Submersion injuries in the paediatric population in Barbados (1990-1996) - Poster abstract

OBJECTIVE: Drowning is the second leading cause of accidental death in the U.S.A., with near drowning accounting for a significant proportion of morbidity. In Barbados, there has been an increase in incidence of near drowning. The objective of this study was to document data for the Barbadian population. METHODS: The records of patients age 0-16 years who were admitted to the Queen Elizabeth Hospital during the period 1990-1996 were reviewed. Information on cases of drowning for the same period and age groups was obtained from the Coroner's Office. RESULTS: During the 7-year period of study, there was 27 near drowning and 19 drownings. The peak ages in both series were 11-16 years (adolescents). The male to female ratio was 3:1. For the near drownings 87 percent occurred in salt water. CONCLUSIONS: The peak incidence occurred during the summer months, June-Sept. However, no correlation between sea currents and tides could be made within the scope of this study. There was no documented evidence of any neurological deficit in the 24 cases of near drowning that were examined.(AU)

A review of 98 cases of near-drowning at the Queen Elizabeth Hospital, Barbados - abstract

Following an apparent recent increase in admissions for near-drowning a ten-year review has been carried out. Of 104 cases since January, 1970 records of 98 were traced and analyzed. The incident occurred in sea-water in 86 cases and in freshwater in 11 (one was unspecified). The male/female ratio was 3.45:1. Ages ranged from two to 69, 68 percent were adults (18 years and over). Of the adults 39 (60 percent were visitors and 28 (40 percent) residents. 45 percent of adult cases occurred in the months January - March, the peak tourist season. Five residents (18 percent) of adults were documented as taking alcohol prior to the incident compared with 13 of the visitors (33 percent). Many histories were inadequate. Other at-risk groups identified included epileptics and unsupervised children. Cases were grouped according to severity (after A.D. Simcock, Practitioner, 1979, 222, p. 527). There were 22 cases in group I (no evidence of aspiration), 67 in group II (pulmonary oedema but assisted ventilation not requird), 7 in group III (assisted ventilation required and two in group IV (CPR required). Two deaths occurred in group III and two in group IV. There were 111 deaths from drowning in the same period. There is an obvious need for a more rational approach to treatment of near-drowning, which may include oxygen, assisted ventilation, sodium bicarbonate, plasma and steroids. The need for assisted ventilation should be assessed promptly and repeatedly by physician and anaesthetist. There is urgent need to warn the public and particularly the tourists of the dangers of swimming after even modest alcohol intake (AU)