Swimming Pool Accidents Research Articles

Drowning Accidents in a Spanish Pediatric Intensive Care Unit: An Observational Study for 29 Years.

Drowning is one of the most frequent accidents in children. We aimed to describe demographic and epidemiological characteristics of drowned children who required admission to a pediatric intensive care unit (PICU) to identify risk factors to guide possible preventive measures to avoid severe drowning. We conducted an observational study for 29 years (retrospective between 1991 and 2004; prospective between 2005 and 2019) that included all children (0-15 years old) requiring PICU admission after drowning. Data regarding patient characteristics, accident circumstances, and neurological outcomes at PICU discharge were analyzed. A total of 160 patients were included, with no significant decrease over the study period. There was a predominance of males (75%), young age (60%; 1-5 years), summer months (91.1%; May-September), tourists (14.12 [95% confidence interval, 9.2-21.7] times higher risk of drowning than residents), swimming pool accidents (88.8%), and inadequate supervision (77.9%). The mortality was 18.7%, and 7.5% of admitted children had severe neurological sequelae. The initial resuscitation maneuvers by accident witnesses were incorrect in nearly half of the patients in whom these could be analyzed. Emphasis should be placed on implementing preventive measures, focused on the described risk groups, and insisting on adequate supervision, swimming training programs, and training of the general population in safe rescue and cardiopulmonary resuscitation.

Fungal septic arthritis in an immunocompetent girl

Results A 14-year-old girl was referred with pain and swelling in her right knee. This was first noticed 3 months earlier after she banged the knee while swimming. There was no involvement of other joints or systemic symptoms. There was no history of significant illness in the past. Examination confirmed active arthritis of the right knee. Other joints were normal with no systemic signs. With a provisional diagnosis of oligoarticular Juvenile Idiopathic Arthritis, her right knee was injected with Triamcinolone hexactonide. The knee did not respond to the steroid injection and she had significant bruising around the injection site. She underwent further blood tests including tests for Lyme disease and Tuberculosis which were negative, after which her right knee was injected again with steroid after aspirating synovial fluid. The MRI scan confirmed knee effusion with some erosive areas. The synovial aspirate was negative for tuberculosis but grew a fungus of doubtful significance on prolonged culture, later identified as Phaeoacremonium spp. It was revealed that during horse riding while on holiday in Dominican Republic a year earlier, she had scraped her right knee against a tree sustaining an abrasion, but there was no swelling of the knee till the swimming pool accident. The arthritis progressively got worse along with systemic symptoms like high temperature. Her CRP was 39mg/L and ESR 48mm/hr. Her joint was aspirated again, which drained pus. She underwent arthroscopic lavage and debridement. The lateral tibial and femoral condyles were autodigested and she underwent partial synovectomy. She was commenced on intravenous antibiotics with Voriconazole because of the growth of the fungus in April. The aspirates grew Phaeoacremonium again and the bacterial cultures were negative confirming the diagnosis of fungal septic arthritis. She was tested extensively for immunodeficiencies, the results of which were normal. She was continued on systemic antifungal treatment for over one year and the knee improved steadily.

Swimming pool, respiratory health, and childhood asthma: Should we change our beliefs?

Swimming is often recommended as a sport because of its several benefits to health. It is also recommended in asthmatic children as a sport with a lower potential for prompting exercise-induced asthma. However, there is growing interest in the potentially harmful effects of repeated respiratory tract exposure to chlorinated products and the problem of possible swimming-related health hazards is gaining importance at international level. It is already known that acute exposure to chlorine gas as in swimming pool accidents causes lung damage and also that elite swimmers may have increased airway inflammation and bronchial hyperreactivity, probably as a result of repeated exposure to chlorine derivatives. Recently some studies have been conducted to investigate whether repeated exposure to chlorine by-products in recreational swimmers might also lead to lung damage. In addition, some studies have been lately published on the even more debated issue of the possible harmful effects of baby swimming on respiratory health. This article reviews and discusses data from the literature on the effects of chlorine derivatives in different categories of people routinely attending swimming pools. The need for longitudinal studies is emphasized to definitely clarify any role of chlorinated swimming pool attendance in the development of asthma in recreational swimmers.

