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Journal of the Korean Society of Traumatology 2003;16(2):107-114.
Prognostic Factors Related to Submerged Patients Treated at an Emergency Medical Center near a Beach
Yong Taeg Jeong, M.D., Se Hyun Oh, M.D., and Boo Soo Lee, M.D.
Department of Emergency Medicine, Gangnung Asan Hospital, College of Medicine, Ulsan University
바닷가에 인접한 응급센터에 내원한 익수환자의 예후인자
정용택·오세현·이부수
울산대학교 의과대학 강릉아산병원 응급의학과
Abstract
Background: Drowning is the fourth most common cause of accidental deaths in Korea. The number of drownings in Korea has decreased, but the number of victims visiting our hospital has increased. If a prognosis is to be given and a poor outcome prevented, it is necessary to know the prognostic factors related to the submerged patients. Methods: The medical records of 126 submerged patients who visited our emergency department between January 1997 and December 2002 were reviewed retrospectively. These patients’ final outcomes were categorized into two groups: good (no neurological impairment) and poor (vegetative or dead). Demographic, clinical, laboratory, and treatment variables were compared between the two groups. The patients were classified in six subgroups using the following clinical parameters in the emergency department: presence of breathing, arterial pulse, pulmonary auscultation, and arterial blood pressure. Results: Among the 126 patients, 101 cases had a good outcome and 25 cases had poor outcome. There was a statistically significant difference between the two groups in respiratory rate, pH, PaCO2, bicarbonate, oxygenation index, serum glucose, and sodium (p<0.05). The six subgroups based on 4 clinical parameters showed significant differences in poor outcome rate. Among the 41 patients who were in cardiopulmonary arrest at scene, 30 patients were given prehospital CPR, and 16 given of them showed a good outcome. The remaining patients, 11 cases who were not given prehospital CPR had a poor outcome. Conclusion: Our results showed that immediate resuscitation prior to arrival at the emergency department was associated with a better clinical outcome in submerged patients. For the purpose of immediate and appropriate prehospital CPR, CPR education for paramedics, lifeguards, and the general populations is needed. To clarify the prehospital prognostic factors and to improve the prognosis for submersion victims, a systematized protocol should be developed which can assess and feed-back actions of prehospital persons.
Key Words: Submersion; Prehospital CPR; Prognostic factors


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