 18 years in the home, and zip code of residence. The participant's phone number was obtained at the end of the encounter for use in the follow-up survey.…”

Section: Methodsmentioning

confidence: 99%

Self-Reported Usage of Safety Equipment Provided Through a Community Partnership Approach to Injury Prevention in the Pediatric Emergency Department

et al. 2022

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Objectives: Previous studies have shown that educational programs in conjunction with provision of free or low-cost safety equipment increases the likelihood of parents changing behaviors at home. This project surveyed caregivers in the pediatric emergency department (ED) about safety behaviors before and after provision of education and safety equipment related to medication storage, firearm storage, and drowning. Methods:A convenience sample of families presenting to the ED for any complaint with a child of any age were approached for participation in this feasibility study. Exclusion criteria included patients presenting for a high acuity problem (Emergency Severity Index 1 or 2) and non-English-speaking caregivers. Enrollment, surveys, and educational intervention were performed by the graduate student investigator from the School of Public Health. Participants were surveyed regarding presence of firearms and medications within the home and their storage practices. Additional questions included relationship to the patient, number and age of children younger than 18 years in the home, and zip code of residence. Educational handouts were reviewed, and participants were provided with a medication lock box, trigger lock, toilet lock, and/or pool watcher tag as indicated by answers given to the survey questions. Process measures were collected for number of products given out, number of children potentially affected by the intervention, and time spent by the investigator. Follow-up calls assessed use of the products provided. Results:The student investigator spent a total of 180 hours and enrolled 357 caregivers accounting for 843 children. Fifty-seven percent of the participants answered the follow-up phone call. Only 9% initially reported that they stored medications in a locked or latched place. Medication lock boxes were given to 316 participants. On follow-up, 88% of those who received a lock box reported using it to store medications and 86% reported satisfaction with the lock box and how it worked. Of the 161 participants who admitted to gun ownership, 45% reported storing their guns locked and unloaded. Of those who reported unsafe manners of gun storage, 96% also reported unsafe manners of medication storage. Although only 161 participants endorsed gun ownership, 236 participants took a gun lock when offered. At follow-up, 66% of participants had used the gun lock and 67% of participants who took the gun lock reported satisfaction with the device. For water safety, 195 toilet latches and 275 drowning prevention lanyards were provided. On follow-up, 48% of those who had received a toilet latch were using it and 62% reported satisfaction with the device. Data were not collected on use of or satisfaction with the drowning prevention lanyards.

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“…They acknowledged the lack of specific evidence supporting the recommendation to stay in the parents' room until the first birthday, and that the first 6 mo were the most critical period where SIDS and sleep-related deaths were more likely to occur. 38,39 In deciding the timing of moving an infant to his or her own room, assessment should include the risk factors for SIDS and implications of room sharing on parental sleep and breastfeeding • A definitive age to stop swaddling has been deleted as infants vary in the age they begin to roll over 38,39 • The age for food choking risk has been increased from 3 y to 4 y in line with current recommendations 40 • Self-closing and self-latching pool enclosure gates further decrease the risk of drowning 41 • Once infants start walking, their risk of burns increases. A statement regarding hot liquids on countertops has been added because scalds were the most common mechanism of burn injuries presenting to the emergency department in Canada 42 • Wording has been broadened to include toxic substances in general.…”

Section: Main Messagementioning

confidence: 98%

“…31 Education and advice Injury prevention: The list of preventable injuries in Resources 1 has been placed in order from most to least prevalent cause of accidental death in young children. 32 Updates include the following advice: never leave a child unattended in a vehicle 33,34 ; replace any car seat involved in a collision 35 and any bicycle helmet if it has sustained an impact or is more than 5 years old 37 ; children and youth younger than 16 years of age should not operate an all-terrain vehicle or a snowmobile, including youth models 36 ; healthy infants should be positioned on their backs on a firm surface for every sleep; avoid use of alcohol or illicit or sedating drugs, as they are risk factors for sudden infant death syndrome; do not swaddle infants once they show signs of attempting to roll 38,39 ; do not introduce solid and sticky foods until 4 years of age because of choking risk (revised from 3 years of age) 40 ; pool fencing should include self-closing and self-latching gates 41 ; and be vigilant with hot liquids on countertops because of the risk of burns. 42 Behaviour and family issues: Revised items include validated poverty identification questions about food security, 43,44 and advice that both reading and singing should begin with young infants 45,46 ; screen time should be optimally managed by children, parents, and caregivers; and videocalling can improve communication with family and friends.…”

Section: General Principlesmentioning

confidence: 99%

2020 edition of the Rourke Baby Record

Rowan-Legg

Kwok

et al. 2021

Can Fam Physician

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Objective To update primary care providers practising well-child and well-baby clinical care on the evidence that contributed to the recommendations of the 2020 edition of the Rourke Baby Record (RBR).Quality of evidence Pediatric preventive care literature was searched from June 2016 to May 2019, primary research studies were reviewed and critically appraised using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology, and recommendations were updated where there was support from the literature.Main message Notable changes in the 2020 edition of the RBR include the recommendations to limit or avoid consumption of highly processed foods high in dietary sodium, to ensure safe sleep (healthy infants should sleep on their backs and on a firm surface for every sleep, and should sleep in a crib, cradle, or bassinette in the parents' room for the first 6 months of life), to not swaddle infants after they attempt to roll, to inquire about food insecurity, to encourage parents to read and sing to infants and children, to limit screen time for children younger than 2 years of age (although it is accepted for videocalling), to educate parents on risks and harms associated with e-cigarettes and cannabis, to avoid pesticide use, to wash all fruits and vegetables that cannot be peeled, to be aware of the new Canadian Caries Risk Assessment Tool, to note new red flags for cerebral palsy and neurodevelopmental problems, and to pay attention to updated high-risk groups for lead and anemia screening. ConclusionThe RBR endeavours to guide clinicians in providing evidenceinformed primary care to Canadian children. The revisions are rigorously considered and are based on appraisal of a growing, albeit still limited, evidence base for pediatric preventive care. This article is eligible for Mainpro+ certified Self-Learning credits. To earn credits, go to www.cfp.ca and click on the Mainpro+ link. This article has been peer reviewed.

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Prevention of Drowning

Cited by 53 publications

References 127 publications

Descriptive Epidemiology of Pediatric Drowning Patients Presenting to a Large Southern US Children’s Hospital

Descriptive Epidemiology of Pediatric Drowning Patients Presenting to a Large Southern US Children’s Hospital

Self-Reported Usage of Safety Equipment Provided Through a Community Partnership Approach to Injury Prevention in the Pediatric Emergency Department

2020 edition of the Rourke Baby Record

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