Predicting Discharge in Uncomplicated Near-Drowning

Am J Emerg Med. 2000 Jan;18(1):9-11. doi: 10.1016/s0735-6757(00)90039-1.

Abstract

To determine if routine, noninvasive parameters could be measured which predict early (4-6 hour) discharge from the emergency department (ED) in mildly symptomatic and asymptomatic victims of childhood near-drowning, a retrospective cohort study was undertaken. Patients with fresh water near-drowning were studied over a 3-year period who presented with Glascow Come Scale (GCS) > or =13 and required no advanced life support prior to or < or =4 hours after ED presentation. Three groups of patients were found: 39 patients (81%) had normal pulmonary examination (PEx) and normal room air oxygen saturation (RASaO2) by 4 to 6 hours and did not deteriorate during the hospital admission (<24 hours); 5 patients (10%) had normal PEx by 4 to 6 hours and RASaO2 by 8 to 12 hours and did not deteriorate during hospitalization (<24 hours). Four patients (8%) were hospitalized for more than 24 hours. No patient with normal RASaO2 at 6 hours deteriorated while in the hospital (CI 92.3-100%). Children who present to the ED with GCS > or =13 and have normal PEx/respiratory effort and RA-SaO2 more than 95% at 4 to 6 hours after ED presentation can be safely discharged home.

MeSH terms

  • Adolescent
  • Blood Gas Analysis
  • Child
  • Child, Preschool
  • Emergency Treatment / methods*
  • Female
  • Glasgow Coma Scale
  • Heart Rate
  • Humans
  • Infant
  • Male
  • Near Drowning / blood
  • Near Drowning / complications
  • Near Drowning / diagnosis*
  • Near Drowning / physiopathology
  • Oxygen / blood
  • Patient Discharge / statistics & numerical data*
  • Predictive Value of Tests
  • Reproducibility of Results
  • Respiratory Mechanics
  • Retrospective Studies
  • Time Factors

Substances

  • Oxygen