Retrospective evaluation of patients admitted to the emergency department due to drowning

Abstract

Introduction: Drowning is a preventable process that can result in respiratory failure and death, and often occurs accidentally. In this study, it was aimed to evaluate the demographic characteristics and clinical course of the patients admitted to our emergency department in a district neighbouring a lake due to drowning. Methods: Demographic characteristics, time of presentation, swimming ability, accident mechanism, predisposing factors, Glasgow coma scores (GCS), treatment, discharge, hospitalisation decisions, and mortality status of all patients admitted to our emergency department between January 2018 and January 2023 were recorded retrospectively from patient files and the digital automation system. Results: Twenty (66.7%) patients were male and 10 (33.3%) were female; the patients wereaged between 6 months and 59 years, with a mean age of 14.06 years. An analysis of the site of incident revealed that 26 cases (86.6%) drowned in the lake and 4 cases (13.3%) drowned in a water canal. When we analysed the predisposing factors, it was found that one of the cases drowned after an accidental fall while walking on the rocks and one of the cases drowned after having chest pain and syncope. Among the cases with a GCS of 3, 1 of them died in the intensive care unit after 12 hours, 3 of them recovered with tracheostomy sequelae, and the remaining 14 cases died in the emergency department. Mortality was not observed in any of the 12 cases with a GCS of 14 or above. Fourteen cases died in the emergency department, 11 were referred to the intensive care unit, and 5 cases were discharged after emergency department follow-up. When we classified the patients according to Szpilman's clinical classification system, 8 cases were classified as Grade1, 4 cases as Grade 2, 16 cases as Grade 5, and 2 cases as Grade 6. Conclusion: Raising awareness of families with children and increasing the necessary safety measures in water canals in summer months and in lakes is believed to reduce drowning-induced mortality. In addition to preventing drowning cases, providing the public with first aid training for drowning and healthcare professionals with appropriate assessment, intervention, and treatment algorithms may further reduce mortality.