Acute Respiratory Distress Syndrome From Chlorine Inhalation During a Swimming Pool Accident: A Case Report and Review of the Literature

Chlorine inhalation can result in significant morbidity and mortality. The most common clinical ramification is mucosal irritation. Rarely, depending upon the degree of exposure, patients can develop acute respiratory distress syndrome. Management is usually supportive with an unproven role for inhaled or systemic corticosteroids. A case of a young woman who developed respiratory failure secondary to acute respiratory distress syndrome from accidental exposure to chlorine fumes at a community swimming pool is described. The patient suffered a prolonged hospitalization with the need for mechanical ventilation. Despite limited data to support the decision, the patient was started on treatment with corticosteroids. She recovered completely from her illness and was discharged home without supplemental oxygen. A concise discussion of chlorine inhalation injury and a literature review on the utility of inhaled and/or systemic corticosteroids for this clinical entity is presented.

“She offered herself up”: The Victim Soul and Victim Spirituality in Catholicism

A teenage Catholic girl lies immobilized in her bed in Worcester, Massachusetts, her dark hair gathered in pink satin ribbons, her lacy nightgown spread neatly around her. The pleasing effect of a damsel in a pre-Raphaelite painting is broken by the sight of a tracheotomy tube in her neck attached to a ventilator, and a feeding tube in her stomach. For the last six years the American media has provided glimpses into the curious vegetative existence of Audrey Santo (1984–), who has lain in a coma-like state since a swimming pool accident at the age of three. Despite the girl's lack of consciousness and brain function, she has been credited as the conduit for extraordinary events in her home which have included bleeding hosts, stigmata, weeping statues, exuding walls, and physical healings. Audrey's popularity is largely a media creation, stemming from a 1996 televised documentary film about her on EWTN, a Christian broadcasting network in Alabama, which spawned a deluge of requests to the Santo family from people wanting to make a pilgrimage to see their daughter.

Short term respiratory effects of acute exposure to chlorine due to a swimming pool accident

OBJECTIVEAcute exposure to chlorine causes lung damage, and recovery may proceed slowly for several weeks. The short term respiratory effects of acute chlorine inhalation during a swimming pool accident were...

The epidemiology of swimming pool injuries in The Netherlands

Objective: To study the frequency and distribution of swimming pool injuries in The Netherlands. Data and methods: We used data of the Dutch Injury Surveillance System, which collects national data on patients treated in a hospital emergency department anywhere in The Netherlands. This system is based on a sample of 16 hospitals, which is representative for the whole country. With the help of pooled data for the years 1995 and 1996, we estimated the annual frequency of swimming pool injuries treated in a hospital emergency department. We made a comparison with the epidemiology of sports injuries with respect to the observed distribution by age, gender, type of injury and injury severity. Results: The average annual number of people seeking treatment at an emergency department after a swimming pool accident is small compared with the average annual number of sports injuries. Almost half of the swimming pool injuries (45%) concern 5–14 year-old children, a much higher proportion than found in sports injuries (27%). In addition, the relative importance of head injuries is considerably higher in swimming pool injuries (35%) than in sports injuries (12%). Swimming pool injuries and sports injuries have equal proportions of patients who are subsequently admitted to hospital (3%). Conclusion: The epidemiology of swimming pool injuries is characterized by a high proportion of 5–14 year-old children and a high share of head injuries. Although the frequency of swimming pool injuries is low, preventive efforts should not be neglected.

Swimming pool immersion accidents: an analysis from the Brisbane Drowning Study

An analysis of a consecutive series of 66 swimming pool immersion accidents is presented; 74% of these occurred in in-ground swimming pools. The estimated accident rate per pool is fives...

Analysis of swimming pool accidents resulting in spinal cord injury.

This paper is a summary of a study of 72 cases of swimming-pool accidents resulting in serious injuries with the potential of permanent disability. Sixty-four of the 72 cases resulted in spinal cord injuries, 57 of which involved quadriplegic lesions. The authors observed that the majority of these injuries resulted from a lack of good judgement and common sense rather than from intoxication or pool structural deficiencies. Also of note was the lack of appropriate first-aid and extrication rendered, as well as the absence of uniform treatment and care received by the majority of the patients.

