Pattern of presenting complaints recorded as near-drowning events in emergency departments

A national surveillance study from Pakistan

Siran He, Jeffrey C. Lunnen, Nukhba Zia, Uzma Rahim Khan, Khusro Shamim, Adnan A. Hyder

Research output: Contribution to journalArticle

Abstract

Background: Drowning is a heavy burden on the health systems of many countries, including Pakistan. To date, no effective large-scale surveillance has been in place to estimate rates of drowning and near-drowning in Pakistan. The Pakistan National Emergency Department Surveillance (Pak-NEDS) study aimed to fill this gap. Methods: Patients who presented with a complaint of "near-drowning" were analyzed to explore patterns of true near-drowning (unintentional) and intentional injuries that led to the "near-drowning" complaint. Bivariate analysis was done to establish patterns among patients treated in emergency departments, including socio-demographic information, injury-related information, accompanying injuries, and emergency department resource utilization. Results: A total of 133 patients (0.2% of all injury patients) with "near-drowning" as presenting complaints were recorded by the Pak-NEDS system. True near-drowning (50.0%) and intentional injuries that led to "near-drowning" complaints (50.0%) differed in nature of injuries. The highest proportion of true near-drowning incidents occurred among patients aged between 25-44 years (47.5%), and among males (77.5%). True near-drowning patients usually had other accompanying complaints, such as lower limb injury (40.0%). Very few patients were transported by ambulance (5.0%), and triage was done for 15% of patients. Eleven (27.5%) true near-drowning patients received cardiopulmonary resuscitation. Conclusion: There was major under-reporting of drowning and near-drowning cases in the surveillance study. The etiology of near-drowning cases should be further studied. Patients who experienced non-fatal drownings were more commonly sent for medical care due to other accompanying conditions, rather than near-drowning event itself. There is also need for recognizing true near-drowning incidents. The results of this study provide information on data source selection, site location, emergency care standardization, and multi-sector collaboration for future drowning prevention studies.

Original languageEnglish (US)
Article numberS4
JournalBMC Emergency Medicine
Volume15
Issue number2
DOIs
StatePublished - Dec 11 2015

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Near Drowning
Pakistan
Hospital Emergency Service
Wounds and Injuries
Ambulances
Triage
Information Storage and Retrieval
Cardiopulmonary Resuscitation
Emergency Medical Services

Keywords

  • Drowning
  • Emergency care management
  • Near-drowning
  • Pakistan

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Pattern of presenting complaints recorded as near-drowning events in emergency departments : A national surveillance study from Pakistan. / He, Siran; Lunnen, Jeffrey C.; Zia, Nukhba; Khan, Uzma Rahim; Shamim, Khusro; Hyder, Adnan A.

In: BMC Emergency Medicine, Vol. 15, No. 2, S4, 11.12.2015.

Research output: Contribution to journalArticle

He, Siran ; Lunnen, Jeffrey C. ; Zia, Nukhba ; Khan, Uzma Rahim ; Shamim, Khusro ; Hyder, Adnan A. / Pattern of presenting complaints recorded as near-drowning events in emergency departments : A national surveillance study from Pakistan. In: BMC Emergency Medicine. 2015 ; Vol. 15, No. 2.
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abstract = "Background: Drowning is a heavy burden on the health systems of many countries, including Pakistan. To date, no effective large-scale surveillance has been in place to estimate rates of drowning and near-drowning in Pakistan. The Pakistan National Emergency Department Surveillance (Pak-NEDS) study aimed to fill this gap. Methods: Patients who presented with a complaint of {"}near-drowning{"} were analyzed to explore patterns of true near-drowning (unintentional) and intentional injuries that led to the {"}near-drowning{"} complaint. Bivariate analysis was done to establish patterns among patients treated in emergency departments, including socio-demographic information, injury-related information, accompanying injuries, and emergency department resource utilization. Results: A total of 133 patients (0.2{\%} of all injury patients) with {"}near-drowning{"} as presenting complaints were recorded by the Pak-NEDS system. True near-drowning (50.0{\%}) and intentional injuries that led to {"}near-drowning{"} complaints (50.0{\%}) differed in nature of injuries. The highest proportion of true near-drowning incidents occurred among patients aged between 25-44 years (47.5{\%}), and among males (77.5{\%}). True near-drowning patients usually had other accompanying complaints, such as lower limb injury (40.0{\%}). Very few patients were transported by ambulance (5.0{\%}), and triage was done for 15{\%} of patients. Eleven (27.5{\%}) true near-drowning patients received cardiopulmonary resuscitation. Conclusion: There was major under-reporting of drowning and near-drowning cases in the surveillance study. The etiology of near-drowning cases should be further studied. Patients who experienced non-fatal drownings were more commonly sent for medical care due to other accompanying conditions, rather than near-drowning event itself. There is also need for recognizing true near-drowning incidents. The results of this study provide information on data source selection, site location, emergency care standardization, and multi-sector collaboration for future drowning prevention studies.",
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AU - Shamim, Khusro

