Triage of Near-Drowning Victims

TitleTriage of Near-Drowning Victims
Publication TypeConference Paper
Year of Publication1997
AuthorsDr Szpilman, MD, D
Conference NameInternational Medical-Rescue Conference
Date Published09/1997
PublisherInternational Life Saving Federation
Conference LocationSan Diego, California, USA
Call Number29
Other Numbers253
Abstract

To establish an updated classification for near-drowning and drowning(ND/D) according to severity and based on mortality rate of subgroups, we reviewed 41,279 cases of predominantly sea water rescues from the coastal area of Rio de Janeiro City, Brazil, from 1972 to 1991. Of this total, 2,304 cases (5.5%) were referred to the NearDrowning Recuperation Center. At the accident site the following clinical parameters were recorded: presence of breathing, arterial pulse, pulmonary auscultation, and arterial blood pressure. From 2,304 cases in the data base, 1,831 cases presented all clinical parameters recorded and were selected for classification in 6 subgroups:

  • 1,189(65%) presented normal pulmonary auscultation with coughing and were classified as Grade 1 (mortality = 0%);
  • 338(18.4%) presented abnormal pulmonary auscultation with rates in some pulmonary fields and were classified as Grade 2 (mortality = 0.6%);
  • 58(3.2%) presented pulmonary auscultation of acute pulmonary edema without arterial hypotension, and were classified as Grade 3 (mortality = 5.2%);
  • 36(2%) presented pulmonary auscultation of acute pulmonary edema with arterial hypotension and were classified as Grade 4 (mortality = 19.4%);
  • 25(1.4%) presented Isolated respiratory arrest and were classified as Grade 5 (mortality = 44%);
  • and 185(10%) presented Cardiopulmonary Arrest(CPA) and were classified as Grade 6 (mortality = 93%)(P<0.000001).