An analysis of the causes of freshwater immersion accidents involving children

An analysis is presented of the aetiological factors responsible for 111 consecutive childhood freshwater immersion accidents. The study comprises data from 56 survivors and 55 fatal cases in the Brisbane Drowning Study, being a total population five year analysis. A total of 16 separate aetiological factors have been identified. Quantitative scores for the relative importance of each of these have been calculated. Lack of parental supervision (78%), absent or inadequate safety barriers surrounding water hazards (63%) and an identifiable parental “vulnerable period” (44%) were the three most common factors. Most drowning accidents were due to multiple coincident causes; in only 16 cases (14%) could the accident be attributed to a single cause. Swimming pool accidents had a median of four separate but coincident causal factors compared with a median of two for those occurring in bathtubs, rivers and creeks. Causes have been classified according to three groups—environmental factors, parental factors, and factors relating to the child himself; quantitative scores for each of these causal groups, by immersion site, are presented. The significance of this work in the context of preventive strategems is discussed.

A Professional Challenge—Swimming Pool Safety

Close attention to detail by aquatic personnel could conceivably reduce the annual number of swimming pool accidents and fatalities by as much as 50 percent. Language: en

An investigation of socio-demographic factors surrounding childhood drowning accidents

An analysis of socio-demographic features surrounding childhood (0–15 yr) drowning and near-drowning accidents is recorded. The demographic profile of childhood fresh water immersions differs radically from that relating to adult drownings. Two distinct age groups of children can be identified at risk. Children of older parents, and children who are members of large families are particularly vulnerable to immersion accidents. Differences in social class (occupational status) are significant as predisposing influences, with a high concentration of swimming pool accidents in upper social class families; bath-tub accidents occur almost exclusively in lower social class homes. Children within single-parent families are not particularly at risk. Evidence is presented which indicates that socio-demographic patterns differ significantly between fatal and non-fatal cases. A significant birth order effect in child trauma is presented for the first time. Birth rank and immigrant status effects have been observed in the survivor group only. The relevance and implications of these findings for the planning of public health preventative strategies are discussed.

SWIMMING POOL IMMERSION ACCIDENTS AN ANALYSIS FROM THE BRISBANE DROWNING STUDY

An analysis of a consecutive series of 66 swimming pool immersion accidents is presented; 74% of these occurred in in-ground swimming pools. The estimated accident rate per pool is five times greater for in-ground pools compared with above-ground pools, where pools are inadequately fenced. Backyard swimming pools account for 74% of pool acidents. Motel and caravan park pools account for 9% of childhood immersion accidents, but the survival rate (17%) is very low. Fifty per cent of pool accidents occur in the family's own backyard pool, and 13.6% in a neighbour's pool; in the latter the survival rate is still low at only 33%. In only one of the 66 cases was there an adequate safety fence; in 76% of cases there was no fence or barrier whatsoever. Tables of swimming pool accidents by age, season, site and outcome are presented.

DROWNING AND NEAR‐DROWNING IN THE AUSTRALIAN CAPITAL TERRITORY A FIVE‐YEAR TOTAL POPULATION STUDY OF IMMERSION ACCIDENTS

A total population study of all serious immersion accidents is reported from the Australian Capital Territory. The annual immersion accident rate of 4-69 per 100,000 of the population at risk is low, and the fresh water fatality rate of 2-58 per 100,000 is very low. The annual fatality rate for childhood swimming pool accidents is 0-34 per 100,000 children (that is, under 16 years of age) at risk. Serious immersion accidents are not increasing in frequency, in striking contrast to the epidemic trends seen from other centres. Factors which might explain this are discussed.

Delayed replantation of avulsed teeth

Avulsion of both central incisors occurred in a 14-year-old boy who was involved in a swimming pool accident. The teeth were found at the bottom of the swimming pool 18 hours later; they were treated endodontically and replanted. Follow-up examinations during an 11-year period showed progressive root resorption; the teeth are clinically normal. Avulsion of both central incisors occurred in a 14-year-old boy who was involved in a swimming pool accident. The teeth were found at the bottom of the swimming pool 18 hours later; they were treated endodontically and replanted. Follow-up examinations during an 11-year period showed progressive root resorption; the teeth are clinically normal.