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N2 - Background: Drowning is a heavy burden on the health systems of many countries, including Pakistan. To date, no effective large-scale surveillance has been in place to estimate rates of drowning and near-drowning in Pakistan. The Pakistan National Emergency Department Surveillance (Pak-NEDS) study aimed to fill this gap. Methods: Patients who presented with a complaint of "near-drowning" were analyzed to explore patterns of true near-drowning (unintentional) and intentional injuries that led to the "near-drowning" complaint. Bivariate analysis was done to establish patterns among patients treated in emergency departments, including socio-demographic information, injury-related information, accompanying injuries, and emergency department resource utilization. Results: A total of 133 patients (0.2% of all injury patients) with "near-drowning" as presenting complaints were recorded by the Pak-NEDS system. True near-drowning (50.0%) and intentional injuries that led to "near-drowning" complaints (50.0%) differed in nature of injuries. The highest proportion of true near-drowning incidents occurred among patients aged between 25-44 years (47.5%), and among males (77.5%). True near-drowning patients usually had other accompanying complaints, such as lower limb injury (40.0%). Very few patients were transported by ambulance (5.0%), and triage was done for 15% of patients. Eleven (27.5%) true near-drowning patients received cardiopulmonary resuscitation. Conclusion: There was major under-reporting of drowning and near-drowning cases in the surveillance study. The etiology of near-drowning cases should be further studied. Patients who experienced non-fatal drownings were more commonly sent for medical care due to other accompanying conditions, rather than near-drowning event itself. There is also need for recognizing true near-drowning incidents. The results of this study provide information on data source selection, site location, emergency care standardization, and multi-sector collaboration for future drowning prevention studies.

AB - Background: Drowning is a heavy burden on the health systems of many countries, including Pakistan. To date, no effective large-scale surveillance has been in place to estimate rates of drowning and near-drowning in Pakistan. The Pakistan National Emergency Department Surveillance (Pak-NEDS) study aimed to fill this gap. Methods: Patients who presented with a complaint of "near-drowning" were analyzed to explore patterns of true near-drowning (unintentional) and intentional injuries that led to the "near-drowning" complaint. Bivariate analysis was done to establish patterns among patients treated in emergency departments, including socio-demographic information, injury-related information, accompanying injuries, and emergency department resource utilization. Results: A total of 133 patients (0.2% of all injury patients) with "near-drowning" as presenting complaints were recorded by the Pak-NEDS system. True near-drowning (50.0%) and intentional injuries that led to "near-drowning" complaints (50.0%) differed in nature of injuries. The highest proportion of true near-drowning incidents occurred among patients aged between 25-44 years (47.5%), and among males (77.5%). True near-drowning patients usually had other accompanying complaints, such as lower limb injury (40.0%). Very few patients were transported by ambulance (5.0%), and triage was done for 15% of patients. Eleven (27.5%) true near-drowning patients received cardiopulmonary resuscitation. Conclusion: There was major under-reporting of drowning and near-drowning cases in the surveillance study. The etiology of near-drowning cases should be further studied. Patients who experienced non-fatal drownings were more commonly sent for medical care due to other accompanying conditions, rather than near-drowning event itself. There is also need for recognizing true near-drowning incidents. The results of this study provide information on data source selection, site location, emergency care standardization, and multi-sector collaboration for future drowning prevention studies.

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KW - Emergency care management

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KW - Pakistan

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