1207 Drowning in Children: The Rotterdam Experience

Abstract

Background and aims: To assess the incidence and outcome of drowning in children.Methods: A retrospective, medical chart review study. All children admitted to the Erasmus MCSophia Children's Hospital because of drowning between January 2005 and December 2009, were included.Results: The study population consisted of 37 children (73% boys, mean age 4 years). 46% was not Dutch Caucasian. Most drowning events (62%) occurred in natural water. In 76% inadequate supervision by adults was the cause of drowning (children without swimming skills). In 5% the cause was non-unintentional, whereas 19% with swimming skills drowned due to an accident. In most cases the submersion time was unknown. At the scene 11 of the 37 children (30%) had no cardiac arrest (survivors n=11), whereas 26 (70%) had cardiac arrest due to hypoxia. Eleven of these 26 children had return of spontaneous circulation (ROSC) after Basis Life Support (BLS) (survivors n=11), whereas 15 required cardiopulmonary resuscitation (CPR). Of these 15 children, 8 had no ROSC and died at the emergency room. Seven children had ROSC after CPR and were admitted to the PICU: non-survivors n=3 (withdrawing treatment due to unfavourable neurological outcome or brain death) and survivors n=4.Conclusion: In most cases the cause of drowning was inadequate supervision in children without swimming skills. The overall survival was 70%. Children requiring CPR are likely to die in the emergency room or PICU (73%). Prevention including swimming programs should consider differences in age and ethnicity.