Combat-associated drowning

Patrick F. Allan, Raymond Fang, Kathleen D. Martin, Michael Glenn, Nicholas G. Conger

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The purpose of this article is to describe the clinical course and outcome of drowning cases related to current US military combat operations. Methods: This retrospective case series spans December 2002 to January 2009 of survivors transferred to an echelon IV military trauma center in Europe serving as the primary evacuation hub for ongoing combat operations. Patient demographics and the situational and clinical findings at the initial drowning scene were reviewed. A comprehensive analysis of care as each patient transitioned through the combat theater to the echelon IV trauma center in Europe was performed. Results: Overall, mortality was 37.5% mortality rate (3 of 8 patients). Advanced modes of respiratory support such as high-frequency ventilation, airway pressure release ventilation, and extracorporeal membrane oxygenation were required in a majority of the cohort (6 of 8 patients). Limited-duration vasopressor infusions (7 of 8 patients) were also required to ensure adequate end-organ perfusion. Glasgow Coma Scale (GCS) scores and the need for cardiopulmonary resuscitation (CPR) at the scene of injury were associated with eventual patient mortality (100% mortality for an initial GCS score of 3 and 75% mortality for on-scene CPR). Survivor long-term morbidity was often related to the sequelae of acute respiratory distress syndrome and hypoxic encephalopathy. Conclusions: Drowning associated with combat operations was associated with severe acute respiratory distress syndrome and cardiovascular shock. GCS score and the need for CPR at the scene of injury were associated with eventual mortality because of anoxic brain injury in all cases.

Original languageEnglish (US)
Pages (from-to)S179-S187
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume69
Issue numberSUPPL. 1
DOIs
StatePublished - Jul 1 2010
Externally publishedYes

Keywords

  • Acute respiratory distress syndrome
  • Drowning
  • Military medicine
  • Shock
  • War
  • Wounds and injuries

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

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