Prolong Submersion in the Swimming Pool without Neurological Outcome

Abstract

Abstract Drowning can be defined as a chain of events of respiratory disability due to submersion or immersion in liquid with sequelae such as irreversible brain damage, heart failure, and death. The main organ in a drowning subject is the brain, which has almost zero energy and oxygen stores and hence needs a continuous supply of blood to fulfill its need for oxygen and loss of laryngospasm. This leads to massive aspiration, lung atelectasis, and edema. This unique and miracle case was a child submerged in a swimming pool for a prolonged period without receiving CPR, traveling from the drowning place to the present hospital around 30 km. The patient came from a small village where there were no facilities of ambulance inbuilt basic facilities or advanced life support. He was on a mechanical ventilator in the pediatric intensive care unit in the present institute. He was unconscious on admission. Recovered from all complications and was discharged without any neurological abnormalities. A 13-year-old boy was admitted to the pediatric emergency department with a history of drowning in a swimming pool; he was a nonswimmer and went with his friends who were swimmers, where he accidentally fell into the water without notice from other friends. After not finding him around, his friends searched for him. They found him immersed in water at the bottom of the pool for about 10–15 min, not receiving cardiopulmonary resuscitation (CPR) as nobody was trained. The primary diagnosis was drowning without neurological complications. Therapeutic interventions included a mechanical ventilator, intravenous antibiotics, intravenous steroids, chest physiotherapy. On discharge patient had no neurological complication except limping of right foot. After 1 month of follow up, central nervous system examination was within the normal limits. No limping was seen. No neurological deficit was observed. Drowning is a common etiology of accidental mortality in the pediatric age group. Most victims not treated with CPR at the site develop permanent neurological deficits. Proper and effective management can improve many complications caused due to drowning. Guidelines should be strictly followed in private/public swimming pools to have all duties of lifeguards who are trained in CPR. Drowning patients should be managed in hospitals with well-equipped mechanical ventilators, including trained staff.